AB0440 USE OF BELIMUMAB IN CLINICAL PRACTICE. CLINICAL AND SEROLOGICAL EFFECTIVENESS AND CORTICOSTEROID-SPARING ACTIVITY

Autor: S. Vela-Bernal, E. Fuertes, P. Albiol, I. de la Morena, C. Bea, A. I. de Gracia, A. de Castro, L. Navarro, M. J. Forner
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 81:1348.1-1348
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2022-eular.3863
Popis: BackgroundSince 2011, the use of Belimumab for the treatment of Systemic Lupus Erythematosus (SLE)has demonstrated efficacy and safety in several randomised clinical trials. However, strict inclusion criteria may restrict those results limiting the interpretation of these results to routine clinical practice populations.ObjectivesThe aim of this study was to analyse the profile of patients using Belimumab as well as the clinical, serological and corticosteroid-sparing outcomes that may result from it use.MethodsRetrospective cohort study including patients diagnosed with SLE and treated with Belimumab. Epidemiological, clinical and analytical data were collected at 6, 12 and 24 months before and after starting treatment with Belimumab. To assess effectiveness, the SELENA-SLEDAI, SLICC, clinical changes, concomitant treatments, corticosteroid dose and ds-DNA and C3-C4 levels were used.Safety was evaluated by assessing the need and cause for discontinuation of Belimumab.ResultsThirty-one patients were included, mostly 28 (90.32%) women, with a mean age of 48.55 ± 1.95 years and a mean time of disease progression since diagnosis of 16.13 ± 1.77 years. The most prevalent affection before initiation of Belimumab were joint (83.87%), systemic (58.06%), skin (29.03%) and nephropathy (22.58%). The mean SELENA-SLEDAI score before Belimumab was 5.32 ± 0.46; 64.5% had elevated anti-dsDNA, 48.39% and 54.84% had low C3 and C4 levels, respectively.Before starting Belimumab, the most used treatments were both antimalarials (72.4%) and corticosteroids (80.6%). The main reason for starting Belimumab was the ineffectiveness of previous treatments (67.7%). The vast majority of patients were treated subcutaneously (90.3%) and there were no major adverse events leading to drug withdrawal, with a median duration of use of 19.3 months (IQR: 9.75-35.55).ConclusionAfter starting Belimumab, a decrease in the SELENA-SLEDAI activity scale, an increase in C3 and C4 levels, and a significant decrease in anti-dsDNA levels at 6 months were observed.At 12 and 24 months, continuity of this trend was observed, although statistical significance was not reached. As concerns corticosteroids, we observed a decrease in steroid use below 7.5mg/day and even 5mg/day after the introduction of Belimumab avoiding the undesirable effects of prolonged steroid use.Table 1.BEFORE BELIMUMAB (n=31)6 MONTHS (n=28)12 MONTHS (n=22)24 MONTHS (n=9)ESLEDAI x̄ (SD)5,32 (0,46)2,28 (0,44)2,90 (0,72)3,44 (1,39)PPp>0,05High dsDNA - n (%)18 (58,06)14 (61,29)14 (45,16)4 (12,9)PP=0,036P=0,7Low C3 (15 (48,39)11 (35,48)9 (29,03)3 (9,68)P=0,006P=0,193P=0,06Low C4 (17 (54,84)14 (45,16)11 (35,48)5 (16,13)PP=0,003P=0,217)Figure 1.Disclosure of InterestsNone declared
Databáze: OpenAIRE
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