Article Text

Download PDFPDF

P33 Cytokine and autoantibody profiles during treatment with belimumab in patients with systemic lupus erythematosus
  1. Ioannis Parodis1,
  2. Emil Åkerström1,
  3. Christopher Sjöwall2,
  4. Azita Sohrabian3,
  5. Andreas Jönsen4,
  6. Alvaro Gomez1,
  7. Martina Frodlund2,
  8. Agneta Zickert1,
  9. Anders A Bengtsson4,
  10. Johan Rönnelid3 and
  11. Iva Gunnarsson1
  1. 1Dept. of Medicine Solna, Karolinska Institutet and Rheumatology, Karolinska University Hospital, Stockholm
  2. 2Dept. of Clinical and Experimental Medicine, Linköping University, Linköping
  3. 3Dept. of Immunology, Genetics and Pathology, Uppsala University, Uppsala
  4. 4Dept. of Clinical Sciences Lund, Lund University, Lund, Sweden


Background Belimumab is approved for the treatment of systemic lupus erythematosus (SLE) since 2011. We investigated whether belimumab treatment impacts on levels of cytokines and autoantibodies of interest in SLE, as well as circulating immune complexes (ICs).

Methods Longitudinally collected serum samples from 78 belimumab-treated SLE patients from the Karolinska, Skåne and Linköping University Hospitals were analysed. Serum cytokine levels and nuclear antigen autoantibody specificities were determined using addressable laser bead immunoassay, and circulating C1q-binding ICs were measured using enzyme-linked immunosorbent assay.

Results In patients with detectable levels at baseline, serum IFN-α2 levels were lower at month 6 (median: 8.9; IQR: 1.5–54.9 pg/mL) versus baseline (median: 28.4; IQR: 20.9–100.3 pg/mL; P=0.043). IL-6 levels decreased from baseline (median: 7.1; IQR: 2.9–16.1 pg/mL) to month 6 (median: 0.5; IQR: 0.5–6.3 pg/mL; P=0.018) and throughout the 24-month follow-up. Levels of IL-10 (baseline median: 12.6; IQR: 2.8–29.7 pg/mL) showed more rapid decreases from month 3 (median: 1.8; IQR: 0.6–9.1 pg/mL; P=0.003). Levels of anti-dsDNA (P<0.001), anti-Sm (P=0.002), anti-SmRNP (P=0.028), anti-U1-RNP (P<0.001) and anti-ribosomal P (P=0.012) antibodies decreased from month 3 and remained decreased over the follow-up. IC levels showed decreases at month 3 (P=0.028), 6 (P=0.009) and 12 (P=0.021). Anti-Sm antibody positivity was associated with higher probability and/or shorter time to achieve sustained SLE Responder Index-4 (HR: 2.52; 95% CI: 1.20–5.29; P=0.015), independently of disease activity and other potential confounding factors (figure 1).

Conclusions In our cohort, belimumab treatment lowered IFN-α2, IL-6, IL-10 and circulating IC levels, as well as levels of multiple autoantibodies against nuclear components. Interestingly, anti-Sm antibody positivity was associated with favourable treatment response.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.