Belimumab May Reduce Organ Damage Among SLE Patients

The targeted biologic drug belimumab was found to improve renal response and decrease organ damage among patients with systemic lupus erythematosus (SLE), researchers stated in the update of the 20219 European Alliance of Associations for Rheumatology (EULAR) recommendations for SLE management.

“Belimumab is a monoclonal antibody that inhibits B lymphocyte stimulator and is the only therapy approved for both SLE and lupus nephritis,” the authors wrote. “Results from a clinical trial showed that in patients with active lupus nephritis, belimumab treatment improved renal response, reduced the risk of renal-related events, and impacted features related to kidney damage progression compared to background therapy alone.”

Among patients with SLE, an important predictor of quality of life and early death in patients is organ damage. More than half of the patients diagnosed with SLE develop extensive organ damage within 10 years, of which 30-50% is reported in the first 5 years. Damage accumulation over time may result in early deaths or a prolonged course of rehabilitation which in turn drives up health care costs significantly.

Organ damage is defined as an irreversible tissue injury occurring after SLE diagnosis and persisting for more than 6 months, according to Systemic Lupus International Collaborating Clinics/ American College of Rheumatology Damage Index. Therefore, the EULAR recommendations for SLE and lupus nephritis management have been updated to add prevention of damage as a key treatment goal.

Across 4 randomized clinical studies and real-world data, researchers found that belimumab in addition to background SLE therapy resulted in consistent decrease in organ damage, disease activity, new flares, and glucocorticoid exposure.

Belimumab treatment in conjunction with background therapy was associated with a 61% reduction in the risk of progression with a hazard ratio of 0.391 (95% CI) and was found to reduce the risk of renal-related outcome or death by 50% compared to placebo.

“These observed impacts of belimumab on organ damage imply a disease-modifying effect on SLE, including lupus nephritis, suggesting potential benefits of belimumab treatment earlier in the disease course,” the researchers advised.

—Priyam Vora

Reference:
Urowitz M, Aranow C, Asukai Y et al. Impact of belimumab on organ damage in systemic lupus erythematosus. Arthritis Care Res. Published online: April 19, 2022. DOI: https://doi.org/10.1002/acr.24901