Belimumab is a fully humanized IgG1gamma monoclonal antibody directed against soluble B lymphocyte stimulator (BLyS), and approved for the treatment of SLE (Systemic Lupus Erythemtosus)
is the first drug to be registered for the treatment of SLE since 1955, when hydroxychloroquine was repurposed and approved (2)
Belimumab is indicated as an add-on therapy for the treatment of adult patients with active, autoantibody-positive, SLE, who are receiving standard therapy (1)
NICE state that:
Belimumab is recommended as an option as add-on treatment for active autoantibody-positive systemic lupus erythematosus in people with high disease activity despite standard treatment, only if:
high disease activity is defined as at least 1 serological biomarker (positive anti-double-stranded DNA or low complement) and a SELENA-SLEDAI score of greater than or equal to 10
treatment is continued beyond 24 weeks only if the SELENA-SLEDAI score has improved by 4 points or more
Belimumab is a recombinant, fully human, monoclonal antibody directed against the cytokine BLyS, also known as B-cell activating factor (BAFF)
belongs to the tumor necrosis factor (TNF) superfamily and plays a central role in B-cell survival and function
overexpression of BLyS promotes survival of B-cells (including autoreactive B-cells) whereas its inhibition results in autoreactive B-cell apoptosis
BLyS plays a key role in the pathogenesis of autoimmune diseases such as SLE
elevated circulating BLyS levels are common in SLE patients, in comparison with healthy individuals, and higher levels correlate with increased disease activity and antidouble-stranded DNA (dsDNA) antibody titers - thus, inhibiting the biological activity of BLyS is potentially helpful in the treatment of the disease
Belimumab acts by binding to soluble BLyS.
its dose is 10 mg/kg administered on days 0, 14, and 28, and then every 28 days thereafter
Reference:
Srivastava A. Belimumab in Systemic Lupus Erythematosus. Indian J Dermatol. 2016;61(5):550-553. doi:10.4103/0019-5154.190107
Samotij D, Reich A. Biologics in the Treatment of Lupus Erythematosus: A Critical Literature Review. Biomed Res Int. 2019;2019:8142368. Published 2019 Jul 18. doi:10.1155/2019/8142368
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