Telitacicept Improves Clinical Response but Increases Infection Risk in Active SLE: NEJM

The trial demonstrated that telitacicept’s mechanism—targeting both BAFF and APRIL pathways—effectively suppresses B-cell overactivation, a key driver of autoimmunity in SLE. Compared with placebo, participants receiving telitacicept showed more frequent achievement of composite clinical response endpoints, including SRI-4 and BICLA measures. Despite the therapeutic benefit, safety data revealed that reductions in immunoglobulin concentrations could predispose some patients to infections, primarily mild to moderate in severity. Injection-site reactions were also noted but were generally self-limiting. The overall risk-benefit profile favored telitacicept, particularly for patients with persistent disease activity despite conventional treatment.

In conclusion, the findings suggest that telitacicept offers a promising new approach for improving disease control in patients with active SLE, though its use requires vigilance for infection risk and immune suppression. By targeting key B-cell survival factors, telitacicept represents a significant advancement in biologic therapy for lupus. The authors emphasize the importance of individualized dosing, infection surveillance, and long-term follow-up to optimize outcomes. As further studies expand on durability and safety, telitacicept may play a pivotal role in modern lupus management.

Keywords: systemic lupus erythematosus, SLE, telitacicept, BAFF, APRIL, B-cell therapy, infection risk, immunoglobulin, New England Journal of Medicine, clinical trial