Lupus & antiphospholipid syndrome
Comparative Risks of Infection With Belimumab Versus Oral Immunosuppressants in Patients With Nonrenal Systemic Lupus Erythematosus
Authors' conclusion
Belimumab was associated with lower risks of serious infection than with oral immunosuppressants.
Study context
- Population
- Patients with systemic lupus erythematosus (SLE) without LN initiating belimumab, azathioprine, methotrexate or mycophenolate, 2011–2021, US multicentre electronic health record database (mean age 45 years; 94% women)
- Exposure
- Belimumab vs each oral immunosuppressant
- Azathioprinen = 6,343reference
- Methotrexaten = 8,242reference
- Mycophenolaten = 8,407reference
- Outcome
- Serious infection and hospitalization for serious infection
Methodological detailstarget trial emulation, multicentre, propensity score overlap weighting, inverse probability of treatment weighting, control outcome of traumatic injury
- Target trial emulation
- Multicentre
- Propensity score overlap weighting
- Inverse probability of treatment weighting
- Control outcome of traumatic injury
Main finding
As reported in the abstract
Serious infection
Hazard ratio (95% CI)
Belimumabvs Azathioprinebelimumab n = 2841
0.82(0.72–0.92)
Belimumabvs Mycophenolatebelimumab n = 2813
0.69(0.61–0.78)
Belimumabvs Methotrexatebelimumab n = 2642; risk of infection
0.86(0.76–0.97)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Hospitalization for infectionBelimumabvs Azathioprine | 0.73 (0.57–0.94) | |
| Hospitalization for infectionBelimumabvs Mycophenolate | 0.56 (0.43–0.71) | |
| 0.512Hazard ratio (log scale) |
Traumatic injury (control outcome)
- No differences in traumatic injury risks across treatment groups
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Comparative Risks of Infection With Belimumab Versus Oral Immunosuppressants in Patients With Nonrenal Systemic Lupus Erythematosus. Arthritis Rheumatol. Published 8 October 2023. doi:10.
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