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<p>Lupus nephritis (LN) is the predominant severe manifestation of systemic lupus erythematosus (SLE). The approach to managing LN is highly heterogeneous&#xa0;due to the clinical heterogeneity&#xa0;of the disease. Here, we report a 28-year-old Caucasian female with refractory biopsy-proven active LN&#xa0;class III and V, diagnosed&#xa0; approximately six years prior to presentation who was&#xa0;successfully managed with both belimumab and voclosporin. Her laboratory findings were significant for high-titer anti-dsDNA antibodies (&gt; 300), low complements, and increasing proteinuria despite ongoing treatment with MMF and low-dose prednisone. The patient fulfilled the EULAR/ACR classification criteria for SLE, achieving a score of 28, reflecting significant systemic disease involvement. The patient tolerated the combination of volcosporin and belimumab well for nine months. She did not report any specific side effects during this time and was in clinical remission with no signs of systemic flare-up based on the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K).&#xa0;This case highlights the potential of combining belimumab, voclosporin, mycophenolate mofetil (MMF), and low-dose steroids&#xa0;in selected patients.</p> Graphical abstract <p></p>

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Effective management of lupus nephritis using a novel combination therapy with low-dose steroids: a case report

  • 期刊论文

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  • 发表日期：

    2025年8月8日

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  • Niloufar Ebrahimi,
  • Duvuru Geetha,
  • Joselyn Reyes-Bahamonde,
  • Craig W. Zuppan,
  • Amir Abdipour,
  • Sayna Norouzi

摘要

Lupus nephritis (LN) is the predominant severe manifestation of systemic lupus erythematosus (SLE). The approach to managing LN is highly heterogeneous due to the clinical heterogeneity of the disease. Here, we report a 28-year-old Caucasian female with refractory biopsy-proven active LN class III and V, diagnosed  approximately six years prior to presentation who was successfully managed with both belimumab and voclosporin. Her laboratory findings were significant for high-titer anti-dsDNA antibodies (> 300), low complements, and increasing proteinuria despite ongoing treatment with MMF and low-dose prednisone. The patient fulfilled the EULAR/ACR classification criteria for SLE, achieving a score of 28, reflecting significant systemic disease involvement. The patient tolerated the combination of volcosporin and belimumab well for nine months. She did not report any specific side effects during this time and was in clinical remission with no signs of systemic flare-up based on the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). This case highlights the potential of combining belimumab, voclosporin, mycophenolate mofetil (MMF), and low-dose steroids in selected patients.

Graphical abstract