Review
Biotechnology & Applied Microbiology
Marlene Pluess, Silvia Piantoni, Bjoern Tampe, Alfred H. J. Kim, Peter Korsten
Summary: Advances in the treatment and management of systemic lupus erythematosus have improved patient outcomes, but lupus nephritis remains a major complication. Belimumab has been shown to be superior as an add-on therapy for lupus nephritis, and personalized treatment options are expected with the development of new therapeutic agents.
HUMAN VACCINES & IMMUNOTHERAPEUTICS
(2022)
Review
Immunology
Feng Chen, Ying Zheng, Xinying Chen, Zhanfa Wen, Youjia Xu, Jinghua Yang, Kaisi Xu
Summary: Belimumab is an important medication for the treatment of cSLE. However, there is a lack of sufficient research on its efficacy and safety, and further studies are needed to validate its clinical value.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Immunology
Liping Xu, Xinwei Song, Qiaoding Dai, Tianrong Guan, Yan Zhang, Na Lin, Ji-an Wang
Summary: This case report highlights the efficacy of Belimumab in treating refractory Lupus Cystitis, with significant improvements in symptoms, urinary markers, and protein levels observed in the patient. No relapse of lupus cystitis or SLE activity occurred during the 10-month follow-up period, demonstrating positive outcomes with Belimumab treatment.
INTERNATIONAL IMMUNOPHARMACOLOGY
(2021)
Article
Rheumatology
Yusuke Miyazaki, Shingo Nakayamada, Koshiro Sonomoto, Kawabe Akio, Yoshino Inoue, Naoaki Okubo, Shigeru Iwata, Kentaro Hanami, Yoshiya Tanaka
Summary: This study investigated the efficacy and safety of belimumab (BEL) in patients with systemic lupus erythematosus (SLE) during maintenance therapy. The results showed that BEL combined with standard-of-care therapy was effective in reducing glucocorticoid (GC) dosage and relapse rate in SLE patients. The study also identified factors associated with successful tapering of GC dosage.
Review
Medicine, General & Internal
Jasvinder A. Singh, Nipam P. Shah, Amy S. Mudano
Summary: Belimumab at the FDA-approved dose of 10 mg/kg may be associated with a clinically meaningful efficacy benefit compared to placebo in participants with SLE. More data are needed for the longer-term efficacy of Belimumab.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2021)
Article
Transplantation
Tineke Kraaij, Eline J. Arends, Laura S. van Dam, Sylvia W. A. Kamerling, Paul L. A. van Daele, Obbo W. Bredewold, Argho Ray, Jaap A. Bakker, Hans U. Scherer, Tom J. W. Huizinga, Ton J. Rabelink, Cees van Kooten, Y. K. Onno Teng
Summary: Combining RTX and BLM in B-cell targeted therapy showed promising clinical outcomes in refractory SLE patients, with improvements in clinical symptoms and reductions in autoantibody levels. The results of this study suggest that this treatment approach may serve as a novel strategy for managing SLE.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2021)
Review
Rheumatology
Resit Yildirim, Tatiana Oliveira, David Alan Isenberg
Summary: In recent years, there have been efforts to improve the prognosis and outcome in patients with autoimmune inflammatory rheumatic diseases by using treat-to-target strategy and early intervention strategies with immunosuppressive agents. However, infectious complications due to medication side effects remain a major concern. Vaccination programmes and vaccine immunity play a crucial role in patients with SLE in terms of morbidity and mortality. Although research on vaccines' efficacy and immune response in immunosuppressed patients has increased, there is still a lack of data investigating these parameters for those receiving biological agents, leading to a lack of consensus on a vaccination policy for patients with SLE.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Review
Immunology
Eugene Krustev, Ann E. Clarke, Megan R. W. Barber
Summary: Refinements in pharmaceutical mechanisms of action, trial design, and patient selection have resulted in recent preliminary successes, offering renewed optimism for B-cell targeted therapeutics in SLE management.
