Belimumab therapy provides better outcome in patients with Cutaneous Lupus Erythematosus

A new study conducted by Rachel Kneeland and team shows that significant belimumab-induced cutaneous clinical responses (44%–55%) and a 50% reduction in flare risk over the course of a year in patients with cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE), respectively. The findings of this study were presented at American College of Rheumatology Convergence 2022.

With or without SLE, SLE can be very disabling, leave behind substantial scarring, and lead to psychological suffering. One of only four drugs for SLE that the FDA has authorized is belimumab, a monoclonal antibody that prevents B-cell activation. Less is known, however, about belimumab's usage in CLE with or without SLE. Furthermore, it is uncertain when individuals with cutaneous illness will respond to belimumab, which might cause them to stop treatment too soon if there aren't any immediate improvements. Therefore, the goals of this meta-analysis were to investigate: a) the effectiveness of belimumab; b) the time to response following belimumab administration in patients with CLE with or without SLE.

The primary outcome was investigated using a random effects modeling (rma) in R to compare clinical response at 52 weeks between belimumab users and non-users. A reduction in the cutaneous domain from a baseline BILAG A or B score to a BILAG score of B-E was considered a clinical response. The time it took to establish a sustained response in CLE with or without SLE after initiating belimumab was also determined, along with the pooled odds ratio for each successive 4-week observation period. Finally, 52-week pooled probabilities of cutaneous flares in belimumab users compared to non-users were combined. Using I2, heterogeneity was evaluated.