{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T17:04:05Z","timestamp":1793898245821,"version":"4.8.0"},"reference-count":32,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017577","name":"Basic Public Welfare Research Program of Zhejiang Province","doi-asserted-by":"publisher","award":["LQ22H050002"],"award-info":[{"award-number":["LQ22H050002"]}],"id":[{"id":"10.13039\/501100017577","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100738"],"award-info":[{"award-number":["82100738"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82100792"],"award-info":[{"award-number":["82100792"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013145","name":"Primary Research and Development Plan of Zhejiang Province","doi-asserted-by":"publisher","award":["2020C03034"],"award-info":[{"award-number":["2020C03034"]}],"id":[{"id":"10.13039\/501100013145","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2024,12,14]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Both belimumab and telitacicept are recognised blockers for B lymphocyte activation, both of which have been approved as add-on therapies for SLE in China. The aim of this study is to compare the efficacy of rituximab (RTX) followed by belimumab or telitacicept in a real-world cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 49 refractory lupus nephritis patients were enrolled from four independent centres, subsequently categorised into two treatment groups: belimumab group (n=35) and telitacicept group (n=14) based on their treatment following RTX. The outcomes of renal response rates were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this study cohort, 63.3% presented with anti-dsDNA antibody positivity and 79.6% exhibited hypocomplementemia, with a mean Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) Score of 13\u00b16, estimated glomerular filtration rate (eGFR) of 76.2 (30.2, 113.7) mL\/min and urinary protein creatinine ratio (uPCR) of 2.45 (0.77, 5.19) g\/g. There was no significant differences between groups. After a follow-up duration of 26\u00b112 months, renal objective remission rate was 80.0% (28 patients) in belimumab group and 85.7% (12 patients) in telitacicept group (difference, 5.7\u2009percentage points, 95% CI, \u221225.8 to 26.8, p=1.000). Renal complete response was 54.3% (19 patients) in belimumab group and 78.6% (11 patients) in telitacicept group (difference, 24.3\u2009percentage points, 95%\u2009CI, 9.7 to 47.8, p=0.194). The anti-dsDNA antibody, complement, eGFR, uPCR and SLEDAI-2K Score were improved in both groups with a significant reduction in prednisone dose. Major adverse effects included immunoglobulin deficiency, respiratory tract infection and urinary tract infection. No death occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The sequential treatment of belimumab or telitacicept following RTX may represent a promising therapeutic approach in the management of refractory lupus nephritis. Further investigation is necessary to establish optimal protocols and long-term benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2024-001296","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T21:00:24Z","timestamp":1736197224000},"page":"e001296","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Belimumab versus telitacicept in sequential treatment after rituximab for refractory lupus nephritis: a real-world multicentre study"],"prefix":"10.1136","volume":"12","author":[{"given":"Yiting","family":"Chen","sequence":"first","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Lei","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhang","family":"Xu","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Pan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiankun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Lishui Central Hospital, Lishui, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junni","family":"Wang","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingping","family":"Ren","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Lan","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Shi","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangliang","family":"Chen","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaomin","family":"Wang","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianghua","family":"Chen","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lie","family":"Jin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Lishui Central Hospital, Lishui, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5363-7556","authenticated-orcid":false,"given":"Fei","family":"Han","sequence":"additional","affiliation":[{"name":"Kidney Disease Center, The First Affiliated Hospital of Zhejiang 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The efficacy of rituximab plus belimumab or telitacicept in refractory lupus nephritis. 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