Subcutaneous formulation of belimumab in treatment of systemic lupus erythematosus: a critical review with focus on safety and satisfaction

Abstract

Hamdy MA Ahmed,1–3 Samar Abohamad,2 Mohanad Elfishawi,4 Mohamed Tharwat Hegazy,2 Kadambari Vijaykumar1,5 1Internal Medicine Department, Rochester General Hospital, Rochester, NY, USA; 2Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 3Rheumatology and Clinical Immunology Division, Internal Medicine Department, University of Alabama at Birmingham, Birmingham, AL, USA; 4Internal Medicine Department, Queens Hospital Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 5Pulmonology and Critical Care Division, Internal Medicine Department, University of Alabama at Birmingham, Birmingham, AL, USA Abstract: Belimumab is a novel add-on therapy that has been approved for patients with active and antibody-mediated systemic lupus erythematosus. It is a monoclonal antibody that decreases the activation of B-cells and consequently decreases antibodies’ production. Recently, the US Food and Drug Administration approved subcutaneous belimumab for patients who have received training on using it. Subcutaneous belimumab can be administered using either a prefilled syringe or an auto-injector device. Weekly subcutaneous belimumab seems to be as effective as monthly intravenous belimumab with a similar safety margin. In this article, we reviewed the literature on subcutaneous belimumab focusing on safety and patients’ experiences and satisfaction. Overall, subcutaneous belimumab appears to be preferred over intravenous belimumab for a number of reasons. However, more studies are still required to prove these findings. Keywords: belimumab, subcutaneous, safety, self-injection, patient satisfaction, adherence, auto-injecto