EXPERT REVIEW OF CLINICAL IMMUNOLOGY
(2023)
Article
Immunology
Hao Cheng, Xiao-ying Zhang, Hui-dan Yang, Zhen Yu, Cheng-lan Yan, Chong Gao, Hong-yan Wen
Summary: This study showed that Belimumab in combination with low-dose intravenous CYC significantly reduced disease activity scores and maintained the B/T cell balance for SLE patients at 24 weeks. The Belimumab treatment group had lower adverse events and higher efficacy compared to conventional treatment.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Rheumatology
Xiaochan Chen, Xiaowei Shi, Han Xue, Honghua Lv, Lishi Yu, Xiudi Wu, Qiaohong Wang, Huaxiang Wu, Fei Han, Jing Xue
Summary: This multicentre prospective cohort study demonstrates that long-term RTX maintenance therapy has high efficacy and acceptable safety in relapsing or refractory SLE patients who had a clinical response to RTX induction therapy.
Article
Medicine, General & Internal
O. Capdevila, F. Mitjavila, G. Espinosa, L. Caminal-Montero, A. Marin-Ballve, R. Gonzalez Leon, A. Castro, J. Canora, B. Pinilla, E. Fonseca, G. Ruiz-Irastorza, RELES, Autoimmune Dis Study Grp GEAS, Spanish Soc Internal Med
Summary: This study analyzed the characteristics and predictive factors of the use of rituximab and belimumab in patients with systemic lupus erythematosus. Rituximab was mainly used for hemolytic anemia or thrombocytopenia, while belimumab was mostly used for arthritis. Younger age, psychosis, and hemolytic anemia were identified as independent predictors of the use of these biological agents.
MEDICINA-LITHUANIA
(2023)
Article
Rheumatology
Yupeng Lai, Bin Li, Jiaming Huang, Jingning Du, Mengli Yue, Xin Shen, Xingjiao Liu, Lingfeng Huang, Jiehua Lin, Aicheng Yang, Meiying Wang
Summary: This study reports the use of belimumab in pregnant SLE patients and analyzes the outcomes through the summary of previous case reports and case series. The results showed that pregnant SLE patients tolerated belimumab well and there were no safety signals for both the mothers and their babies.
Article
Pharmacology & Pharmacy
Jing Wang, Bomiao Ju, Li Zhu, Hanchao Li, Jing Luo, Jing Zhang, Nan Hu, Lingfei Mo, Yanhua Wang, Ying Pan, Jing Huang, Xiaohong Lv, Dan Pu, Zhiming Hao, Lan He, Yuanyuan Li
Summary: The study aimed to examine the kinetics of B cell subsets and activation markers in the early stage of belimumab treatment and their correction with treatment response. Flow cytometry was used to test the B cell subsets and activation markers of 27 systemic lupus erythematosus (SLE) patients receiving 6 months belimumab treatment. The results showed that B cell hyperactivity was rapidly inhibited in the early stage of belimumab treatment and the ratio of p-SYK/p-AKT may predict SLEDAI-2K decline.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Medicine, Research & Experimental
Mieke van Schaik, Eline J. Arends, Darius Soonawala, Ellen van Ommen, Karina de Leeuw, Maarten Limper, Pieter van Paassen, Tom W. J. Huizinga, Rene E. M. Toes, Cees van Kooten, Joris I. Rotmans, Ton J. Rabelink, Y. K. Onno Teng
Summary: The Synbiose 2 trial is the first multicenter phase 3 clinical trial investigating the efficacy of combined rituximab and belimumab therapy in severe SLE, including lupus nephritis.
Article
Biotechnology & Applied Microbiology
Roberto Depascale, Mariele Gatto, Margherita Zen, Francesca Saccon, Maddalena Larosa, Elisabetta Zanatta, Sara Bindoli, Andrea Doria, Luca Iaccarino
Summary: Belimumab, a fully humanized monoclonal antibody targeting B cells, has demonstrated efficacy and safety in clinical practice. Questions regarding the timing of its use, discontinuation, and potential combination with other biological drugs require further investigation.
EXPERT OPINION ON BIOLOGICAL THERAPY
(2021)
Review
Rheumatology
Soledad Retamozo, Pilar Brito-Zeron, Antoni Siso-Almirall, Alejandra Flores-Chavez, Maria-Jose Soto-Cardenas, Manuel Ramos-Casals
Summary: HLH is a hyperferritinaemic hyperinflammatory syndrome characterized by decreased interferon gamma production and activated NK phenotype. Viruses are closely linked to the development of HLH, and the break of tolerance to self-antigens is considered a critical mechanism in immune-mediated conditions triggered by viral infections.
