The efficacy of rituximab plus telitacicept in neuropsychiatric systemic lupus erythematosus: A retrospective study.

OBJECTIVE Neuropsychiatric systemic lupus erythematosus (NPSLE) presents significant management challenges and high mortality. While rituximab (RTX) is used via B cell depletion, telitacicept's efficacy remains unclear. This study retrospectively evaluated telitacicept, alone or after RTX, in NPSLE treatment.

METHODS We analyzed 38 NPSLE patients from two Chinese centers, divided into conventional therapy (n = 11), telitacicept therapy (n = 15), and RTX followed by telitacicept (n = 12). Outcomes included event-free survival (EFS), self-care and modified Rankin Scale (mRS) scores, SLEDAI-2 K, and SLEDAI-NP.

RESULTS Telitacicept and RTX plus telitacicept groups showed effective B cell depletion and improved EFS, self-care, and mRS scores versus conventional therapy. Glucocorticoid tapering was most rapid with RTX plus telitacicept. Infections were manageable in telitacicept-based groups, while conventional therapy had higher severe event rates.

CONCLUSIONS Telitacicept is promising for NPSLE, both as monotherapy and following RTX induction. Confirmation of its efficacy and safety in this study, however, requires further prospective investigation.