Background Baseline profile of systemic lupus erythematosus patients on treatment with Belimumab of a Spanish multicenter cohort.
Methods Multicenter retrospective and longitudinal cohort study. Data was collected at baseline, 6, 12 months and in the last visit available. Different periods (2010–2015/2016–2021) were compared.
Results 324 patients (91% female) were enrolled. Mean (±SD) age at diagnosis: 31.8 years (±11.9); mean disease duration of 8.7 years (±9.07). At baseline, mean SLEDAI-2K score was 10.4 (±5.25); 152 (47.5%) patients had damage with a mean SDI score of 0.83 (±1.2). 289 patients (89.2%) had received DMARDs before BLM: cDMARDS in 282 (87%) and bDMARDs in 74 patients (22.8%); 164 (51.9%) had received more than one cDMARDs, methotrexate being the most frequently used (44.4%) and Rituximab the most frequent bDMARDs used (80%). Antimalarials were used in 83,2% and glucocorticoids (GC) in 91.2%, with a mean dose of 12.3 mg/day. 67.9% of patients were receiving more than 5 mg/day and 58.4% more than 7.5 mg/day of prednisone. BLM was used in monotherapy in 30.5% of subjects. Reasons of prescription: disease activity in 95% of patients and/or as a GC sparing agent in 59%. Only a few patients received BLM just for maintenance (4/322) or save GC (8/322). At baseline, 6 patients (1.9%) were in DORIS-21-remission and LLDAS. The main reasons of prescription for ongoing activity were arthritis (65.4%), cutaneous (40.7%) or both (81%). No differences were observed in prescription reasons between periods.
Conclusions Belimumab was mainly prescribed after the use of other DMARDs and more than 50% had received at least 2 DMARDs and were receiving GC at medium doses. Most patients received BLM due to active disease and/or as GC sparing agent. Activity in articular and cutaneous domains were the main reasons of indication. No changes in prescription habits were identified.
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