Safety and Efficacy of Belimumab to Treat Systemic Lupus Erythematosus in Academic Clinical Practices.

Abstract

OBJECTIVE:

To evaluate the use and efficacy of belimumab in academic practices. Belimumab is a human monoclonal antibody that inhibits soluble B lymphocyte stimulator and has been approved for the treatment of adults with systemic lupus erythematosus (SLE).

METHODS:

Invitations to participate and complete a 1-page questionnaire for each patient prescribed belimumab were sent to 16 physicians experienced in SLE phase III clinical trials. The outcome was defined as the physician's impression of improvement in the initial manifestation(s) being treated without worsening in other organ systems.

RESULTS:

Of 195 patients treated with belimumab at 10 academic centers, 96% were taking background medications for SLE at initiation of belimumab, with 74% taking corticosteroids. The main indications for initiation of belimumab were arthritis, rash, and/or worsening serologic activity, with 30% of patients unable to taper corticosteroids. Of the 120 patients taking belimumab for at least 6 months, 51% responded clinically and 67% had ≥ 25% improvement in laboratory values. While numbers are limited, black patients showed improvement at 6 months. In a subset of 39 patients with childhood-onset SLE, 65% responded favorably at 6 months, and 35% discontinued corticosteroids.

CONCLUSION:

Our data demonstrate favorable clinical and laboratory outcomes in patients with SLE at 6 months across all racial and ethnic groups, with similar improvement seen among patients with childhood-onset SLE.

• Authors: Joyce S Hui-Yuen, Arthi Reddy, Jennifer Taylor, Xiaoqing Li, Andrew H Eichenfield, Liza M Bermudez, Amy J Starr, Lisa F Imundo, Jill Buyon, Richard A Furie, Diane L Kamen, Susan Manzi, Michelle Petri, Rosalind Ramsey-Goldman, Ronald F van Vollenhoven, Daniel J Wallace, Anca Askanase
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 42 Issue 12 Pg. 2288-95 (Dec 2015) ISSN: 0315-162X [Print] Canada
• PMID: 26523030 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal, Humanized
• belimumab

Topics

• Academic Medical Centers
• Adolescent
• Adult
• Age Factors
• Age of Onset
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Humans
• Lupus Erythematosus, Systemic (diagnosis, drug therapy, epidemiology)
• Male
• Middle Aged
• Patient Safety
• Prospective Studies
• Risk Assessment
• Severity of Illness Index
• Sex Factors
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome
• Young Adult