Systemic lupus erythematosus (SLE) is a chronic inflammatory systemic autoimmune disease. Recurrent relapses of disease and development of long-term organ damage are two key unsolved clinical problems. Belimumab is the only FDA-approved biological agent for SLE. Data showed that treatment with belimumab on the background of standard therapy was effective in active SLE patients. However, the efficacy of low-dose belimumab for prevention of disease flares in SLE patients with low disease activity is to be explored.
Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease with the incidence of about 70/100,000 in China. Recurrent relapses of disease and development of long-term organ damage are two key unsolved clinical problems. Its pathogenesis is still unclear, but B cells have been confirmed to play a vital role in it. Belimumab, a B-lymphocyte stimulating factor (Blys) inhibitor, was the only FDA-approved biological agent for SLE. BLISS-52 showed that more active lupus patients had their SELENA-SLEDAI score reduced by at least 4 points during 52 weeks with belimumab 10 mg/kg (58% vs 46%, p=0·0024) than with placebo. But there was limited data about belimumab in SLE patients with low disease activity. Our previous study indicated that even these patients still have an annual flare rate of 30-40%. Therefore, we try to explore whether low-dose of belimumab could prevent the disease flares in SLE patients with low disease activity.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
231
Shuang Ye, MD
Shanghai, Shanghai Municipality, China
Percentage of patients with disease flares
Disease flare is defined by modified SELENA-SLEDAI SLE flare index (SFI).
Time frame: 52 weeks
Percentage of patients with mild/moderate flares
Disease flare is defined by modified SELENA-SLEDAI SLE flare index (SFI).
Time frame: 52 weeks
Percentage of patients with major flares
Disease flare is defined by modified SELENA-SLEDAI SLE flare index (SFI).
Time frame: 52 weeks
Time to first disease flare
Time to first disease flare
Time frame: 52 weeks
prednisone dose at each visit
compare the prednisone dose at each visit
Time frame: 52 weeks
SELENA-SLEDAI score at each visit
compare the disease activity measured by SELENA-SLEDAI score at each visit
Time frame: 52 weeks
BiLAG score at each visit
compare the disease activity measured by BILAG score at each visit
Time frame: 52 weeks
The percentage of patients achieving prednisone-free successfully
the percentage of patients achieving prednisone-free successfully
Time frame: 52 weeks
Number of participants with adverse events as assessed by CTCAE v4.0
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the safety of belimumab
Time frame: 52 weeks