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Belimumab Brand Names- Benlysta | Benlysta SC
What is Belimumab
Belimumab is a human monoclonal antibody that inhibits B lymphocyte stimulator protein (BLyS). Inhibition of BLyS inhibits the survival of B cells including autoreactive B cells and reduces the differentiation of B cells into immunoglobulin-producing plasma cells.
Belimumab is indicated as an adjunct to standard therapy for the treatment of active, autoantibody-positive, systemic lupus erythematosus (SLE).
Standard SLE therapy includes corticosteroids, antimalarials, NSAIDs, and/or immunosuppressants (e.g., azathioprine, mycophenolate, or methotrexate). While the ACR and EULAR guidelines for the management of SLE do not mention the use of belimumab, these guidelines were published before the drug’s availability.
NICE guidelines recommend that belimumab only be used as add-on therapy if the patient has a Safety of Estrogen in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score of 10 or more despite standard treatment; continued belimumab treatment beyond 6 months is only recommended if the SELENA-SLEDAI score is reduced by 4 points or more.
Intravenous use of belimumab is associated with infusion-related reactions, and the symptoms of these reactions may overlap with those noted with hypersensitivity reactions.
Serious and sometimes fatal hypersensitivity reactions and infections have been reported in patients receiving biologic immunosuppressive agents, including both intravenous and subcutaneous belimumab.
Indications
- systemic lupus erythematosus (SLE)
For the treatment of active, autoantibody-positive, systemic lupus erythematosus (SLE) in combination with standard therapy
Side Effects
- anaphylactic shock
- angioedema
- antibody formation
- anxiety
- bradycardia
- cystitis
- depression
- diarrhea
- dyspnea
- edema
- erythema
- fatigue
- fever
- headache
- hematoma
- hypotension
- infection
- infection
- influenza
- infusion-related reactions
- injection site reaction
- insomnia
- leukoencephalopathy
- leukopenia
- migraine
- myalgia
- nausea
- new primary malignancy
- pharyngitis
- pruritus
- rash
- sinusitis
- suicidal ideation
- urticaria
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- Black patients
- breast-feeding
- contraception requirements
- depression
- geriatric
- immunosuppression
- infants
- infection
- infusion-related reactions
- neonates
- new primary malignancy
- pregnancy
- progressive multifocal leukoencephalopathy
- psychiatric event
- reproductive risk
- requires an experienced clinician
- serious hypersensitivity reactions or anaphylaxis
- suicidal ideation
- vaccination
Interactions
- Cyclophosphamide
- Live Vaccines
- Ocrelizumab
- Ofatumumab
- Rituximab
- Rituximab; Hyaluronidase
- Tumor Necrosis Factor modifiers
