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Belimumab: A Review in Systemic Lupus Erythematosus

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Abstract

Belimumab (Benlysta®) is a human immunoglobulin G1λ monoclonal antibody that inhibits the binding of soluble B lymphocyte stimulator to B cells. It is the only biological agent currently approved for the treatment of non-renal systemic lupus erythematosus (SLE). Belimumab is approved in the EU, the USA and other countries as add-on therapy in adult patients with active, autoantibody-positive SLE despite standard therapy. In phase III trials, treatment with IV or SC belimumab plus standard therapy was effective in terms of reducing overall disease activity and reducing the incidence and severity of flares, without worsening of patients’ overall condition or the development of significant disease activity in new organ systems. Sustained disease control was maintained during longer-term (up to 10 years) treatment with IV belimumab. Belimumab also demonstrated steroid-sparing effects and was associated with clinically meaningful improvements in health-related quality of life and fatigue. Belimumab was generally well tolerated in clinical trials, with low rates of immunogenicity. In view of the flexibility regarding the route of administration and the convenience of the once-weekly, self-administered, SC regimen, add-on therapy with belimumab is a useful treatment option for patients with active, autoantibody-positive SLE despite standard therapy.

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Acknowledgements

During the peer review process, the manufacturer of belimumab was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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Correspondence to Hannah A. Blair.

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The preparation of this review was not supported by any external funding.

Conflict of interest

Hannah Blair and Sean Duggan are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.

Additional information about this Adis Drug Review can be found at http://www.medengine.com/Redeem/DCD8F0603CADACA0.

Additional information

The manuscript was reviewed by: M. A. Khamashta, Lupus Research Unit, St Thomas’ Hospital, London, UK; R. A. Levy, Department of Rheumatology, State University of Rio de Janeiro, Brazil; Y. J. Poh, Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore; C. Richez, Department of Rheumatology, Hopital Pellegrin, Bordeaux, France.

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Blair, H.A., Duggan, S.T. Belimumab: A Review in Systemic Lupus Erythematosus. Drugs 78, 355–366 (2018). https://doi.org/10.1007/s40265-018-0872-z

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