American College of Rheumatology, Nov. 10-14

Shivani Garg, M.D., of the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues found that belimumab (Benlysta) is an effective biological therapy for patients with cutaneous lupus erythematosus (CLE) with or without SLE, demonstrating a strong clinical response, ranging from 44 to 55 percent, and a significant reduction in flare risk.

In a systematic review and meta-analysis, the authors examined the efficacy of belimumab in CLE, assessed its ability to reduce cutaneous flare risk, and measured the time to response after starting the drug. The researchers found that at 52 weeks, belimumab users had 44 percent greater odds of having clinical response in the meta-analysis. After including all observational studies, the investigators noted that the overall clinical response in belimumab users was 55 percent. A clinically significant response was seen in belimumab users at week 20, was sustained through week 52, and peaked at one year. Furthermore, the researchers observed 49 percent lower odds of cutaneous flares in belimumab users compared with nonusers.

“Our study uniquely identified that belimumab can take up to 20 weeks to achieve clinically significant response in patients; thus, the medication should not be prematurely discontinued,” Garg said. “This study will inform practice and guide clinicians to discuss treatment options and expectations with patients when starting belimumab to avoid premature discontinuation of therapy in the absence of early benefits. Finally, our study strongly supports the inclusion of belimumab in the existing treatment paradigm for cutaneous manifestations of SLE to improve outcomes and quality of life.”

Press Release

As part of the Start Time Optimization of Biologic Therapy in Polyarticular JIA (STOP-JIA) study, Yukiko Kimura, M.D., of the Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center in New Jersey, and colleagues found that patients with polyarticular juvenile idiopathic arthritis (poly JIA) who start a biologic early, in combination with methotrexate, spend more time in inactive disease and achieve clinical remission more often.

The STOP-JIA study aimed to use standardized treatment plans — referred to as consensus treatment plans (CTPs) — which were developed by the CARRA Registry (a large network of pediatric rheumatology researchers and clinicians in the United States and Canada) to answer the question of when is the best time to start biologics in poly JIA. The three CTPs included: (1) step up (methotrexate monotherapy with a biologic added after three months, if needed); (2) early combination (conventional disease-modifying antirheumatic drug and biologic started together); and (3) biologic first (biologic therapy only). This current analysis assessed three years of data from patients enrolled in STOP-JIA.