Effectiveness, Tolerability, and Safety of Belimumab in Patients with Refractory SLE: a Review of Observational Clinical-Practice-Based Studies.
To date, belimumab is the only biological drug approved for the treatment of patients with active refractory SLE. We compared and critically analyzed the results of 11 observational clinical-practice-based studies, conducted in SLE referral centers. Despite the differences in endpoints and follow-up duration, all studies remarked that belimumab provides additional benefits when used as an add-on to existing treatment, allowing a higher rate of patients to reach remission and to taper or discontinue corticosteroids. In the OBSErve studies, 2-9.6% of patients discontinued corticosteroids and 72-88.4% achieved a ≥ 20% improvement by physician's judgment at 6 months. In Hui-Yuen's study, 51% of patients attained response by simplified SRI at month 6. In Sthoeger's study, 72.3% of patients discontinued corticosteroids and 69.4% achieved clinical remission by PGA after a median follow-up of 2.3 years. In the multicentric Italian study, 77 and 68.7% of patients reached SRI-4 response at months 6 and 12, respectively. In all the studies, disease activity indices decreased over time. Retention rates at 6, 9, and 12 months were 82-94.1, 61.2-83.3, and 56.7-79.2%, respectively. The main limitations of these studies include the lack of a control group, the short period of observation (6-24 months) and the lack of precise restrictions regarding concomitant medication management. This notwithstanding, these experiences provide a more realistic picture of real-life effectiveness of the drug compared with the randomized controlled clinical trials, where stringent inclusion/exclusion criteria and changes in background therapy could limit the inference of data to the routine clinical care.
['Trentin|Francesca|F|', 'Gatto|Mariele|M|', 'Zen|Margherita|M|', 'Larosa|Maddalena||', 'Maddalena|Larosa|L|', 'Nalotto|Linda|L|', 'Saccon|Francesca|F|', 'Zanatta|Elisabetta|E|', 'Iaccarino|Luca|L|', 'Doria|Andrea|A|0000-0003-0548-4983']
D061067:Antibodies, Monoclonal, Humanized D002986:Clinical Trials as Topic D004351:Drug Resistance D004359:Drug Therapy, Combination D019317:Evidence-Based Medicine D006801:Humans D007166:Immunosuppressive Agents D008180:Lupus Erythematosus, Systemic D012008:Recurrence D016896:Treatment Outcome
Belimumab BLyS Drug efficacy Drug survival Real-life experience Systemic lupus erythematous