Effect and safety profile of belimumab and tacrolimus combination therapy in thirty-three patients with systemic lupus erythematosus

Nakai, Takehiro; Fukui, Sho; Kidoguchi, Genki; Ikeda, Yukihiko; Kitada, Ayako; Nomura, Akihiro; Tamaki, Hiromichi; Kishimoto, Mitsumasa; Okada, Masato

doi:10.1007/s10067-022-06325-6

Cited by 5 publications

(4 citation statements)

References 45 publications

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“…Combination therapy can encompass multiple fields, including medicine, psychology, physical therapy, and occupational therapy. By integrating expertise and skills from different domains, combination therapy offers a more comprehensive understanding of the patient's problems and provides a more holistic treatment plan 44,45 . In this meta‐analysis, the impact of various antibiotic injection schemes on patients with severe infection was compared.…”

Section: Discussionmentioning

confidence: 99%

“…By integrating expertise and skills from different domains, combination therapy offers a more comprehensive understanding of the patient's problems and provides a more holistic treatment plan. 44 , 45 In this meta‐analysis, the impact of various antibiotic injection schemes on patients with severe infection was compared. By synthesizing the results from multiple independent studies, several important conclusions were drawn.…”

Section: Discussionmentioning

confidence: 99%

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The impact of different antibiotic injection regimens on patients with severe infections: A meta‐analysis

Li,

Mo,

Liang

et al. 2024

International Wound Journal

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Severe infection is a critical health threat to humans, and antibiotic treatment is one of the main therapeutic approaches. Nevertheless, the efficacy of various antibiotic injection regimens in severe infection patients remains uncertain. This study aimed to comprehensively evaluate the impact of various antibiotic injection strategies on patients with severe infection through a meta‐analysis. Relevant research literature was collected by searching databases such as PubMed, Embase, and Cochrane Library. The retrieved literature was screened according to inclusion and exclusion criteria. Relevant data, including study design, sample size, and antibiotic regimens, were extracted from the included studies. The Cochrane Collaboration's Risk of Bias tool was employed to assess the risk of bias in each study. Statistical analysis was performed based on the results of the included studies. A total of 15 articles were included, covering various types of severe infection patients, including pulmonary and abdominal infections. The analysis provided insights into mortality rates, treatment efficacy, adverse reactions (ARs), Acute Physiology and Chronic Health Evaluation (APACHE) scores, among other outcomes. The results indicated that combination therapy was superior to monotherapy in terms of mortality rate, treatment efficacy, and APACHE scores, while the incidence of ARs was lower in the monotherapy group compared to the combination therapy group (p < 0.05). Combination therapy showed better treatment efficacy compared to monotherapy, although it was associated with a higher incidence of ARs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of different antibiotic injection regimens on patients with severe infections: A meta‐analysis

Li,

Mo,

Liang

et al. 2024

International Wound Journal

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“…Consistent with the findings of previous studies, we verified the safety and efficacy of combined treatments of belimumab with MMF, rituximab, or Tac. [27][28][29][30][31] Although data on the long-term safety profile of these combination therapies remain scarce, the current study showed that no specific medication was related to decreased drug retention rate or increased infection rate; therefore, combination therapy with belimumab and a standard care agent is recommended in patients who need effective and sustained immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

Disease-modifying effect and long-term safety of belimumab in patients with systemic lupus erythematosus: A single-center retrospective study

