Can the dose of belimumab be reduced in patients with systemic lupus erythematosus?

IF 4.7 2区医学 Q1 RHEUMATOLOGY

Rheumatology Pub Date : 2025-03-01 DOI:10.1093/rheumatology/keae270

Iñigo Rua-Figueroa, Irene Altabás-González, Coral Mouriño, Karen Roberts, Andrea Hernández-Martín, Ivette Casafont-Solé, Judit Font-Urgelles, Jose A Román-Ivorra, Marta de la Rubia Navarro, Maria Galindo-Izquierdo, Tarek C Salman-Monte, Javier Narváez, Paola Vidal-Montal, Maria Jesús García-Villanueva, Sandra Garrote-Corral, Maria Angeles Blazquez-Canamero, Carlos Marras Fernandez-Cid, Maria Piqueras-García, Julia Martínez-Barrio, Marina Sánchez-Lucas, Josefina Cortés-Hernández, Eleonora Penzo, Jaime Calvo-Alén, Juan Ramón de Dios, Belén Alvarez-Rodríguez, Margarida Vasques-Rocha, Eva Tomero, Raul Menor-Almagro, Myriam Gandía, José A Gómez-Puerta, Beatriz Frade-Sosa, Consuelo Ramos-Giráldez, Carmen Trapero-Pérez, Elvira Diez, Clara Moriano, Alejandro Muñoz-Jiménez, José María Pego-Reigosa

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引用次数: 0

Abstract

Objectives: The aims of this study were to investigate the prevalence of dose reduction in patients with SLE treated with belimumab (BEL) in Spain, analyse treatment modalities, and determine impact on control of disease activity.

Methods: Retrospective longitudinal and multicentre study of SLE patients treated with BEL. Data on disease activity, treatments and outcomes were recorded before and after reduction (6-12 months), and they were compared.

Results: A total of 324 patients were included. The dose was reduced in 29 patients (8.9%). The dosing interval was increased in nine patients receiving subcutaneous BEL and in six patients receiving intravenous BEL. The dose per administration was reduced in 16 patients. Pre-reduction status was remission (2021 DORIS) in 15/26 patients (57.7%) and LLDAS in 23/26 patients (88.5%). After reduction, 2/24 patients (8.3%) and 3/22 patients (13.6%) lost remission at 6 months and 12 months, respectively [not statistically significant (NS)]. As for LLDAS, 2/23 patients (8.7%) and 2/21 patients (9.5%) lost their status at 6 and 12 months, respectively (NS). Significantly fewer patients were taking glucocorticoids (GCs) at their 12-month visit, although the median dose of GCs was higher at the 12-month visit (5 [0.62-8.75] vs 2.5 [0-5] at baseline).

Conclusion: Doses of BEL can be reduced with no relevant changes in disease activity-at least in the short term-in a significant percentage of patients, and most maintain the reduced dose. However, increased clinical or serologic activity may be observed in some patients. Consequently, tighter post-reduction follow-up is advisable.

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系统性红斑狼疮患者能否减少贝利木单抗的剂量？

研究目的本研究旨在调查西班牙接受贝利木单抗（BEL）治疗的系统性红斑狼疮患者减少剂量的发生率，分析治疗方式，并确定对疾病活动控制的影响：方法：对接受贝利木单抗治疗的系统性红斑狼疮患者进行回顾性纵向多中心研究。方法：对接受 BEL 治疗的系统性红斑狼疮患者进行回顾性纵向和多中心研究，记录减量前后（6-12 个月）的疾病活动、治疗和结果数据，并进行比较：结果：共纳入了 324 名患者。结果：共纳入 324 例患者，其中 29 例患者（8.9%）减少了剂量。9名皮下注射 BEL 的患者和 6 名静脉注射 BEL 的患者增加了给药间隔。有 15/26 名患者（57.7%）在减量前处于缓解状态（2021 DORIS），23/26 名患者（88.5%）处于 LLDAS 状态。减量后，分别有 2/24 名患者（8.3%）和 3/22 名患者（13.6%）在 6 个月和 12 个月时失去缓解（无统计学意义 [NS]）。至于 LLDAS，分别有 2/23 名患者（8.7%）和 2/21 名患者（9.5%）在 6 个月和 12 个月时失去状态（无统计学意义 [NS]）。在12个月就诊时，服用糖皮质激素（GCs）的患者明显减少，尽管12个月就诊时GCs的中位剂量更高（5 [0.62-8.75] vs 2.5 [0-5]）：结论：相当一部分患者在减少 BEL 剂量的同时，疾病活动性不会发生相关变化（至少在短期内如此），而且大多数患者都能维持减少后的剂量。然而，一些患者的临床或血清学活动可能会增加。因此，减少剂量后最好进行更严格的随访。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

期刊介绍： Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.