COMMENTARY

The Year in Rheumatology: Studies Not to Miss From 2011

Kevin Deane, MD

Disclosures

November 23, 2011

In This Article

Introduction

Herein I review several advances that are important to the clinical practice of rheumatology. I selected these particular advances based on my review of the literature, observing what appeared to be "hot topics" at the 2011 American College of Rheumatology Annual Meeting, as well as through consultation with my colleagues. There are certainly many more advances that are not discussed; hopefully, however, the topics that I have chosen to review will prove useful to practitioners of clinical rheumatology.

Belimumab Approved

Belimumab, a fully human monoclonal antibody that inhibits B-lymphocyte stimulator, was approved by the US Food and Drug Administration (FDA) for the treatment of active autoantibody-positive systemic lupus erythematosus (SLE) at a 10 mg/kg dose infused every 2 weeks for the first 3 weeks and every 4 weeks thereafter. This approval was based in part on the results of a 52-week randomized, controlled trial comparing belimumab infusions at 1 mg/kg or 10 mg/kg to placebo. Belimumab use resulted in improvement in SLE based on measurement of a SLE Responder Index that incorporated measures from several SLE assessment measures.[1]

It is exciting that a new agent has been approved for SLE (the last agents approved by the FDA were hydroxychloroquine and corticosteroids in the 1950s). However, going forward, the precise role that belimumab will play in the management of SLE, especially renal and central nervous system disease, has yet to be determined. Furthermore, in several studies, there were more deaths in patients treated with belimumab compared to placebo, including deaths from suicide, so the impact of the medication on mental health will need to be watched carefully.[2]

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