Nakai,

Fukui,

Sawada

et al. 2023

Lupus

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Background Disease modification in systemic lupus erythematosus (SLE) is important for minimizing disease activity while limiting treatment-associated toxicities. Belimumab can be used as a remission-induction/maintenance systemic lupus erythematosus therapy; however, its disease-modifying effects are unclear. We aimed to determine these effects in patients with systemic lupus erythematosus. Methods This single-center retrospective cohort study included 92 patients with systemic lupus erythematosus treated with belimumab. We analyzed the changes in flare free rate/lupus low disease activity state (LLDAS) attainment rate/glucocorticoid dosage/Systemic Lupus International Collaborating Clinics and American College of Rheumatology damage index (SDI) score/drug retention rate after treatment initiation. Results Fifty-two weeks after initiating belimumab, the flare rate decreased from 82.6% to 14.1% ( p < .01). Until week 52 and 1000 days after initiating belimumab treatment, > 70% and ∼90% of the patients attained lupus low disease activity state, respectively. Belimumab treatment significantly reduced glucocorticoid demand (initiation day, 8.88 (6.00–15.00) mg/d; week 52, 5.00 (2.00–7.00) mg/d; final day of the study period, 3.00 (0.46–6.06) mg/d, initiation day vs. week 52: p < .01, initiation day vs. final day: p < .01); at the end of the study period, 68.5% of patients required ≤5 mg/d prednisolone, and 22.8% discontinued glucocorticoids. Most patients were SDI progression-free (week 52, ∼95%; day 1000, ∼90%), and belimumab showed a high drug retention rate (week 52, 90%; day 1000 > 80%). Conclusion Most patients experienced lupus low disease activity state, reduced flare rate and glucocorticoid demand, and a stable SDI trend after belimumab treatment initiation. Given its efficacy and retention rate, belimumab treatment may serve as a fundamental strategy in disease modification.

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“…Similarly, data from several studies have indicated the efficacy of multitarget immunosuppression (i.e., CNI with MMF) in refractory LN (157,158). Minimal data exist for the use of CNIs with belimumab: in a small, single-center, retrospective analysis of 33 patients with SLE (including 11 patients with renal flares) treated with a combination of belimumab and tacrolimus, a state of low disease activity of lupus was achieved in 64.0% of patients at 52 weeks after initiation compared with 9.1% at initiation; the combination did not appear to increase the risk of infectious complications (159) reduction in proteinuria and glucocorticoid dose after 8-14 months without evidence of toxicity or intolerable side effects (160). Although initial data is promising, further research on combination therapies with belimumab and voclosporin is needed to establish their role in treatment of refractory LN.…”

Section: Treatment Of Refractory Diseasementioning

confidence: 99%

Insights into future management of lupus nephritis

Askanase,

Dall’Era,

Almaani

2024

Front. Lupus

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Lupus nephritis (LN) is a common and serious manifestation of systemic lupus erythematosus and is a major cause of mortality and morbidity. The current standard-of-care treatment for LN include conventional immunosuppressive treatments such as mycophenolate mofetil, cyclophosphamide, or azathioprine, combined with glucocorticoids. However, this treatment approach has several unmet needs, such as achieving only modest remission rates, potential toxicities, and prolonged cumulative steroid exposure, resulting in suboptimal patient outcomes. The LN treatment landscape is evolving rapidly to meet these unmet needs, with belimumab and voclosporin being the first drugs approved specifically for treatment of LN in 2020 and 2021, respectively. Here, we review the likely roles in LN therapy for several targeted therapies, including select therapies under investigation, and interventions in early development such as therapies targeting B cells (obinutuzumab, atacicept, ianalumab, and CD19 chimeric antigen T-cell therapy), inflammatory cytokines (secukinumab and anifrolumab), and the immunoproteasome (zetomipzomib); we also review treatment strategies designed to minimize steroid exposure. Treatments in development have demonstrated encouraging short- and long-term efficacy and steroid-sparing potential, potentially paving the way for improved treatment regimens and patient outcomes in LN.

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Effect and safety profile of belimumab and tacrolimus combination therapy in thirty-three patients with systemic lupus erythematosus

Cited by 5 publications

References 45 publications

The impact of different antibiotic injection regimens on patients with severe infections: A meta‐analysis

The impact of different antibiotic injection regimens on patients with severe infections: A meta‐analysis

Disease-modifying effect and long-term safety of belimumab in patients with systemic lupus erythematosus: A single-center retrospective study

Insights into future management of lupus nephritis

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