CLINICAL RHEUMATOLOGY
(2021)
Article
Rheumatology
Manuel Ramos-Casals, Nihan Acar-Denizli, Arjan Vissink, Pilar Brito-Zeron, Xiaomei Li, Francesco Carubbi, Roberta Priori, Natasa Toplak, Chiara Baldini, Enrique Faugier-Fuentes, Aike A. Kruize, Thomas Mandl, Minako Tomiita, Saviana Gandolfo, Kunio Hashimoto, Gabriela Hernandez-Molina, Benedikt Hofauer, Samara Mendieta-Zeron, Astrid Rasmussen, Pulukool Sandhya, Damien Sene, Virginia Fernandes Moca Trevisani, David Isenberg, Erik Sundberg, Sandra G. Pasoto, Agata Sebastian, Yasunori Suzuki, Soledad Retamozo, Bei Xu, Roberto Giacomelli, Angelica Gattamelata, Masa Bizjak, Stefano Bombardieri, Richard-Eduardo Loor-Chavez, Anneline Hinrichs, Peter Olsson, Hendrika Bootsma, Scott M. Lieberman
Summary: Childhood-onset primary Sjogren's syndrome is characterized by sicca features, parotid enlargement, and systemic disease, with age at diagnosis influencing the phenotypic expression of the disease. Symptom presentation includes dry mouth, dry eyes, positive ANA, anti-Ro/La antibodies, and positive RF, among others.
Article
Rheumatology
Pilar Brito-Zeron, Sheila Melchor, Raphaele Seror, Roberta Priori, Roser Solans, Belchin Kostov, Chiara Baldini, Francesco Carubbi, Jose Luis Callejas, Pablo Guisado-Vasco, Gabriela Hernandez-Molina, Sandra G. Pasoto, Valeria Valim, Antoni Siso-Almirall, Xavier Mariette, Patricia Carreira, Manuel Ramos-Casals
Summary: Patients with primary Sjogren's syndrome who develop SARS-CoV-2 infection have higher rates of hospitalization and poorer outcomes, with underlying comorbidities being a key factor in determining the severity of the disease.
Article
Virology
P. Brito-Zeron, B. Gracia-Tello, A. Robles, A. Alguacil, M. Bonet, B. De-Escalante, A. Noblejas-Mosso, R. Gomez-de-la-Torre, M. Akasbi, M. Perez-de-Lis, R. Perez-Alvarez, M. Ramos-Casals
Summary: This study analyzed the clinical characteristics and outcomes of SARS-CoV-2 infection in patients with sarcoidosis in Southern Europe. Elderly patients with comorbidities, such as cardiovascular disease, diabetes, and chronic liver/kidney diseases, were more likely to require hospitalization. The study recommended close monitoring of SARS-CoV-2 infection in elderly sarcoidosis patients with underlying cardiopulmonary diseases and liver or renal failure.
Article
Rheumatology
Celline C. Almeida-Brasil, John G. Hanly, Murray Urowitz, Ann Elaine Clarke, Guillermo Ruiz-Irastorza, Caroline Gordon, Rosalind Ramsey-Goldman, Michelle Petri, Ellen M. Ginzler, D. J. Wallace, Sang-Cheol Bae, Juanita Romero-Diaz, Mary Anne Dooley, Christine Peschken, David Isenberg, Anisur Rahman, Susan Manzi, Soren Jacobsen, Sam Lim, Ronald F. van Vollenhoven, Ola Nived, Andreas Jonsen, Diane L. Kamen, Cynthia Aranow, Jorge Sanchez-Guerrero, Dafna D. Gladman, Paul R. Fortin, Graciela S. Alarcon, Joan T. Merrill, Kenneth Kalunian, Manuel Ramos-Casals, Kristjan Steinsson, Asad Zoma, Anca Askanase, Munther A. Khamashta, Ian N. Bruce, Murat Inanc, Michal Abrahamowicz, Sasha Bernatsky
Summary: The risk of SLE flare was higher after HCQ tapering or discontinuation compared to HCQ maintenance, especially for patients with low educational level and prednisone use. Special attention should be paid to specific subgroups when making decisions on HCQ maintenance.
