Background:
Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by aberrant B cell activation and heightened autoantibody production. Targeting B cells constitutes a pivotal therapeutic strategy in managing SLE. Telitacicept, a novel biologic drug, specifically inhibits B lymphocyte stimulator (BLyS) and a proliferation-inducing ligand (APRIL), demonstrating promising efficacy in SLE treatment. Objectives:
This study aims to investigate the early impact of telitacicept in combination with standard treatments on B cell subsets in SLE patients within the first 6 months. Methods:
Twenty active SLE patients (SLEDAI-2K≥6) were enrolled, and B cell subset analyses were conducted at 0, 4, 12, and 24 weeks after initiating Telitacicept treatment. Flow cytometry was used to quantify B cell subset dynamics. The SLE Responder Index-4 (SRI-4) response rate at 6 months and changes in clinical and laboratory parameters were assessed. Results:
After 6 months of treatment, the SRI-4 response rate was remarkable at 95% (19/20). In comparison to the baseline, significant improvements were observed in SLEDAI-2K scores (12.00 ± 3.28 VS. 1.78 ± 2.29, p< 0.001), anti-dsDNA levels, and complement C3 and C4 levels (p<0.05). A notable decrease in 24-hour urine protein (p=0.004) was recorded. B cell subset analysis in 15 patients completing four follow-ups revealed a decrease in the proportions of total B cells (14.03%± 6.87% VS. 4.44%± 2.63%, p< 0.001), naive B cell(54.985± 17.96% VS. 25.78 %± 10.72, p< 0.001), and short-lived plasma cells(0.10% ± 0.11% VS. 0.04% ± 0.04%, p=0.027), along with an increase in transitional B cells (T1) (0.10% ± 0.22% VS. 0.74% ± 1.11%, p=0.046), switched memory B cells(12.09%±15.39% VS. 24.68%±10.57%, p=0.020), double-negative B cells(8.73%± 8.46% VS. 15.8%±9.26%, p=0.001), and Breg cells (10.56% ± 10.61% VS. 19.33%±10.03%, p=0.002). Conclusion:
The combination of Telitacicept with standard treatment led to significant improvements in disease activity, renal parameters, and B cell subset dynamics. These findings underscore the potential of Telitacicept in modulating the B cell landscape and achieving favorable treatment responses in active SLE patients. REFERENCES:
NIL. Acknowledgements:
Thanks to all the follow-up patients and the doctors involved in the follow-up. Disclosure of Interests:
None declared.