Telitacicept Matches Belimumab in Controlling Childhood Lupus, Study Finds
China: A prospective multicentre cohort study from China suggests that telitacicept, when used alongside standard of care (SoC), offers meaningful clinical benefits for children and adolescents with systemic lupus erythematosus (cSLE), with outcomes comparable to those achieved with belimumab.
The findings were published in Arthritis & Rheumatology by Chong Luo from the Department of Rheumatology and Immunology, Children’s Hospital of Chongqing Medical University, and colleagues.
Childhood-onset SLE is often more aggressive than adult disease, frequently requiring prolonged corticosteroid use that can adversely affect growth and development. While biologic therapies such as belimumab are increasingly used, evidence supporting newer agents in paediatric populations remains limited. Against this background, the researchers evaluated the real-world effectiveness of telitacicept combined with SoC and compared it with belimumab plus SoC using robust statistical adjustment.
The study enrolled patients aged 5 to 18 years across seven tertiary hospitals in China. A total of 60 children with cSLE received telitacicept and were followed prospectively for a median of 12 months. Their outcomes were compared with a historical control group of 67 patients previously treated with belimumab. To minimise baseline differences between the two groups, the investigators applied propensity score–based inverse probability of treatment weighting (IPTW).
Key efficacy outcomes included attainment of Lupus Low Disease Activity State (LLDAS) and Definition of Remission in SLE (DORIS) at 3, 6, and 12 months, along with flare rates and changes in corticosteroid dosing.
The study led to the following findings:
- Disease control improved progressively in patients treated with telitacicept, with nearly two-thirds achieving LLDAS and over one-third attaining DORIS remission by 12 months.
- Flare rates remained low during follow-up, increasing gradually from below 2% at three months to just over 14% at one year.
- A marked reduction in glucocorticoid use was observed, with almost 75% of patients tapering prednisone to ≤7.5 mg/day by 12 months compared with a small proportion at baseline.
- IPTW-adjusted analyses showed telitacicept to be comparable to belimumab, with no significant differences in LLDAS and DORIS achievement, steroid reduction, flare control, or improvement in immunologic markers.
The authors noted key limitations, including the use of adult LLDAS criteria instead of the newer childhood-specific version, potential residual confounding due to reliance on historical controls, and a 12-month follow-up that was too short to assess long-term outcomes such as organ damage, infection risk, and growth effects.
"Despite these constraints, the study provides important real-world evidence in an area where paediatric data are scarce. Overall, the findings indicate that telitacicept combined with standard therapy can effectively control disease activity, facilitate steroid tapering, and achieve remission targets in cSLE, offering clinicians an additional biologic option for personalised management of paediatric lupus," the authors concluded.
Reference:
Luo, C., Su, S., Liu, J., Lin, J., Song, J., Chen, Z., Peng, Y., Jiang, L., Jia, M., Wang, L., Jiang, X., Zhang, W., Rong, Z., Zhao, B., Wang, Y., & Tang, X. Efficacy of Telitacicept in Childhood-Onset Systemic Lupus Erythematosus: A Prospective Multicenter Cohort Study With Inverse Probability of Treatment Weighting –Adjusted Comparison to a Historical Control Group Treated With Belimumab. Arthritis & Rheumatology. https://doi.org/10.1002/art.43417
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