Treatment strategy for systemic lupus erythematosus using belimumab as indicated by multi-omics analysis

Abstract

Belimumab is an antibody targeting the cytokine B-cell activating factor (BAFF), which is crucial for B cell differentiation, and is the first molecularly targeted drug approved for systemic lupus erythematosus (SLE). The primary endpoints have been met in clinical trials of belimumab involving patients with active SLE without severe organ complications, as well as in trials involving patients with lupus nephritis. In addition, the effects of belimumab in preventing relapses and reducing glucocorticoid use have been confirmed. Moreover, there were no significant differences in the incidences of many adverse events between the belimumab and placebo groups. Recent multi-omics analyses have revealed that the cells targeted by belimumab are limited to naïve B cells and a subset of memory B cells. These findings align with the efficacy and safety profile of belimumab. An improved understanding of the mechanism of action of belimumab could support its use earlier during the treatment course or in a broader range of SLE cases.