Table 1 Description of studies included in Literature Review
Author, Year | Type of Study | Subjects | Baseline Disease features | Baseline Nephritis | Previous Therapy | Treatment | Outcome | Results |
|---|---|---|---|---|---|---|---|---|
Staveri, 2016 [20] | Case series | 1 caucasian greek female 31 yrs. old | Seropositive Active lupus (constitutional, mucocutaneous, hematologic involvement, arthritis,) | No baseline kidney involvement | Oral CG, HCQ, MTX, RTX and AZA IV GC pulses | After 3 months of treatment with Belimumab, onset of Proteinuria 1600 mg/24 h. Diagnosis of LN WHO Class III. Treated with AZA 3 mk/Kg | ||
1 caucasian greek female 38 yrs. old | Seropositive Active lupus (fever, arthritis, pleuropericarditis, NPS involvement) | No baseline kidney involvement | Oral GCs and MTX CNS lupus: CYC e and RTX | After 3 months of treatment with Belimumab, active urinary sediment, proteinuria (6 g/24 h). Diagnosis of LN WHO Class V. Treated with MMF 2 g/day | ||||
Danve, 2016 [19] | Case Report | 1 caucasian female 38 yrs. old Pregnancy planning | Seropositive Active lupus and aPL syndrome (mucocutaneous lupus, angioedema, lupus nephritis, leukopenia, anti-phospholipid syndrome) | Active urinary sediment No biopsy proven | Before pregnancy: Oral GC, HCQ, AZA, RTX | Ongoing: HCQ Before Pregnancy: Belimumab + MMF for 6 months than Belimumab alone During pregnancy: Belimumab till the 32 week During breast-feading: Belimumab was resumed 2 weeks after delivery | Serum creatinine, UPC ratio | Clinical remission Before pregnancy, during and after pregnancy |
De Scheerder, 2016 [16] | Case Report | 1 African female 26 yrs. old | Chronic dacryoadenitis Seropositive Active lupus (mucocutaneous, NPS, ocular vasculitis) | LN Class V LN Class V Proteinuria 2.72 g/24 h SELENA-SLEDAI 24 | GCs, HCQ, MMF 3 g/day, After 2 months MMF was tapered to 1.5 g/day and tacrolimus was associated | Belimumab in combination with MMF 1.5 g/day, Tacrolimus, GCs and HCQ | SELENA-SLEDAI BILAG Proteinuria | Proteinuria was 1.93 g/24 h after 1 month, 0.19 g/24 h after 3 months and 0.07 g/24 h after 6 months |
Furer, 2016 [22] | Case series | 1 female 25 yrs. old | Seropositive Active SLE (mucocutaneous, hematologic involvement, arthritis) | No baseline LN | HCQ, AZA, MT | Belimumab monotherapy was added with a favourable clinical response. After 2 years, the treatment was discontinued (urticaria). Eight months after belimumab discontinuation severe flare with new-onset LN class IV | ||
Gonzalez-Echavarri, 2016 [17] | Case report | 1 female 25 yrs. old | Seropositive Longstanding Active SLE with class IV LN, arthritis, constitutional and vasculitic mucocutaneous involvement | LN Class IV | LN induction with CYC and maintenance with AZA. Several LN flares: different therapies, including 4 courses of RTX. After 1 year new renal flare unresponsive to GCs, IVIG, CYC | Belimumab + MMF 750 mg/day, Tacrolimus 7 mg/day, Prednisone 5 mg/day, HCQ | Proteinuria | Proteinuria started to decrease at month 2 with clinical remission at month 4 (0.1 g/24 h) |
Simonetta, 2016 [18] | Case report | 1 Bolivian female 23 yrs. old | Seropositive Active SLE (constitutional, mucocutaneous, serositic, hematologic involvement, arthritis, nephritis) | LN Class IV S(A) UCP ratio > 1.5 SELENA-SLEDAI> 20 | GCs, HCQ MMF 2.5 g/day Belimumab + MMF RTX 1 g × 2 | Second course of Belimumab after Rituximab | SELENA SLEDAI UPC ratio | SELENA-SLEDAI 0 Renal Response UPC ratio < 0.5 Remission of systemic manifestations |
Kraaij, 2014 [15] | Case series | 1 female 32 yrs. old | Seropositive Active SLE (constitutional, mucocutaneous involvement, nephritis) | LN Class IV | MMF, Eurolupus CYC and again MMF with no renal response. RTX followed by MMF with partial response | Belimumab monotherapy | SELENA SLEDAI Proteinuria | Proteinuria decreased to 0.9 g/24 h, SELENA-SLEDAI 6 |
1 male 42 yrs. old | Seropositive Active SLE (constitutional, mucocutaneous and NPS involvement, nephritis) | LN Class IV | LN induction with CYC and MMF, each followed by MMF, GC, HCQ maintenance. Renal flare treated with RTX followed by MMF with initial partial remission and relapse after MMF withdrawal | Belimumab monotherapy | SELENA SLEDAI Proteinuria | Proteinuria improved (1.5 g/24 h), SELENA-SLEDAI 4 | ||
Fliesser, 2013 [14] | Case Report | 1 female 19 yrs. old | Seropositive Active SLE (constitutional, serositic, mucocutaneous, haematologic involvement, nephritis) | LN Class III (A/C) | HCQ, MMF, GC with no renal response | Belimumab in combination with MMF (2 g/day tapered to 1 g/day), GCs and HCQ | Proteinuria | Progressive decline of proteinuria (409 mg/24 h after 2 weeks; 202 mg/24 h after 4 weeks; 1 year later 75 mg/d24h and sediment normalization |
Sjowall, 2014 [21] | Case report | 1 caucasian female 62 yrs. old | Seropositive Active Lupus and aPL syndrome (erosive arthritis, serositic involvement) History of cervical cancer in situ and ocular melanoma | No baseline kidney involvement | Oral GC, HCQ, AZA, MMF | Belimumab in combination with MMF 1 g/day. After 3 months: remission of constitutional and serositic involvement, beginning of steroid spare. After 10 months, recurrence of pleural effusion and onset of LN class III. Treated with CYC (EuroLupus). | ||