Real world data on dual BLyS/APRIL inhibition with telitacicept for lupus nephritis.

Background: This study aimed to evaluate the efficacy and safety of telitacicept for the treatment of lupus nephritis (LN) in real-world clinical practice.

Methods: Adult patients with lupus nephritis receiving additional telitacicept at 80/160 mg once per week were recruited, while patients receiving only standard therapy were included as the control group using a 1:1 propensity score matching approach. The primary outcomes were the proportions of patients achieving complete renal response (CRR) and primary efficacy renal response (PERR).

Results: Forty-four patients in both the control and telitacicept groups were enrolled, with median follow-up periods of 10.78 ± 3.37 and 10.5 ± 3.78 months, respectively. Compared to the control group, a significant improvement was observed in the proportion of patients achieving CRR (11.36% vs. 29.55%, P = 0.034) and PERR (45.45% vs. 68.18%, P = 0.031) in the telitacicept group at the last visit. Median proteinuria was reduced by 0.97 g/d (63.82%) from baseline in the telitacicept group, compared to a reduction of 0.31 g/d (25.31%) in the control group. Additionally, the telitacicept group showed notable treatment responses in the median SLEDAI score, PGA score, and glucocorticoid dose reduction. Subgroup analysis revealed that telitacicept exhibited a more prominent therapeutic effect in patients with type V LN and those with proteinuria exceeding 3 g/d. Telitacicept was well tolerated, and the incidence of adverse events was similar between the two groups.

Conclusions: Lupus nephritis patients receiving additional telitacicept treatment demonstrated better disease remission, particularly in those with type V LN and proteinuria ≥ 3 g/d, with a favorable safety profile in real-world clinical practice.