Discontinuation of belimumab in systemic lupus erythematosus patients who achieved disease stability: a retrospective cohort study.

Abstract

Objectives: To investigate the changes in various indicators of systemic lupus erythematosus (SLE) patients who discontinue belimumab after achieving disease stability, assess the potential impacts and risks of discontinuing belimumab, and provide scientific evidence and references for clinical decision-making.

Methods: Pertinent data were retrospectively collected from SLE patients at the Second Affiliated Hospital of Jiaxing University who either discontinued or continued belimumab treatment after achieving disease stability. The study compared changes in disease activity, glucocorticoid usage, immunological markers, and other relevant indicators between the two groups after 6 months of follow-up.

Results: After 6 months of follow-up, patients in the experimental group exhibited increased Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2000) scores, enhanced activity of immunological markers, a greater proportion of patients requiring increased glucocorticoid doses, and experienced new-onset systemic involvement. Notably, only 20% of these patients achieved low disease activity state (LLDAS). In contrast, patients in the control group experienced decreased SLEDAI-2000 scores, improved immunological markers, and a greater proportion requiring a reduction in glucocorticoid dosage, with 76.67% achieving LLDAS. The differences between the two groups were statistically significant (P < 0.05). No statistically significant difference was observed between the two groups concerning hospital readmissions due to disease activity, new organ damage, or the incidence of adverse events.

Conclusions: Discontinuing belimumab in patients with stable SLE may lead to higher glucocorticoid requirements, enhanced activity of immunological markers, increased disease activity, and new-onset systemic involvement. Research in this area is necessary and can provide certain reference and guidance for clinical decision-making. Key Points • The subsequent conditions of SLE patients who discontinue belimumab after achieving disease stability warrant attention. • Discontinuing belimumab may lead to higher glucocorticoid requirements, enhanced activity of immunological markers, increased disease activity, and new-onset systemic involvement. • These findings provide crucial decision-making references and may help reduce unnecessary discontinuations.