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ORIGINAL RESEARCH article

Front. Lupus
Sec. Clinical Research and Treatment in Lupus
Volume 2 - 2024 | doi: 10.3389/flupu.2024.1459949

Comparative efficacy and safety of belimumab and hydroxychloroquine in the maintenance phase in patients with systemic lupus erythematosus: a retrospective cohort study

Provisionally accepted
Koichi Kimura Koichi Kimura 1Masahiro Ayano Masahiro Ayano 1*Shun-Ichiro Ota Shun-Ichiro Ota 2Kazuo Kushimoto Kazuo Kushimoto 2Yasutaka Kimoto Yasutaka Kimoto 1HIROKI MITOMA HIROKI MITOMA 3Nobuyuki Ono Nobuyuki Ono 1Yojiro Arinobu Yojiro Arinobu 1Koichi Akashi Koichi Akashi 1Takahiko Horiuchi Takahiko Horiuchi 3Hiroaki Niiro Hiroaki Niiro 4
  • 1 Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
  • 2 Department of Rheumatology, Shimonoseki City Hospital, Yamaguchi, Yamaguchi, Japan
  • 3 Kyushu University Beppu Hospital, Beppu, Ōita, Japan
  • 4 Department of Medical Education, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

The final, formatted version of the article will be published soon.

    Objectives: Hydroxychloroquine (HCQ), a cornerstone drug, is recommended for longterm use in treating systemic lupus erythematosus (SLE). However, in cases where HCQ is unavailable, it is unclear which drugs should be prioritised for continuation. We aimed to clarify whether belimumab (BLM), which has recently been reported to have long-term safety and efficacy, could be a viable alternative to HCQ.We retrospectively compared the efficacy, drug continuation rate and safety of HCQ and BLM in the maintenance phase in patients with SLE. The efficacy endpoints were the cumulative incidence of flares over 2 years, the increase in the damage index and the changes in the SLE Disease Activity Index 2000 (SLEDAI) score and prednisolone dose. The safety endpoint was the adverse event rates.Results: Among 96 patients analysed, 15 out of 84 patients (17.9%) in the HCQ group and 1 out of 12 patients (8.3%) in the BLM group experienced a flare with no significant difference in the cumulative incidence of flares between the two groups (p = 0.47). No differences were observed in the cumulative incidence of the increase in the damage index, changes in the SLEDAI score and prednisolone dose, drug continuation rates and adverse events. 4Conclusions: The efficacy and safety of BLM were similar to those of HCQ. BLM could be a valuable treatment option for patients with SLE as an alternative for those who cannot tolerate HCQ.

    Keywords: systemic lupus erythematosus, Hydroxychloroquine, belimumab, Flare, Maintenance

    Received: 05 Jul 2024; Accepted: 30 Aug 2024.

    Copyright: © 2024 Kimura, Ayano, Ota, Kushimoto, Kimoto, MITOMA, Ono, Arinobu, Akashi, Horiuchi and Niiro. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Masahiro Ayano, Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

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