Table 1.

Comparison of biologics directly and indirectly targeting.

	Molecular structure and mechanism of action	Disease in reference	Effectiveness and Safety	Applicable disease
rituximab	It is a human-mouse chimeric monoclonal CD20 type I antibody that specifically binds to the CD20 antigen on the surface of pre-B and mature B lymphocytes and initiates an immune response that mediates B-cell lysis (massive depletion of peripheral B cells, including peripheral blood memory B cells) (6).	proliferative lupus nephritis (52)	In a phase III clinical trial of lupus nephritis patients, the overall renal response rate at 52 weeks was greater in the Rituximab group than in the placebo group, although the difference was not statistically significant. Additionally, there was no change in the patient’s clinical prognosis despite receiving Rituximab treatment for a full year. Adverse reactions include infusion adverse reactions, infection, etc (52).	Off-label for the treatment of SLE, MN, micropathological nephropathy, etc
obinutuzumab	It is a human-derived type II CD20 monoclonal antibody that targets the CD20 antigen expressed on the surface of pre-B lymphocytes and mature B lymphocytes and mediates B cell lysis. Obinutuzumab induces direct cell death with greater activity and affinity for the FcɣRIII receptor protein than rituximab.	proliferative lupus nephritis (53)	When obinutuzumab was added to standard therapy alone, it resulted in a significantly higher rate of complete renal remission at week 52 than standard therapy alone. The most common adverse event was an infection, with an incidence that was similar to that seen in the control group (53).	Off-label for lupus nephritis
belimumab	It is a human lgG1λ monoclonal antibody specific for soluble human BAFF, which inhibits B cell survival (including autoreactive B cells) and B cell differentiation.	active lupus nephritis (29)	The remission rate of the urine protein-creatinine ratio and glomerular filtration rate at 104 weeks was higher in the belimumab group compared to the placebo group. Infection-related deaths occurred at a similar rate in both the belimumab group and the placebo group (29).	For active, autoantibody-positive systemic lupus erythematosus (SLE) patients 5 years of age and older with high disease activity (e.g., positive anti-dsDNA antibody and low complement, SELENA-SLEDAI score ≥ 8) despite conventional therapy
atacicept	TACI-FC fusion protein	active lupus nephritis (54)	The Phase IIb clinical trial of atacicept did not meet its primary endpoint, although there was a trend toward increased the SLE responder index 4 (SRI4) remission rates at week 24 in the 75 mg and 150 mg atacicept groups. Adverse reactions in the atacicept group were no higher than in the placebo group (54).	Clinical trials of Atacicept for RA, SLE, and others are ongoing (55)
telitacicept	TACI-FC fusion protein	SLE, IgA nephropathy, and others	As mentioned above, stage III SLE and stage IIb IgA nephropathy all showed effectiveness, the adverse reactions were within a controllable range, and symptomatic treatment was required.	Based on conventional treatment, there is still high disease activity and autoantibody-positive systemic lupus erythematosus; clinical trials for systemic myasthenia gravis are ongoing (56).