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. 2025 Aug 8.
doi: 10.1007/s40620-025-02361-y. Online ahead of print.

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

Niloufar Ebrahimi  1 , Duvuru Geetha  2 , Joselyn Reyes-Bahamonde  3   4 , Craig W Zuppan  5 , Amir Abdipour  1 , Sayna Norouzi  6
Affiliations

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

Niloufar Ebrahimi et al. J Nephrol. .

Erratum in

Abstract

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.

Keywords: Belimumab; Lupus nephritis; Voclosporin.

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Conflict of interest statement

Declarations. Conflict of interest: Dr. Sayna Norouzi is on the speaker bureau for Calliditas Therapeutics. She is also a consultant for Calliditas Therapeutics and Otsuka Pharmaceutical Co. Ethical approval and consent to participate: Informed consent was obtained from the participant included in the study. Consent for publication: Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

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