Long-term belimumab therapy in patients with systemic lupus erythematosus

Therapy of systemic lupus erythematosus (SLE) remains a difficult task. Long-term use of glucocorticoids (GC) and cytostatic drugs significantly improves the prognosis of life, but at the same time contributes to the accumulation of irreversible damage to the internal organs and, as a result, to the deterioration of the quality of life, disability, social disadaptation and premature mortality. Preventing such consequences, achieving and maintaining long-term remission and reducing the need in high and medium doses of GC remain important tasks in SLE therapy, which has been facilitated by introduction of biologic disease-modifying antirheumatic drugs (bDMARDs) into clinical practice. Belimumab is the first bDMARD to be approved for the treatment of SLE. The accumulated experience allows conclusions to be drawn about its therapeutic properties and efficacy in a specific subtype of the disease, but feasibility and safety of long-term use of bDMARDs have not been sufficiently investigated. In this article, three clinical cases are presented in which belimumab was successfully used over a period of 9–10 years.