Lupus & antiphospholipid syndrome
Real-world experience with personalised belimumab spacing in sustained SLE remission: a multicentre study
Authors' conclusion
Progressive belimumab dose spacing and withdrawal, coupled with clinical monitoring, could be a practicable approach in selected patients with SLE with long-standing disease remission on minimal glucocorticoid doses, no additional immunosuppressants and low serological activity.
Study context
- Population
- Patients with SLE fulfilling the 2019 EULAR/American College of Rheumatology (ACR) criteria in long-standing remission on belimumab, four tertiary rheumatology centres22 (14.5%) underwent spacing
- Participants
- 152 patients
- Exposure
- Belimumab dose spacing vs standard-dose belimumab
- Spacingn = 22
- Outcome
- SLE flares occurrence
Methodological detailsmulticentre, four tertiary rheumatology centres, real-world
- Multicentre
- Four tertiary rheumatology centres
- Real-world
Main finding
As reported in the abstract
SLE flares · 21±5.4 months of follow-up
- No SLE flares occurred during follow-up
Observational data: associations, not effects.
Further findings
| Outcome | Spacing | P value |
|---|---|---|
| Mean remission duration (baseline)Spacing vs Standard-dose | mean 67 (SD 30) months | P < 0.001 |
| Serological activity (low complement and/or positive anti-dsDNA) (baseline)Spacing vs Standard-dose | 31.8% | P = 0.048 |
| SLEDAI-2K (baseline)Spacing vs Standard-dose | mean 0.77 (SD 1.23) | P < 0.001 |
| On GC (baseline)Spacing vs Standard-dose | 22.7% | P = 0.029 |
| On additional immunosuppressants (baseline)Spacing vs Standard-dose | 0.0% | P < 0.001 |
- Mean remission duration (baseline): Standard-dose mean 33 (SD 32) months
- Serological activity (low complement and/or positive anti-dsDNA) (baseline): Standard-dose 54.6%
- SLEDAI-2K (baseline): Standard-dose mean 1.98 (SD 2.01)
- On GC (baseline): Standard-dose 47.7%
- On additional immunosuppressants (baseline): Standard-dose 50.8%
Belimumab discontinuation
- Patients who discontinued belimumab
- 7
Safety
- None of the patients required GC dose escalation or reduced the dose interval
- 0
Original publication
Real-world experience with personalised belimumab spacing in sustained SLE remission: a multicentre study. Lupus Sci Med. Published 9 July 2026. doi:10.
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