Journal
NEW ENGLAND JOURNAL OF MEDICINE
Volume 383, Issue 12, Pages 1117-1128Publisher
MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMoa2001180
Keywords
-
Categories
Funding
- GlaxoSmithKline
Ask authors/readers for more resources
BackgroundIn adults with active lupus nephritis, the efficacy and safety of intravenous belimumab as compared with placebo, when added to standard therapy (mycophenolate mofetil or cyclophosphamide-azathioprine), are unknown. MethodsIn a phase 3, multinational, multicenter, randomized, double-blind, placebo-controlled, 104-week trial conducted at 107 sites in 21 countries, we assigned adults with biopsy-proven, active lupus nephritis in a 1:1 ratio to receive intravenous belimumab (at a dose of 10 mg per kilogram of body weight) or matching placebo, in addition to standard therapy. The primary end point at week 104 was a primary efficacy renal response (a ratio of urinary protein to creatinine of <= 0.7, an estimated glomerular filtration rate [eGFR] that was no worse than 20% below the value before the renal flare (pre-flare value) or >= 60 ml per minute per 1.73 m(2) of body-surface area, and no use of rescue therapy), and the major secondary end point was a complete renal response (a ratio of urinary protein to creatinine of <0.5, an eGFR that was no worse than 10% below the pre-flare value or 90 ml per minute per 1.73 m(2), and no use of rescue therapy). The time to a renal-related event or death was assessed. ResultsA total of 448 patients underwent randomization (224 to the belimumab group and 224 to the placebo group). At week 104, significantly more patients in the belimumab group than in the placebo group had a primary efficacy renal response (43% vs. 32%; odds ratio, 1.6; 95% confidence interval [CI], 1.0 to 2.3; P=0.03) and a complete renal response (30% vs. 20%; odds ratio, 1.7; 95% CI, 1.1 to 2.7; P=0.02). The risk of a renal-related event or death was lower among patients who received belimumab than among those who received placebo (hazard ratio, 0.51; 95% CI, 0.34 to 0.77; P=0.001). The safety profile of belimumab was consistent with that in previous trials. ConclusionsIn this trial involving patients with active lupus nephritis, more patients who received belimumab plus standard therapy had a primary efficacy renal response than those who received standard therapy alone. (Funded by GlaxoSmithKline; BLISS-LN ClinicalTrials.gov number, NCT01639339.) This phase 3 multicenter, randomized, double-blind, placebo-controlled 2-year trial compared the efficacy and safety of intravenous belimumab with those of placebo, plus standard therapy, in patients with active lupus nephritis. More patients who received belimumab had a primary efficacy renal response than those who received placebo.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available