Prospects for the use of belimumab in lupus nephritis

Abstract

Over the past 50 years the survival rate of patients with systemic lupus erythematosus (SLE) significantly improved, however, it is necessary to develop a new generation of drugs for the treatment of lupus nephritis (LN), the development of which is one of the main factors of high mortality risk in at least 50% of SLE patients. The international clinical trial BLISS-LN has demonstrated a high rate of achievement and maintenance of renal response (RR), confirmed by a higher rate of achievement of RR primary efficacy and complete renal response when using belimumab (BLM) in addition to standard therapy (ST) compared to ST alone in patients with LN. When using BLM, there was a statistically significant reduction in the risk of developing adverse renal events (in particular, deterioration of renal function) or death within 104 weeks compared with placebo. Improvement in LN outcomes was achieved in the setting of long-term reduction in glucocorticoids use after the induction phase. With BLM therapy, there was also a decrease in the total activity of SLE, a decrease in the number of severe exacerbations, and an improvement in serological markers. The benefit/risk ratio of BLM in combination with ST for LN treatment was favorable. BLM can be recommended for LN therapy in combination with standard treatment methods in order to achieve and maintain remission.