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Belimumab’s Sustained Impact in Lupus

Mrinalini Dey, MBBChir, MA(Hons) Cantab., MRCP, FHEA Jun 13, 2024

In the wake of the EULAR 2023 guidelines on the management of SLE, it is perhaps pertinent that the EULAR 2024 congress features three abstracts from a large integrated analysis from five international Phase 3 belimumab trials in adults with active SLE (BLISS-76, BLISS-52, North East Asia, EMBRACE and BLISS-SC). Participants were randomised to belimumab (10 mg/kg/month intravenously or 200 mg/week subcutaneously) or placebo, plus standard therapy.

#EULAR2024 POS0152 How prevalent is severe refractory #lupus? Multicentre cohort in Asia defined this as SLEDAI-2K=>10 + on GC + immunosuppressant. One in 7 met this definition, assoc w high activity & low T2T achievement. Useful for sample size calc for clinical study @RheumNow https://t.co/bq4gxX7kjI

https://twitter.com/Yuz6Yusof/status/1801213114760704445/photo/1

#EULAR2024 POS0191 Development and validation of plasma biomarkers to predict #lupus flare in the next 12 weeks. Quick turnover results. Need to focus on steps to bring these novel tools from bench to clinical practice @RheumNow https://t.co/64EppGI7bv

OP0201- clinical characteristics of pts failing ≥2 b/tsDMARDs D2T RA pts characterised by ⏰ Earlier disease ⏰ Later initiation of DMARD therapy Discontinuation of drugs mainly due to inefficacy regardless of number of drug lines or MOAs used #EULAR2024 @RheumNow

#EULAR2024 OP0008 Phase 2 #Sjogren RCT Iscalimumab, anti-CD40mAb in two cohorts (1=High systemic activity; 2=High symptom burden but low systemic) showed sustained improvement in ESSDAI & ESSPRI at 48wks in ISC-ISC group, as well as those switched at 24wks from PBO-ISC @RheumNow https://t.co/GuifDHA0lK

#EULAR2024 OP0089 Promising data from Phase 2 RCT on dual blockade depletion & BAFF-R-i, Ianalumab in #lupus. After 24 wks double-blind, sustained response (SRI-4 + Pred ≤5mg/d or ≤ BL dose) was seen in IAN-IAN group while PBO-IAN improved in open label phase at 48wks @RheumNow https://t.co/MUo76ii4vB

https://twitter.com/Yuz6Yusof/status/1801149630542946445/photo/1

12-week ARGO Phase 2 trial data of IL-17A- and IL-17F-inhibiting Nanobody sonelokimab delivers rapid onset and robust levels of clinical response, including high-threshold outcomes, compared with placebo in patients with active PsA, with a favorable benefit–risk profile. It met… https://t.co/4wj222FkzP https://t.co/ipUSjKvpuB

OP0140-When should we give #pneumococcal #vaccine to pts starting MTX? Study in RA:PCV13 vaccine given 1 month BEFORE starting MTX leads to higher immunological response at 1m, vs pts vaccinated simultaneously w MTX ⏩Vaccinate patients before starting MTX! @RheumNow #EULAR2024

When patients say their joints are swollen, what does it mean? Easy to dismiss it as a symptom, but this clinically suspect arthralgia cohort from Leiden shows: - some correlation with MRI/USS findings - predicts RA development still worthwhile! #EULAR2024 POS0609 @RheumNow https://t.co/dw2p5Eo26C

https://twitter.com/drdavidliew/status/1801220393036038147/photo/1

#Editors Picks @eular_org @ARD_BMJ @ACR_Journals Can #rheumatologists effectively #dx of #ankylosing #spondylitis? 👍 552 pts - 1/3 axSpA w high certainty Certainty of #dx changed over time 2 features #sacroileitis good #nSAID response #EULAR2024 @RheumNow https://t.co/NN3GZTmgn9

#EULAR2024 OP0059 Propensity match scoring of 179 pts w #lupus nephritis in AURA & AURORA1 vs ALMS. Triple therapy (voclosporin + MMF2g/d + low dose GC) led to earlier, greater reduction in proteinuria, & improved safety profile vs dual (MMF3g/d or Cyclo + High dose GC) @RheumNow https://t.co/UdcuaRTtzC

#EULAR2024 OP0017 If one target isn’t enough, why not two! Open label Phase I showed a double-pronged approach, compound BCMA-CD19 CAR Tcells (cCAR) improved clinical response, autoabs elimination & minimal infection in severe refractory #lupus nephritis @RheumNow #EULARBEST https://t.co/6MPHZKxKTB

https://twitter.com/Yuz6Yusof/status/1801133508699586601/photo/1

Combination of GOL/MTX was not significantly superior in reducing PASDAS-measured disease activity at 24 weeks. First line treatment of early, DMARD naïve PsA with MTX 25 mg/week and CS produced effective disease control. There was low utilisation of bDMARDs at 52 weeks in both… https://t.co/aEg9rw4evM https://t.co/prDtnHm793

I think you can guess why in the USA many Pts with #immunesuppressives In #chronic #diseases? IT IS the 💵 cost of #medications in uninsured pts #EULAR2024 @RheumNow @ACRheum @eular_org A call for #equitable #fair #pharmacare #EULARBEST https://t.co/VRnmKrf3DZ

We’ve got better at treating RA over the last 20 years, and it’s genuinely saving lives. Something to be very proud of. Let’s not forget that! 5y mortality from DANBIO 🇩🇰 (still, we still have work to do in seropos RA in men!) #EULAR2024 OP0162 @RheumNow https://t.co/RfvABXhPvS

https://twitter.com/drdavidliew/status/1801183966709628934/photo/1

Join us live for the RheumNow Daily Recap Series, starting today at 12 PM EST! Get the latest insights and updates from #EULAR2024. Don’t miss out on expert analysis and engaging discussions. See you there! https://t.co/pnEI9WKssL

#EULAR2024 @RheumNow https://t.co/nXpDI52R2U

https://twitter.com/DrMiniDey/status/1801187162534052223/photo/1

OP0181- What are the best drugs to treat D2T RA? In this cohort of 185 pts, switching biologic or JAKi improved disease activity & was considered to be effective for patients with D2TRA, regardless of mode of action @RheumNow #EULAR2024

10 baseline predictors for achieving treatment response to Secukinumab in the EuroSpA study. Having non-radiographic disease was a negative predictor of obtaining LDA at 6 months and remaining on treatment at 12 months in European axSpA patients initiating secukinumab.… https://t.co/HrRnoDzSPP https://t.co/Gp1KZmPych

OP0165- incidence & risk factors of D2T RA in an early RA cohort Factors assoc with D2T RA: 🩸 Seropositivity 🦴 Erosions 📈 Disease activity 📊 D2T pts have higher steroid doses & more commonly develop iatrogenic-related #comorbidities, e.g. osteoporosis #EULAR24 @RheumNow

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Belimumab’s Sustained Impact in Lupus

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