Background In 2017, Belimumab (BEL) was approved in subcutaneous (SC) version.1 The effectiveness after switching from intravenous (IV) to SC and patient satisfaction in daily clinical practice has not been studied. During the pandemic, patient follow-up and treatment were significantly affected, including the administration of IV biologic therapies. In some patients, a change from IV to SC, including BEL therapy, was required.2 Our aim was to evaluate in daily clinical practice satisfaction to BEL SC therapy in patients previously treated IV BEL. We hypothesized that SC BEL in SLE patients previously treated with IV BEL was similar in effectiveness and conferred higher satisfaction.
Methods Observational, multicenter study, conducted in 7 reference centres in Catalonia (Spain). Inclusion criteria: Stable SLE patients (EULAR/ACR 2019) on treatment with BEL SC and previous use of BEL IV (at least 3 months of treatment with BEL IV before switching).
Since there are no well-validated tools for SC BEL treatment satisfaction, we used RASQ-SC, validated in patients with lymphoma who switched from Rituximab IV to SC treatment,3 modified for BEL treatment.
Results Twenty-seven patients were included. Demographic and general characteristics are summarized in table 1. The mean time from treatment with BEL IV before switch to SC was 26 (SD 21) months. 84% of patients reported confidence in BEL SC. 80% felt that treatment with BEL SC was convenient or very convenient. 85% felt they had gained time with the change. 89% would recommend the SC injection to other patients (figure 1a,b,c,d). Disease activity (mean SLEDAI) and remission rates remain stable after switching (see table 1). No major new side effects were reported.
Conclusions Overall satisfaction, satisfaction with via of administration and satisfaction with the time taken to receive BEL were higher for SC BEL treatment. A switching SC strategy is a reasonable alternative for BEL patients.
Stohl W, Schwarting A, Okada M, et al. Efficacy and safety of subcutaneous belimumab in systemic lupus erythematosus: a fiftytwo-week randomized, double-blind, placebo-controlled study. Arthritis Rheum. 2017;69(5):1016–1027. doi:10.1002/art.40049
Mucke J, Brinks R, Fischer-Betz R, Richter JG, Sander O, Schneider M, Chehab G. Patient satisfaction and disease control in patients with systemic lupus erythematosus is not affected by switching from intravenous belimumab to subcutaneous injections. Patient Prefer Adherence. 2019;13:1889–1894
Theodore-Oklota C, Humphrey L, Wiesner C, Schnetzler G, Hudgens S, Campbell A. Validation of a treatment satisfaction questionnaire in non-Hodgkin lymphoma: assessing the change from intravenous to subcutaneous administration of rituximab. Patient Prefer Adherence. 2016;10:1767–1776
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