ANNALS OF THE RHEUMATIC DISEASES
(2022)
Article
Rheumatology
George C. Drosos, Daisy Vedder, Eline Houben, Laura Boekel, Fabiola Atzeni, Sara Badreh, Dimitrios T. Boumpas, Nina Brodin, Ian N. Bruce, Miguel Angel Gonzalez-Gay, Soren Jacobsen, Gyorgy Kerekes, Francesca Marchiori, Chetan Mukhtyar, Manuel Ramos-Casals, Naveed Sattar, Karen Schreiber, Savino Sciascia, Elisabet Svenungsson, Zoltan Szekanecz, Anne-Kathrin Tausche, Alan Tyndall, Vokko van Halm, Alexandre Voskuyl, Gary J. Macfarlane, Michael M. Ward, Michael T. Nurmohamed, Maria G. Tektonidou
Summary: This study developed recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, emphasizing the importance of regular screening and management of modifiable CVR factors as well as patient education. The recommendations covered CVR prediction tools, interventions on traditional CVR factors, and interventions on disease-related CVR factors.
ANNALS OF THE RHEUMATIC DISEASES
(2022)
Article
Rheumatology
Alessia Alunno, Aurelie Najm, Pedro M. Machado, Heidi Bertheussen, Gerd-Rudiger R. Burmester, Francesco Carubbi, Gabriele De Marco, Roberto Giacomelli, Olivier Hermine, John D. Isaacs, Isabelle Kone-Paut, Cesar Magro-Checa, Iain B. McInnes, Pier Luigi Meroni, Luca Quartuccio, A. Ramanan, Manuel Ramos-Casals, Javier Rodriguez Carrio, Hendrik Schulze-Koops, Tanja A. Stamm, Sander W. Tas, Benjamin Terrier, Dennis G. McGonagle, Xavier Mariette
Summary: Immunomodulatory therapies play a crucial role in the treatment of COVID-19, with evidence supporting the incremental efficacy of glucocorticoids in combination with other drugs, especially in severe patients. Further research and clinical trials are needed to explore the potential application of other therapeutic approaches in COVID-19 treatment.
ANNALS OF THE RHEUMATIC DISEASES
(2022)
Review
Medicine, General & Internal
Soledad Retamozo, Luca Quartuccio, Manuel Ramos-Casals
Summary: Cryoglobulins are immunoglobulins that precipitate at temperatures below 37 degrees C. Cryoglobulin-associated disease is a heterogeneous condition that can have various clinical presentations, with vasculitis being the most common. The main cause used to be chronic HCV infection, but it is now mainly associated with autoimmune diseases and malignancies. Treatment should be tailored to the underlying cause and severity of organ involvement.
Article
Rheumatology
Alexandra Legge, Susan Kirkland, Kenneth Rockwood, Pantelis Andreou, Sang-Cheol Bae, Caroline Gordon, Juanita Romero-Diaz, Jorge Sanchez-Guerrero, Daniel J. Wallace, Sasha Bernatsky, Ann E. Clarke, Joan T. Merrill, Ellen M. Ginzler, Paul R. Fortin, Dafna D. Gladman, Murray B. Urowitz, Ian N. Bruce, David A. Isenberg, Anisur Rahman, Graciela S. Alarcon, Michelle Petri, Munther A. Khamashta, M. A. Dooley, Rosalind Ramsey-Goldman, Susan Manzi, Asad A. Zoma, Cynthia Aranow, Meggan Mackay, Guillermo Ruiz-Irastorza, S. Sam Lim, Murat Inanc, Ronald F. van Vollenhoven, Andreas Jonsen, Ola Nived, Manuel Ramos-Casals, Diane L. Kamen, Kenneth C. Kalunian, Soren Jacobsen, Christine A. Peschken, Anca Askanase, John G. Hanly
Summary: The study found that higher baseline SLICC-FI values were associated with increased hospitalizations during follow-up, and among patients with hospitalizations, higher baseline SLICC-FI values predicted a greater proportion of follow-up time spent hospitalized.
