Analysis Of The Efficacy Of Biological Agents In The Treatment Of SLE And The Pregnancy Outcome Associated With Anti-SSA/RO Antibodies

Efficacy and safety of biological agents in the treatment of systemic lupus erythematosusObjective:To compare the efficacy and safety of belimumab and telitacicept in the treatment of SLE.Method:Patients with systemic lupus erythematosus who used biological agents in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Soochow University Hospital from 01 January 2021 to 30 September 2022 were selected.According to the types of biological agents used,patients were divided into the belimumab group and telitacicept group.The clinical symptoms,laboratory tests and adverse events during follow-up were compared between the two groups before and after treatment.Results:The SRI-4 response rate at week 24 was significantly higher in the telitacicept group compared to the belimumab group(P<0.05).At week 4,the SLEDAI-2K score,hormone dose,24-hour urine protein,and platelet count were significantly lower(P<0.05).C3 and C4 levels were significantly higher(P<0.05),dsDNA,IgG,and white blood cell counts were not significantly different in the telitacicept group compared to the belimumab group.At week 12,the SLEDAI-2K score,hormone dose,dsDNA and platelet levels were significantly lower(P<0.05),C3 were higher(P<0.05),and complement C4,24-hour urine protein,IgG and white blood cell count were not significantly different in the telitacicept group compared to the belimumab group.At week 24,there was no significant difference between the two groups.There was no significant difference in the incidence of adverse events between the two groups.Conclusion:Compared to belimumab,SLE patients responded better to the treatment with telitacicept,which helped to reduce hormone doses more quickly and improve multisystemic symptoms with long-term effectiveness.There was no statistical difference in the incidence of safety events between the two groups.Maternal and infant outcomes of pregnancy associated with anti-SSA/RO antibodies:A systematic review and meta-analysisObjective:The relationship between anti-SSA/RO antibodies and pregnancy has been reported previously,and we aim to visualize the rates of maternal and infant outcomes with anti-SSA/RO.Methods:Records were searched from Pubmed,Cochrane,Embase,and Web of Science databases,and references were screened according to inclusion and exclusion criteria.The included observational studies were evaluated using the Newcastle-Ottawa Quality Assessment Scale(NOS).The incidence of antibody-related adverse pregnancy outcomes was used as the outcome index.The meta-analysis,subgroup analysis,and sensitivity analysis were performed using RStudio(2022.07.2)and RevMan 5.4 statistical software.Results:A total of 18 records comprising 1675 patients and 1920 pregnancies were searched from the electronic databases.For maternal outcomes,the pooled estimate rates were 4%for termination of pregnancy,5%for spontaneous abortion,26%for preterm labor,and 50%for cesarean operation.While for fetal outcomes,the pooled estimate rates were 4%for perinatal death,3%for intrauterine growth retardation,6%for endocardial fibroelastosis,6%for dilated cardiomyopathy,7%for congenital heart block,12%for congenital heart block recurrence,19%for cutaneous neonatal lupus erythematosus,12%for hepatobiliary disease and 16%for hematological manifestations.A subgroup analysis of congenital heart block prevalence was performed,diagnostic method and study region were found to affect heterogeneity to some extent.Conclusion:Cumulative analysis of data from real-world studies confirmed adverse pregnancy outcomes of women with anti-SSA/RO,serves as a reference and a guide for the diagnosis and subsequent treatment of these women,thereby enhancing maternal and infant health.Additional studies with real-world cohorts are required to validate these results.