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24 May 2020
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Early belimumab use in SLE patients may maximize treatment efficacy

05 May 2020

In the treatment of active systemic lupus erythematosus (SLE), early administration of belimumab especially in patients with low damage at baseline is likely to lead to remission and low-disease activity (LDA), according to real-world data.

Researchers looked at 466 active SLE patients receiving intravenous belimumab as add-on treatment at multiple referral centres. The median follow‐up was 18 months. Evaluations included remission, LDA and SLE Responder Index‐4 (SRI‐4). Systemic Lupus International Collaborating Clinics (SLICC) damage index (SDI) was calculated annually.

SRI‐4 was documented in 49.2 percent of patients at month 6, 61.3 percent at month 12, 69.7 percent at month 24, 69.6 percent at month 36 and 66.7 percent at month 48. Baseline predictors of 6-month response were SLEDAI‐2K≥10 (odds ratio [OR], 3.14) and disease duration ≤2 years (OR, 1.94); 12-month response were SLEDAI‐2K≥10 (OR, 3.48) and SDI=0 (OR, 1.74); 24-month response were SLEDAI‐2K≥10 (OR, 4.25) and disease duration ≤2 years (OR, 3.79); and 36-month response were SLEDAI‐2K≥10 (OR, 14.59) and baseline smoking (OR, 0.19).

Patients spending ≥25 percent of follow‐up time in remission (42.9 percent) or ≥50 percent time of follow-up time in LDA (66.0 percent) accrued significantly less damage (p=0.046 and p=0.007, respectively). Baseline SDI=0 was strongly associated with LDA ≥50 percent and remission ≥25 percent, such that the lower the baseline damage, the higher the probability of remission ≥25 percent. In contrast, a higher number of previous flares predicted belimumab discontinuation due to inefficacy (p= 0.009).

Currently, belimumab is commonly used as the last option in SLE treatment, the researchers noted. Findings of the present study suggest that an earlier belimumab use may maximize its efficacy, as it improves patient prognosis with respect to better response, remission/LDA achievement and damage accrual prevention.

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Most Read Articles
24 May 2020
The use of capsule endoscopy (CE) appears to be effective in the diagnosis of iron deficiency anaemia (IDA), yielding a 33.9-percent yield in this study, with 65.8 percent of patients undergoing further workup and 12.7 percent requiring therapeutic intervention.
Roshini Claire Anthony, 2 days ago

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

4 days ago
Eating behaviours have been shown to moderate the relationship between cumulated risk factors in the first 1,000 days and adiposity outcomes at 6 years of age, which underscores modifiable behavioural targets for interventions, reports a study.
Stephen Padilla, 3 days ago
Use of noninvasive ventilation (NIV), similar to invasive mechanical ventilation (IMV), appears to lessen mortality but may increase the risk for transmission of the novel coronavirus disease (COVID-19) in healthcare workers, suggest the results of a study.