ARTHRITIS CARE & RESEARCH
(2022)
Article
Rheumatology
Gabriela Hernandez-Molina, Belchin Kostov, Pilar Brito-Zeron, Arjan Vissink, Thomas Mandl, Anneline C. Hinrichs, Luca Quartuccio, Chiara Baldini, Raphaele Seror, Antonia Szanto, David Isenberg, Roberto Gerli, Gunnel Nordmark, Astrid Rasmussen, Roser Solans-Laque, Benedikt Hofauer, Damien Sene, Sandra G. Pasoto, Maureen Rischmueller, Sonja Praprotnik, Tamer A. Gheita, Debashish Danda, Berkan Armagan, Yasunori Suzuki, Valeria Valim, Valerie Devauchelle-Pensec, Soledad Retamozo, Marika Kvarnstrom, Agata Sebastian, Fabiola Atzeni, Roberto Giacomelli, Steven E. Carsons, Seung-Ki Kwok, Hideki Nakamura, Virginia Fernandes Moca Trevisani, Alejandra Flores-Chavez, Xavier Mariette, Manuel Ramos-Casals
Summary: This study characterized 414 patients with primary SS who developed haematological malignancies and analyzed the impact of SS- and lymphoma-related features on presentation patterns and outcomes. The results showed that B-cell lymphomas, especially MALT lymphoma, predominated in the salivary glands and had a favorable prognosis.
Article
Medicine, General & Internal
Sergi Casado-Llombart, Hoda Gheitasi, Silvia Arino, Marta Consuegra-Fernandez, Noelia Armiger-Borras, Belchin Kostov, Manuel Ramos-Casals, Pilar Brito-Zeron, Francisco Lozano
Summary: The genetic variations of genes such as CD5, CD6, and CD166/ALCAM are found to be associated with the clinical manifestations and analytical outcomes in patients with primary Sjogren's syndrome. These findings indicate the importance of gene variations in modulating the disease progression and prognosis of pSS patients.
FRONTIERS IN MEDICINE
(2022)
Review
Medicine, General & Internal
Pilar Brito-Zeron, Roberto Perez-Alvarez, Manuel Ramos-Casals
Summary: Sarcoidosis is a systemic autoimmune disease primarily affecting lymph nodes, lungs, skin, and eyes. It is relatively uncommon but not rare, with higher prevalence in northern Europe, the United States, and India. The disease predominantly affects women aged 30 to 50 and is closely linked to environmental factors, particularly occupational exposures. Diagnosis requires multidisciplinary clinical units to integrate clinical, analytical, radiological, and histopathological data. Treatment options include corticosteroids as first-line therapy, immunosuppressants as second-line therapy, and anti-TNF agents for severe and/or refractory cases.
Review
Pharmacology & Pharmacy
Manuel Ramos-Casals, Alejandra Flores-Chavez, Pilar Brito-Zeron, Olivier Lambotte, Xavier Mariette
Summary: Immunotherapies are effective treatments for inflammatory diseases, but their use has been linked to the development of autoimmune disorders. The use of immunotherapies in solid cancer patients has dramatically changed the scenario, causing collateral side effects on the immune system. The broad pharmacological and phenotypic scenario of immune-related adverse events (irAEs) associated with kinase inhibitors needs more research from a multidisciplinary perspective.
PHARMACOLOGY & THERAPEUTICS
(2022)
Review
Immunology
Pilar Brito-Zeron, Elyse E. Lower, Manuel Ramos-Casals, Robert P. Baughman
Summary: This article provides an updated overview of the hematological involvement associated with sarcoidosis, including the management approach for cytopenias and the association with hematological malignancies. The etiology of cytopenias in sarcoidosis can be attributed to infiltration of hematopoietic organs and autoimmune-mediated cytopenias. The association between sarcoidosis and hematologic involvement is best understood as a pathogenic continuum, where cytopenias and hematologic neoplasms are intertwined due to various etiopathogenic mechanisms.
EXPERT REVIEW OF CLINICAL IMMUNOLOGY
(2023)
Review
Rheumatology
P. Brito-Zeron, A. Siso-Almirall, A. Flores-Chavez, S. Retamozo, M. Ramos-Casals
Summary: Patients with systemic autoimmune diseases (SAD) have an increased risk of SARS-CoV-2 infection and worse outcomes, including higher rates of hospitalization/ICU admission and poorer survival rates.
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY
(2021)
