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  • P147 Is belimumab dose optimization possible in patients with systemic lupus erythematosus? Analysis of this therapeutic strategy in a large multicenter cohort of patients from Spanish rheumatology departments

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P147 Is belimumab dose optimization possible in patients with systemic lupus erythematosus? Analysis of this therapeutic strategy in a large multicenter cohort of patients from Spanish rheumatology departments
  1. Irene Altabás-González1,
  2. José María Pego-Reigosa1,
  3. Norman Jiménez1,
  4. Andrea Hernández-Martín2,
  5. Judit Font Urgelles3,
  6. Ivette Casafont-Sole3,
  7. Marta de la Rubia Navarro4,
  8. José Andrés Román Ivorra4,
  9. María Galindo Izquierdo5,
  10. Tarek Salman Montes6,
  11. Javier Narváez7,
  12. Paola Vidal-Montal7,
  13. María Jesús García-Villanueva8,
  14. Sandra Garrote8,
  15. Carlos Marras Fernández9,
  16. María Piqueras García9,
  17. Julia Martínez Barrio10,
  18. Marina Sánchez Lucas10,
  19. Josefina Cortés Hernández1,
  20. Eleonora Penzo11,
  21. Jaime Calvo Alen12,
  22. Juan Ramón de Dios12,
  23. Eva Tomero13,
  24. Raúl Menor Almagro14,
  25. Myriam Gandía Martínez14,
  26. Jos A Gómez-Puerta15,
  27. Beatriz Frade-Sosa15,
  28. Consuelo Ramos Giraldez16,
  29. Carmen Trapero Pérez16,
  30. Elvira Díez Álvarez17,
  31. Clara Moriano17,
  32. Alejandro Muñoz Jiménez18 and
  33. Iñigo Rúa-Figueroa2
  1. 1Rheumatology Dept., IRIDIS Group, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
  2. 2Rheumatology Dept., Hospital Doctor Negrín, Las Palmas de Gran Canaria, Spain
  3. 3Rheumatology Dept., Hospital Universitario Germans Trias i Pujol, Badalona, Spain
  4. 4Rheumatology Dept., Hospital Universitario y Politécnico La Fe, Valencia, Spain
  5. 5Rheumatology Dept., Hospital 12 de octubre, Madrid, Spain
  6. 6Rheumatology Dept., Hospital del Mar, Barcelona, Spain
  7. 7Rheumatology Dept., Hospital Universitario de Bellvitge, Barcelona, Spain
  8. 8Rheumatology Dept., Hospital Universitario Ramón y Cajal, Madrid
  9. 9Rheumatology Dept., Hospital Virgen de la Arrixaca, Murcia, Spain
  10. 10Rheumatology Dept., Hospital General Universitario Gregorio Marañón, Madrid, Spain
  11. 11Rheumatology Dept., Hospital Universitario Valle d´Hebron, Barcelona, Spain
  12. 12Rheumatology Dept., Hospital Universitario Araba, Vitoria, Spain
  13. 13Rheumatology Dept., Hospital Universitario de La Princesa, Madrid, Spain
  14. 14Rheumatology Dept., Hospital Universitario de Jerez, Cádiz, Spain
  15. 15Rheumatology Dept., Hospital Clinic de Barcelona, Barcelona, Spain
  16. 16Rheumatology Dept., Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain
  17. 17Rheumatology Dept., Hospital Universitario de León, León, Spain
  18. 18Rheumatology Dept., Hospital universitario Virgen del Rocío, Sevilla, Spain

Abstract

Objective To assess the prevalence of dose optimization in patients with SLE treated with BLM, its modalities and its impact on disease activity control.

Methods Retrospective longitudinal and multicenter study of SLE patients treated with BLM in Spain. Activity (SLEDAI), treatments and outcomes (remission (DORIS-2021) and low disease activity (LLDAS) were collected at baseline (pre-optimization) (VB), at 6 (V6M) and at 12 months (V12M) post optimization. A comparative analysis was performed pre- and post-optimization.

Results 324 patients were included; mean age (±DS): 42.4 (±12.9) years. A total of 29 patients (8.9%) were optimized. Median time to optimization 2.7 (1.77–4.48) years. Mean time on optimization: 11.36 (±2.5) months. BLM was administrated intravenously (iv) in 20 patients and 9 used the subcutaneous route (sc). A total of 15/20 iv BLM patients had their dose reduced (from 10mg/kg to 5–9 mg/Kg). Other 5/20 iv BLM patients, had their administration interval increased (from 4 weeks to 5–6 weeks). All sc BLM patients increased the interval of administration (from 7 to 10–21 days).

Pre-optimization status (VB): 15/26 (57.7%) in DORIS-21 and 23/26 (88.5%) in LLDAS. Post-optimization: 2/24 (8.3%) and 3/22 (13.6%) patients lost DORIS-21 in V6M and V12M, respectively (no statistically significant differences). Regarding to LLDAS, 2/23(8.7%) and 2/21(9.5%) did so in V6M and V12M, respectively (no statistically significant differences). Out of 11/23(47.8%) and 9/21(42.9%) moved from SLEDAI 0 to SLEDAI >0 in V6M and V12M, respectively. In terms of disease activity, no significant differences were found pre- and post-optimization in any of the measures, except for hypocomplementemia (p = 0.0276). Changes in activity did not lead to relevant changes in treatment. Significantly fewer patients received GC in V12M, even though the median dose of GC was higher in V12M (5 (0.62–8.75) vs. 2.5 (0–5) in (VB) (table 1).

Conclusions It is possible to optimize doses of BLM without relevant changes in disease activity, at least in the short term, in a significant percentage of patients, and the most of them maintain the optimized dose. However, the increased clinical or serologic activity is possible in some patients. This makes a tighter post-optimization follow-up advisable.

View this table:
Abstract P147 Table 1

Clinical, serological and treatment differences between pre and post BLM treatment

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/lupus-2024-el.201

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