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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.

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EULAR 2024 - Day 1 Report

Jack Cush, MD Jun 12, 2024

Wednesday was Day One at EULAR 2024 in Vienna. While the day was a slow start, the poster halls and auditoriums quickly filled with thousands of rheumatologists, eager to reunite at this international educational forum. Below are a few of my favorites from Day 1.

#EULAR2024 OP0145 Can we reclassify people with ANA+ RMD to improve clinical outcomes & stratify for basket trials? Deep machine learning identified distinct classes of ANA-RMD with distinct phenotypes & predicted long-term outcomes better than the legacy diagnoses @RheumNow https://t.co/W2hmmj0v8Y

https://twitter.com/Yuz6Yusof/status/1801179216769139144/photo/1

#EULAR2024 OP0149 When the Doctor says YES but the patients say NO. Data from UK BILAG-BR in moderate to severe #lupus showed ~half patients who met clinical response did not improve their psychological wellbeing. Factors of discordant: ancestry, damage, SLEDAI-2K @RheumNow https://t.co/9cqcPripA2

https://twitter.com/Yuz6Yusof/status/1801182856523251734/photo/1

#EULAR2024 OP0180 Can we safely taper GC in #lupus patients who are in remission? Single study in Italy showed in pts with SLEDAI=0 + pred =<5mg/d + stable IS/HCQ, GC discontinuation after proper tapering appeared safe and was associated with a low risk of flare @RheumNow https://t.co/8IIgPuZUrF

#EULAR2024 OP0187 Can we identify a subgroup of #lupus patients at the outset who may benefit from early intensive therapies inc biologics? Data from an inception cohort showed low complement & cSLEDAI=>9 were assoc w increased risk of intensive therapy need/Tx failure @RheumNow https://t.co/jmahjcqom3

A fantastic tool LupusGPT by @LupusEurope for our patients to help self-manage #SLE was launched yesterday. Building on information from Lupus100 & supplemented by scientific data and relevant guidelines. I have tried it and worked well. Please disseminate https://t.co/a1qXGZyRE6 https://t.co/LTQM6A8Zq3

#EULAR2024 OP0206 In a cohort study, of pts with #lupus nephritis, 81% tapered IS ~32 mths post-renal response. Of this, 17% flared. Strategies for safe tapering: ensure CR is achieved, low SLEDAI-2K at 12mths, low SLEDAI-2K & on HCQ at the time of tapering initiation @RheumNow https://t.co/hAMAdsL7Jn

https://twitter.com/Yuz6Yusof/status/1801236983794078190/photo/1

#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

#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

#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

Can you ⬇️ #Glucocorticoids or #immunesuppressive in #SLE & change am’t of damage From Asia Pacific #lupus collab (Biologics not included) Compared 7.5 mg #prednisone or less Or DMARD 1/2 flared after LLDAS ⬇️dose didn’t prevent damage #EULAR2024 @eular_org @RheumNow https://t.co/QmjEz87Cvw

https://twitter.com/Janetbirdope/status/1801192968524538095/photo/1

#EULAR2024 Cutaneous #lupus is variable & can be difficult to treat. Promising post-hoc data frm Phase 2 RCT showing Deucravacitinib (Tyk2-i) led to improvement & sustained CLASI-50 response in all subtypes (ACLE, SCLE, Chonic and Discoid) @RheumNow #EULARBEST https://t.co/ArAzdLYiYY

#EULAR2024 OP0043 Data from UK BILAG-BR registry showed in n>100 patients w neuropsychiatric #lupus (NPSLE), over 2/3 improved with rituximab. NPSLE tended to occur with other #SLE features and with high level of organ damage @RheumNow https://t.co/q5olZgr6Pt

https://twitter.com/Yuz6Yusof/status/1801123910437482766/photo/1

#EULAR2024 OP0077 How can we improve Bcell killing and does deep depletion matter? Biomarkers from RCT showed Obinutuzumab led to profound circulatory depletion in #lupus nephritis & those w sustained depletion had better complete renal response than those who didn’t @RheumNow https://t.co/2KTZBR2njk

https://twitter.com/Yuz6Yusof/status/1801116419540586582/photo/1

Who needs intensive therapy in #lupus Intensive Rx in #SLE from 2 inception cohorts in Leeds Either #Cyclo or #biologics ⬆️ If low complement Within 2 yrs after #dx #SLEDAI >9 AntiRo+ OP0187 #EULAR2024 @RheumNow @eular_org https://t.co/oKhwMmHhSs

3 facts in #lupus to make you think 🤔 💧biomarkers in #SLE blood & #urine May predict #activity OP0255 #Membranous #nephritis is serious in SLE @ZahiTouma POS0732 #prednisone dose irrelevant for #damage if in LLDAS -no diff between 7.5mg vs 5mg OP0124 #EULAR2024 @RheumNow

#Hope for patients with #active #SLE The next hurdle is getting through ▶️Phase3 #RCTs And ▶️Obtaining drug reimbursement so patients can get access to effective #lupus #Rx #EULAR2024 @RheumNow @eular_org https://t.co/sGzQXO4A2r

https://twitter.com/lupusreference/status/1800914620653420937

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Belimumab’s Sustained Impact in Lupus

EULAR 2024 - Day 1 Report

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