Treatment With Belimumab Showed Improvement In Symptoms In 46 Percent Of Lupus Patients At 52 Weeks

Main Category: Lupus
Also Included In: Clinical Trials / Drug Trials
Article Date: 19 Jun 2007 - 18:00 PDT

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Treatment with belimumab resulted in a sustained improvement of systemic lupus erythematosus (SLE or lupus) disease activity in 46% of patients at week 52, according to a novel combined responder index in results presented at EULAR 2007, the Annual European Congress of Rheumatology in Barcelona, Spain.

Historically, it has been difficult to adequately measure the therapeutic responses to drug intervention in SLE patients, due to the diverse presentations of the disease itself. A novel combined responder index which takes into account three commonly used measures of disease progression -- SELENA SLEDAI (SS), physician global assessment (PGA) and presence of BILAG-classified flares (new 1A or 2B) -- was utilised by the research team to analyse the effect of the BLyS inhibitor belimumab on the progression of SLE disease activity.

Lead author Dr Ellen Ginzler, of SUNY-Downstate Medical Center, New York, US, commented: "While the results demonstrated that treatment with belimumab resulted in a sustained improvement in SLE symptoms in patients with serologically active disease, we also confirmed that combining multiple disease activity measures is a successful method of assessing overall disease activity, and appears to be associated with the presence of biomarkers and quality of life improvements in responders."

Patients enrolled in this 52 week randomised, double-blind, placebo-controlled study received belimumab in doses of 1mg/kg, 4mg/kg and 10mg/kg or placebo plus SLE standard therapy. Overall, ~70% of subjects were taking prednisone and/or anti-malarials such as plaquenil ( used in SLE treatment regimes); 50% of these subjects were also taking an immunosuppressive drug (e.g., methotrexate, azathioprine, mycophenolate, leflunomide). The 449 patients entering the study were evaluated according to the disease activity measurement scores SS and Disease Activity Index, PGA, BILAG, SF-36 and biomarkers including B-cell subsets and autoantibodies. 71.5% of the initial 449 patients entered the study with baseline serological activity. An evidence-based combined endpoint was developed that incorporates a response parameter and controls against worsening in other organ systems.

A combined response, consisting of an improvement in SS score of 4 points or more, with no new BILAG 1A or 2B flares, and no worsening in PGA (<0.3 point increase), was observed in serologically-active patients at week 52 (46% belimumab versus 29% placebo, p=0.006) and improved further to 56% for the belimumab-treated population at week 76. Responders had a greater reduction in activated B-cells (36% responders versus 20% non-responders, p=<0.05). A greater reduction in anti-dsDNA, (antibodies created against human double stranded DNA commonly found in patients with SLE(, was also found in responders (53% responders versus 38% non-responders, p=<0.05). Responders additionally reported a greater improvement in SF-36 Physical Component Summary score (PCS; increase =4.1, MCID =2.5) at week 52 than non-responders (increase =1.0, p=<0.001).

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Article adapted by Medical News Today from original press release.
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Systemic lupus erythematosus (SLE or lupus) is a chronic autoimmune disease that is potentially debilitating and sometimes fatal as the immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage. The course of the disease is unpredictable, with periods of illness (called flares) alternating with periods of inactivity (remission). SLE is found most commonly in women.

Belimumab

Belimumab (LymphoStat-B) is a human monoclonal antibody that inhibits the biological activity of the B-lymphocyte stimulator (BLyS). BLyS is a naturally occurring soluble protein required for the development of B-lymphocytes into mature plasma B cells which produce antibodies. In SLE, elevated levels of BLyS are believed to contribute to the production of autoantibodies involved in damage to the body's own healthy tissues, a key marker of SLE disease activity. B-cell antagonists or inhibitors such as belimumab are believed to reduce autoantibody levels and help control SLE autoimmune disease activity.

Abstract number: OPO018

About EULAR

* The European League Against Rheumatism (EULAR) is the organization which represents the patient, health professional and scientific societies of rheumatology of all the European nations.

* The aims of EULAR are to reduce the burden of rheumatic diseases on the individual and society and to improve the treatment, prevention and rehabilitation of musculoskeletal diseases. To this end, EULAR fosters excellence in education and research in the field of rheumatology. It promotes the translation of research advances into daily care and fights for the recognition of the needs of people with musculoskeletal diseases by the governing bodies in Europe.

* Diseases of bones and joints, such as rheumatoid arthritis and osteoarthritis cause disability in 4 - 5 % of the adult population and are predicted to rise as people live longer.

* As new treatments emerge and cellular mechanisms are discovered, the 8th Annual European Congress of Rheumatology in Barcelona (EULAR 2007) brings together more than 10,000 experts - scientists, clinicians, healthcare workers, pharmaceutical companies and patients - to share their knowledge in a global endeavour to challenge the pain and disability caused by musculo-skeletal disorders.

* To find out more information about the activities of EULAR, visit: http://www.eular.org/

Contact: Rory Berrie
European League Against Rheumatism