ArticleAmerican journal of translational research2025
Belimumab combined with mycophenolate mofetil for treating severe lupus nephritis: effects on renal recovery, immune regulation, and long-term prognosis.
Article in American journal of translational research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo assess the combined therapeutic effects of belimumab and mycophenolate mofetil (MMF) in severe lupus nephritis (LN), focusing on renal recovery, immune regulation, and long-term outcome.
methodsWe retrospectively analyzed data from 188 patients hospitalized between March 2019 and April 2022. Of these, 106 received belimumab (10 mg/kg) in addition to standard therapy, while 82 received standard care alone. Endpoints included renal function indices (proteinuria, serum creatinine, albumin), Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores, anti-dsDNA antibody titers, complement C3 and C4 levels, and inflammatory markers (hs-CRP, IL-6, TNF-α). Remission rates were calculated, and prognostic factors for end-stage renal disease (ESRD) and mortality were evaluated using Cox regression and competing risk analysis.
resultsThe combination therapy yielded a 94% remission rate, significantly higher than the 70% observed for controls (P<0.001). Complete remission was achieved in about 50% of treated patients, compared to 40% in the control group (P=0.025), with a notably lower non-responder rate. Belimumab-treated patients exhibited greater reductions in proteinuria, serum creatinine, SLEDAI score, erythrocyte sedimentation rate (ESR), and inflammatory cytokines, alongside increases in albumin and complement levels (all P<0.001). Baseline creatinine and albumin levels were consistent predictors of ESRD (P<0.001) and mortality (P=0.006) by multivariate and competing risk analyses.
conclusionIn severe LN, the combination of belimumab and MMF provided superior improvements in renal function, immune status, and long-term prognosis compared to standard therapy. Baseline renal biomarkers, particularly creatinine and albumin, may guide patient stratification and personalized treatment approaches.
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