ArticleLupus science & medicine2026
Impact of belimumab on the utility of serological markers for assessing systemic lupus erythematosus activity.
Article in Lupus science & medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of telitacicept in adults with systemic lupus erythematosus: a systematic review and stratified meta-analysis.Frontiers in medicine · 2026Pooled it
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Authors and funding
38 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the dynamics of C3, C4 and anti-dsDNA antibody levels and their association with clinical activity and flares in patients with systemic lupus erythematosus (SLE) treated with belimumab (BEL).
methodsRetrospective longitudinal cohort study from the BELILES-GEAS registry. Serological markers were assessed at the time of SLE diagnosis, at baseline, at each follow-up visit (months 3, 6, 12, 18, and 24 after treatment initiation) and during disease flares.
resultsA total of 371 patients were included, with a median drug exposure of 13.2 months. At baseline, 70.1% of patients were seropositive. SLE Disease Activity Index 2000 (SLEDAI-2K) and cSLEDAI scores and prednisone doses decreased significantly over time, whereas serum C3 and C4 levels, anti-dsDNA positivity and immunosuppressant use remained stable. Among 95 (25.6%) patients who experienced 139 (14.5%) flares, longitudinal analysis adjusted by immunosuppressant use and prednisone dose revealed no association between flare occurrence and low C3 or C4, whereas anti-dsDNA antibody positivity was (C3 OR=1.31, 95% CI 0.82 to 2.09; C4 OR=1.08, 95% CI 0.62 to 1.86, and anti-dsDNA OR=1.81, 95% CI 1.09 to 3.01, respectively). When stratified by flare severity, low C3 levels showed a borderline association with moderate-to-severe flares (OR=1.82, 95% CI 0.99 to 3.31), while no significant associations were observed for C4 or for mild flares. There was no association between serum level of C3 or C4 and cSLEDAI. The flare-discriminative performance of SLEDAI-2K and cSLEDAI was similar (AUC-ROCs 0.779 vs 0.781, p=0.88).
conclusionIn SLE patients treated with BEL, the clinical utility of serological markers appears dissociated from disease activity. While C3 and C4 levels were not clearly related to disease activity or flares, low C3 levels showed a borderline association with moderate-to-severe flares, and anti-dsDNA positivity remained associated with increased flare risk, supporting a clinical assessment-driven approach with complementary use of anti-dsDNA.
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