Abstract
Lupus nephritis (LN) is an important complication of systemic lupus erythematosus, for which glucocorticoids (GCs) are the primary treatment. Due to the side effects associated with GCs, their long-term use should ideally be tapered and discontinued. At present, no such possibility exists without problematic flares after discontinuation. We administered belimumab, a human monoclonal antibody that binds to a soluble B lymphocyte stimulator to reduce the number of activated B cells, to six patients with Type IV LN to discontinue GCs. The six patients were 10-15 years old when LN developed and 15-24 years old when belimumab treatment was initiated. Prednisolone was tapered from 6 to 20 mg by 2.5-5 mg every month until the dosage reached 5 mg, at which point the dosage was further reduced by 1 mg every 6 months. One patient was transferred to another hospital midway and five patients discontinued GCs. No flares occurred 8-38 months post discontinuation. No adverse effects were observed following belimumab treatment. In conclusion, belimumab was effective in the successful discontinuation of GCs.