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| Efficacy of Rituximab Combined with Belimumab in the Treatment of Refractory Systemic Lupus Erythematosus Complicated with Thrombotic Microangiopathy |
| ZHANG Lijuan, HAN Lishuai |
| Department of Rheumatology and Immunology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan 450001 |
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Abstract 【Objective】 To investigate the efficacy of rituximab combined with belimumab in the treatment of refractory systemic lupus erythematosus (SLE) complicated with thrombotic microangiopathy (TMA). 【Methods】 A total of 80 patients with refractory SLE and TMA were randomly divided into the rituximab monotherapy group (the control group, 37 cases) and the rituximab combined with belimumab group (the combination group, 43 cases). Both groups received treatment for 12 weeks. The therapeutic efficacy, changes in SLE Disease Activity Index (SLEDAI), hematological parameters [white blood cell count (WBC), platelet count (PLT)], renal function indicators [serum creatinine (SCr), urinary red blood cells], immune function markers [complement components 3(C3) and complement components 4(C4)], inflammatory markers [erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP)], and adverse reactions were compared between the two groups before and after treatment. 【Results】 After treatment, the total effective rate in the combination group was 93.02%, significantly higher than 72.97% in the control group (P<0.05). Compared with baseline, both groups showed improvement in all clinical parameters after treatment (P<0.05), with the combination group showing more significant improvements in SLEDAI, WBC, PLT, albumin levels, C3, ESR, and hs-CRP compared with the control group (P<0.05). No significant differences were observed between the two groups in urinary protein, SCr, and urinary red blood cell counts (P>0.05). The incidence of adverse reactions did not differ significantly between groups (P>0.05). 【Conclusion】 Rituximab combined with belimumab in patients with refractory SLE complicated with TMA significantly improves clinical efficacy, hematological and renal function parameters, while maintaining good safety.
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Received: 10 April 2025
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