Belimumab shows promise in neuropsychiatric lupus: Another challenge to find the offender

Abstract

Introduction: Agents that can be used for the treatment of neuropsychiatric lupus (NPSLE) are lacking in the therapeutic armamentarium. Belimumab is a monoclonal antibody targeting the B-cell activating factor (BAFF) and is approved by the US Food and Drug Administration as an additional treatment for systemic lupus erythematosus patients with persistent disease activity and lupus nephritis (LN); however, severe active central nervous system manifestations were excluded. Case Report: We report on a treatment-naïve LN patient with refractory NPSLE complicated with progressive posterior reversible encephalopathy syndrome (PRES) who was successfully treated via the combination of mycophenolate and belimumab, resulting in reversal of persistent headache and neuroradiologic manifestations. Conclusion: Research on this topic could be relevant for identifying a possible correlation between BAFF and psychiatric NPSLE manifestations. K E Y W O R D S belimumab, lupus nephritis, neuropsychiatric lupus, posterior reversible encephalopathy syndrome Key points• The nephrotic state is a specific risk factor for posterior reversible encephalopathy syndrome (PRES) in patients with lupus renal flares. • Belimumab showed efficacy and safety in a lupus nephritis patient with PRES.

Mitochondrial aberrations in systemic lupus erythematosus pathogenesis: Insights and therapeutic implications

“…Notably, foundational research targeting specific pathways and the development of new medications have significantly propelled the progression of SLE treatments. [3][4][5][6] However, a complete cure for SLE remains elusive, and the prognosis for patients with SLE is still severe. This could be attributed to the intricate clinical manifestations of SLE, its strong heterogeneity, and the unpredictable nature of multiorgan damage.…”