Traditional treatment regimens for rheumatic and autoimmune diseases are associated with significant adverse effects, and some patients develop drug resistance leading to poor prognosis. Telitacicept, a biologic agent and fusion protein targeting B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL), offers a novel therapeutic strategy for refractory rheumatic and autoimmune diseases. Clinical trials have demonstrated promising efficacy and safety. In systemic lupus erythematosus, telitacicept reduces disease activity and facilitates glucocorticoid sparing, with favorable outcomes also observed in pediatric patients. In Sjögren’s syndrome, telitacicept achieves sustained improvement in clinical symptoms and disease activity. In rheumatoid arthritis, telitacicept improves American College of Rheumatology 20% improvement criteria (ACR20) and American College of Rheumatology 50% improvement criteria (ACR50) response rates while significantly reducing glucocorticoid requirements. In IgA vasculitis, studies have primarily focused on patients with renal involvement, showing efficacy in reducing proteinuria in both adults and children. In myasthenia gravis, telitacicept reduces disease severity and improves quality of life. Additionally, telitacicept has shown preliminary therapeutic potential in IgG4-related disease and granulomatosis with polyangiitis, warranting further investigation. Existing clinical data indicate a favorable overall safety profile for telitacicept; however, attention should be paid to long-term risks of infection, decreased immunoglobulin levels, potential resistance mechanisms, and its efficacy and safety in special populations. This review summarizes the research progress of telitacicept in rheumatic and autoimmune diseases, aiming to provide a reference for its clinical application.
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