Long-term safety profile of belimumab plus standard therapy in patients with systemic lupus erythematosus

Joan T. Merrill, Ellen M. Ginzler, Daniel J. Wallace, James D. McKay, Jeffrey R Lisse, Cynthia Aranow, Frank R. Wellborne, Michael Burnette, John Condemi, Z. John Zhong, Lilia Pineda, Jerry Klein, William W. Freimuth

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Objective. To evaluate the safety profile of longterm belimumab therapy combined with standard therapy for systemic lupus erythematosus (SLE) in patients with active disease. Methods. Patients who were randomized to receive intravenous placebo or belimumab 1, 4, or 10 mg/ kg, plus standard therapy, and completed the initial 52-week double-blind treatment period were then allowed to enter a 24-week open-label extension phase. During the extension period, patients in the belimumab group either received the same dose or were switched to 10 mg/kg and patients in the placebo group were switched to belimumab 10 mg/kg. Patients who achieved a satisfactory response during the 24-week extension period were allowed to participate in the long-term continuation study of monthly belimumab 10 mg/kg. Adverse events (AEs) and abnormal laboratory results were analyzed per 100 patient-years in 1-year intervals. Results. Of the 364 patients who completed the 52-week double-blind treatment period, 345 entered the 24-week extension, and 296 continued treatment with belimumab in the long-term continuation study. Safety data through 4 years of belimumab exposure (1,165 cumulative patient-years) are reported. Incidence rates of AEs, severe/serious AEs, infusion reactions, infections, malignancies, grades 3/4 laboratory abnormalities, and discontinuations due to AEs were stable or declined during 4-year belimumab exposure. The most common AEs included arthralgia, upper respiratory tract infection, headache, fatigue, and nausea. Serious infusion reactions were rare: only 1 occurred during the 4-year followup period. Rates of serious infection decreased from 5.9/100 patient-years to 3.4/100 patientyears, and no specific type of infection predominated. Conclusion. Belimumab added to standard therapy was generally well-tolerated over the 4-year treatment period in patients with SLE, which suggests that belimumab can be administered long term with an acceptable safety profile.

Original languageEnglish (US)
Pages (from-to)3364-3373
Number of pages10
JournalArthritis and Rheumatism
Volume64
Issue number10
DOIs
StatePublished - Oct 2012

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Systemic Lupus Erythematosus
Safety
Therapeutics
Infection
Placebos
belimumab
Arthralgia
Respiratory Tract Infections
Nausea
Fatigue
Headache
Incidence

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Rheumatology
  • Pharmacology (medical)

Cite this

Merrill, J. T., Ginzler, E. M., Wallace, D. J., McKay, J. D., Lisse, J. R., Aranow, C., ... Freimuth, W. W. (2012). Long-term safety profile of belimumab plus standard therapy in patients with systemic lupus erythematosus. Arthritis and Rheumatism, 64(10), 3364-3373. https://doi.org/10.1002/art.34564

Long-term safety profile of belimumab plus standard therapy in patients with systemic lupus erythematosus. / Merrill, Joan T.; Ginzler, Ellen M.; Wallace, Daniel J.; McKay, James D.; Lisse, Jeffrey R; Aranow, Cynthia; Wellborne, Frank R.; Burnette, Michael; Condemi, John; Zhong, Z. John; Pineda, Lilia; Klein, Jerry; Freimuth, William W.

In: Arthritis and Rheumatism, Vol. 64, No. 10, 10.2012, p. 3364-3373.

Research output: Contribution to journalArticle

Merrill, JT, Ginzler, EM, Wallace, DJ, McKay, JD, Lisse, JR, Aranow, C, Wellborne, FR, Burnette, M, Condemi, J, Zhong, ZJ, Pineda, L, Klein, J & Freimuth, WW 2012, 'Long-term safety profile of belimumab plus standard therapy in patients with systemic lupus erythematosus', Arthritis and Rheumatism, vol. 64, no. 10, pp. 3364-3373. https://doi.org/10.1002/art.34564
Merrill, Joan T. ; Ginzler, Ellen M. ; Wallace, Daniel J. ; McKay, James D. ; Lisse, Jeffrey R ; Aranow, Cynthia ; Wellborne, Frank R. ; Burnette, Michael ; Condemi, John ; Zhong, Z. John ; Pineda, Lilia ; Klein, Jerry ; Freimuth, William W. / Long-term safety profile of belimumab plus standard therapy in patients with systemic lupus erythematosus. In: Arthritis and Rheumatism. 2012 ; Vol. 64, No. 10. pp. 3364-3373.
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AU - Ginzler, Ellen M.

AU - Wallace, Daniel J.

AU - McKay, James D.

AU - Lisse, Jeffrey R

AU - Aranow, Cynthia

AU - Wellborne, Frank R.

AU - Burnette, Michael

AU - Condemi, John

AU - Zhong, Z. John

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AB - Objective. To evaluate the safety profile of longterm belimumab therapy combined with standard therapy for systemic lupus erythematosus (SLE) in patients with active disease. Methods. Patients who were randomized to receive intravenous placebo or belimumab 1, 4, or 10 mg/ kg, plus standard therapy, and completed the initial 52-week double-blind treatment period were then allowed to enter a 24-week open-label extension phase. During the extension period, patients in the belimumab group either received the same dose or were switched to 10 mg/kg and patients in the placebo group were switched to belimumab 10 mg/kg. Patients who achieved a satisfactory response during the 24-week extension period were allowed to participate in the long-term continuation study of monthly belimumab 10 mg/kg. Adverse events (AEs) and abnormal laboratory results were analyzed per 100 patient-years in 1-year intervals. Results. Of the 364 patients who completed the 52-week double-blind treatment period, 345 entered the 24-week extension, and 296 continued treatment with belimumab in the long-term continuation study. Safety data through 4 years of belimumab exposure (1,165 cumulative patient-years) are reported. Incidence rates of AEs, severe/serious AEs, infusion reactions, infections, malignancies, grades 3/4 laboratory abnormalities, and discontinuations due to AEs were stable or declined during 4-year belimumab exposure. The most common AEs included arthralgia, upper respiratory tract infection, headache, fatigue, and nausea. Serious infusion reactions were rare: only 1 occurred during the 4-year followup period. Rates of serious infection decreased from 5.9/100 patient-years to 3.4/100 patientyears, and no specific type of infection predominated. Conclusion. Belimumab added to standard therapy was generally well-tolerated over the 4-year treatment period in patients with SLE, which suggests that belimumab can be administered long term with an acceptable safety profile.

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