Evidence map›Paper›PMID 40037576›Full record

ArticleRheumatology (Oxford, England)2025

Belimumab concentrations and immunogenicity in relation to drug effectiveness and safety in SLE within a Swedish real-world setting.

Alvaro Gomez, Tomas Walhelm, Floris C Loeff, Andreas Jönsen, Dionysis Nikolopoulos, Bryan van den Broek, Anders A Bengtsson, Annick de Vries, Theo Rispens, Christopher Sjöwall and 1 more

Abstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Alvaro GomezDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and Center for Molecular Medicine (CMM), Stockholm, Sweden.ORCID 0000-0001-9618-1755
Tomas WalhelmDivision of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.ORCID 0000-0003-4590-4866
Floris C LoeffR&D, Sanquin Diagnostic Services, Amsterdam, The Netherlands.
Andreas JönsenDepartment of Clinical Sciences Lund, Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden.
Dionysis NikolopoulosDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and Center for Molecular Medicine (CMM), Stockholm, Sweden.
Bryan van den BroekR&D, Sanquin Diagnostic Services, Amsterdam, The Netherlands.
Anders A BengtssonDepartment of Clinical Sciences Lund, Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden.
Annick de VriesR&D, Sanquin Diagnostic Services, Amsterdam, The Netherlands.
Theo RispensR&D, Sanquin Diagnostic Services, Amsterdam, The Netherlands.
Christopher SjöwallDivision of Inflammation and Infection/Rheumatology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.ORCID 0000-0003-0900-2048
Ioannis ParodisDivision of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and Center for Molecular Medicine (CMM), Stockholm, Sweden.ORCID 0000-0002-4875-5395

Funding

Erik and Edith Fernström Foundation 2021-00209Karolinska InstitutetKing Gustaf V and Queen Victoria's Freemasons' FoundationKing Gustaf V's 80-year Foundation FAI-2022-0877King Gustaf V's 80-year Foundation FAI-2023-1006King Gustaf V's 80-year Foundation FAI-2023-1055Nyckelfonden OLL-1000881Professor Nanna Svartz Foundation 2021-00436Region Östergötland ALF RÖ-981263Region Stockholm FoUI-1004114Swedish Research Council for Medicine and Health 2023-02256Swedish Rheumatism Association R-993724Swedish Rheumatism Association R-995557Swedish Rheumatism Association R-995882Swedish Society of Medicine SLS-974449Ulla and Gustaf af Uggla Foundation 2023-025029Ulla and Roland Gustafsson Foundation 2023-36Ulla and Roland Gustafsson Foundation 2024-43Ulla and Roland Gustafsson Foundation 2024-49
6 · The paper itself

Abstract

objectivesStudies supporting therapeutic drug monitoring to biopharmaceuticals in SLE are scarce. We aimed to assess anti-drug antibody (ADA) occurrence in belimumab-treated SLE patients and associations between belimumab concentrations and clinical response, serological outcomes and adverse events.

methodsWe included 100 patients treated with intravenous belimumab. Clinical data and biological samples were collected at baseline and months 3, 6, 12 and 24. Belimumab levels were determined by quantitative sandwich ELISA, and ADA by an acid-dissociation radioimmunoassay. Clinical activity was evaluated with the SLEDAI-2000 (SLEDAI-2K), revised SLE activity measure (SLAM-R) and physician's global assessment (PhGA). Serological markers included C3, C4 and anti-dsDNA. We performed cross-sectional Spearman's rank correlation analyses, and longitudinal analyses using generalized estimating equations.

resultsBelimumab concentrations varied widely (median: 25.8; interquartile range [IQR]: 20.9-43.5 μg/ml) but were stable over time at the group level. Pre-existing ADA was detected in two patients, but no patient developed ADA during follow-up. Belimumab levels moderately correlated with SLEDAI-2K (ρ: -0.37; P = 0.003) and PhGA (ρ: -0.41; P = 0.005) at month 6, while longitudinal analysis revealed a very weak association with SLEDAI-2K (β: -0.10; SE: 0.05; P = 0.031) and a weak association with SLAM-R (β: -0.32; SE: 0.13; P = 0.014). Despite moderate correlations between belimumab levels and serological markers at month 6, there were no associations in longitudinal analysis. There was no relationship between belimumab levels and adverse events.

conclusionBelimumab yielded no immunogenicity. Belimumab levels were modestly associated with clinical activity but not with serological activity or adverse events.

Indexed as

Antibodies, Monoclonal, HumanizedImmunosuppressive AgentsLupus Erythematosus, SystemicAdultAntibodies, AntinuclearBiomarkersCross-Sectional StudiesDrug MonitoringFemaleHumansLongitudinal StudiesMaleMiddle AgedSeverity of Illness IndexSwedenTreatment OutcomeAntibodies, AntinuclearAntibodies, Monoclonal, HumanizedbelimumabBiomarkersImmunosuppressive Agentsanti-drug antibodiesB cellsbelimumabbiologicsB lymphocyteimmunogenicitysystemic lupus erythematosustherapeutic monitoring

Identifiers

PMID40037576
PMCPMC12107032

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.