Advertisement

Efficacy of Belimumab for refractory systemic lupus erythematosus (SLE) involving the central nervous system

  • Author Footnotes
    1 These authors contributed equally to this work.
    Hao Cheng
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Rheumatology, Shanxi Medical University, the Second Hospital of Shanxi Medical University, No.382 WuYi Road, Taiyuan, Shanxi province, China, 030001
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
    Chen-sheng Zhao
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Neurology, Shanxi Provincial Cardiovascular Hospital, No.18 Yifen Street, Taiyuan, Shanxi province, China, 030024
    Search for articles by this author
  • Cheng-lan Yan
    Affiliations
    Department of Rheumatology, Shanxi Medical University, the Second Hospital of Shanxi Medical University, No.382 WuYi Road, Taiyuan, Shanxi province, China, 030001
    Search for articles by this author
  • Chong Gao
    Affiliations
    Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
    Search for articles by this author
  • Hong-yan Wen
    Correspondence
    Corresponding author.
    Affiliations
    Department of Rheumatology, Shanxi Medical University, the Second Hospital of Shanxi Medical University, No.382 WuYi Road, Taiyuan, Shanxi province, China, 030001
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
      Neuropsychiatric manifestations of SLE (NPSLE) is associated with increased morbidity and mortality, intractable, complicating, and poor prognosis [
      • Magro-Checa C
      • Zirkzee EJ
      • Huizinga TW
      • Steup-Beekman GM.
      Management of neuropsychiatric systemic lupus erythematosus: current approaches and future perspectives.
      ,
      • Bertsias GK
      • Boumpas DT.
      Pathogenesis, diagnosis and management of neuropsychiatric SLE manifestations.
      ,
      • Kampylafka EI
      • Alexopoulos H
      • Kosmidis ML
      • Panagiotakos DB
      • Vlachoyiannopoulos PG
      • Dalakas MC
      • et al.
      Incidence and prevalence of major central nervous system involvement in systemic lupus erythematosus: a 3-year prospective study of 370 patients.
      ]. Although the severity of NPSLE correlates with poor prognosis, no established treatment protocol and resistance to general treatment in many cases are making this condition worse. Existing studies has shown expression of key B cell cytokines such as BAFF and IL-6 were increased in SLE [
      • Aringer M
      • Costenbader K
      • Daikh D
      • et al.
      European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus.
      ,
      • Iaccarino L
      • Andreoli L
      • Bocci EB
      • et al.
      Clinical predictors of response and discontinuation of Belimumab in patients with systemic lupus erythematosus in real life setting. Results of a large, multicentric, nationwide study.
      ]. Belimumab, an anti-BAFF monoclonal antibody, was approved by the FDA for use in treating SLE. Belimumab has recently been used for the treatment of a variety of SLE disease conditions [
      • Aringer M
      • Costenbader K
      • Daikh D
      • et al.
      European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus.
      ]. To date, reports on Belimumab treatment for SLE have covered various conditions, resulting in a decrease in the SLE DAI score, arthropathy, nephropathy, thrombocytopenia and hemolytic anemia, while the effect of Belimumab on refractory NPSLE is still unclear [
      • George-Chandy A
      • Trysberg E
      • Eriksson K.
      Raised intrathecal levels of APRIL and BAFF in patients with systemic lupus erythematosus: relationship to neuropsychiatric symptoms.
      ,
      • Hopia L
      • Thangarajh M
      • Khademi M
      • Laveskog A
      • Wallström E
      • Svenungsson E
      • Andersson M.
      Cerebrospinal fluid levels of a proliferation-inducing ligand (APRIL) are increased in patients with neuropsychiatric systemic lupus erythematosus.
      ].
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Magro-Checa C
        • Zirkzee EJ
        • Huizinga TW
        • Steup-Beekman GM.
        Management of neuropsychiatric systemic lupus erythematosus: current approaches and future perspectives.
        Drugs. 2016; 76: 459-483
        • Bertsias GK
        • Boumpas DT.
        Pathogenesis, diagnosis and management of neuropsychiatric SLE manifestations.
        Nat Rev Rheumatol. 2010; 6: 358-367
        • Kampylafka EI
        • Alexopoulos H
        • Kosmidis ML
        • Panagiotakos DB
        • Vlachoyiannopoulos PG
        • Dalakas MC
        • et al.
        Incidence and prevalence of major central nervous system involvement in systemic lupus erythematosus: a 3-year prospective study of 370 patients.
        Plos One. 2013; 8: e55843
        • Aringer M
        • Costenbader K
        • Daikh D
        • et al.
        European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus.
        Ann Rheum Dis. 2019; 78: 1151-1159
        • Iaccarino L
        • Andreoli L
        • Bocci EB
        • et al.
        Clinical predictors of response and discontinuation of Belimumab in patients with systemic lupus erythematosus in real life setting. Results of a large, multicentric, nationwide study.
        J Autoimmun. 2018; 86: 1-8
        • George-Chandy A
        • Trysberg E
        • Eriksson K.
        Raised intrathecal levels of APRIL and BAFF in patients with systemic lupus erythematosus: relationship to neuropsychiatric symptoms.
        Arthritis Res Ther. 2008; 10: R97
        • Hopia L
        • Thangarajh M
        • Khademi M
        • Laveskog A
        • Wallström E
        • Svenungsson E
        • Andersson M.
        Cerebrospinal fluid levels of a proliferation-inducing ligand (APRIL) are increased in patients with neuropsychiatric systemic lupus erythematosus.
        Scand J Rheumatol. 2011; 40: 363-372
        • Basta F
        • Fasola F
        • Triantafyllias K
        • Schwarting A.
        Systemic Lupus Erythematosus (SLE) therapy: the old and the new.
        Rheumatol Ther. 2020; 7: 433-446
        • Tanaka Y.
        Recent progress in neuropsychiatric systemic lupus erythematosus.
        Brain Nerve. 2013; 65 (Japanese. PMID: 24200603): 1255-1267