Abstract: SA-PO0843
Less Oral Glucocorticoid Use After Belimumab Initiation in US Patients with Lupus Nephritis
Session Information
- Glomerular Management: Real-World Lessons and Emerging Therapies
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Patel, Aarat, GSK, US Medical Affairs, Durham, North Carolina, United States
- Worley, Karen, GSK, Global Real-World Evidence & Health Outcomes Research, Collegeville, Pennsylvania, United States
- Clark, Laura Ann, GSK, Global Real-World Evidence & Health Outcomes Research, Collegeville, Pennsylvania, United States
- Ellis, Jeff, GSK, Global Real-World Evidence & Health Outcomes Research, Collegeville, Pennsylvania, United States
- Ma, Liyuan, GSK, Real-World Analytics (RWA), Collegeville, Pennsylvania, United States
Background
The therapeutic strategy for lupus nephritis (LN) aims for steroid reduction due to long-term risks of cumulative use. Belimumab (BEL), a B-cell modulator monoclonal antibody that selectively inhibits BLyS and reduces autoreactive B cells that drive systemic lupus erythematosus (SLE), shows steroid-sparing effects, but real-world data evaluating this in patients with LN are limited. We assessed how oral glucocorticoid (OGC) dosage changed in US patients with LN who initiated BEL.
Methods
This retrospective cohort study (GSK Study 222165) identified patients with LN in the MarketScan Claims database (9/23/2015–9/30/2023); eligibility criteria included continuous enrollment ≥12 months + 100 days pre-index (baseline) and ≥12 months follow-up, OGC use at baseline and index date (first BEL claim for LN during: 1/1/2017–9/30/2022), no pre-index BEL use or drug-induced SLE at any time. Outcomes were reduction or complete discontinuation of OGC at follow-up, and change in median OGC average daily dosage (ADD; mg/day prednisone equivalent) at baseline and follow-up periods (0–24 months). Statistical analysis in Fig footnote.
Results
Of 148 identified patients (mean [SD] age: 36.7 [11.7] years; 92% female), 84% used immunosuppressants; 82% and 97% had moderate SLE flare and renal flare pre-index. After starting BEL, 83% of patients reduced/discontinued OGC within 6 months; ≥86% did so 6–24 months post-BEL initiation (Fig A). Among patients with OGC ADD ≥5 and ≥10 mg/day (N=134 and 111) 6 months before index, 32% and 30% reduced ADD to <5 mg/day by 6 months post-BEL initiation. OGC ADD decreased ≥70% from baseline to 12–24 months post-BEL initiation (13.4–17.5 vs 3.8–4.0 mg/day; Fig B). Compared to 6–12 months before index, OGC ADD at 6–12 months post-BEL initiation was significantly lower (13.4 vs 5.3 mg/day; p<0.0001; Fig B).
Conclusion
Most patients with LN initiating BEL in the US consistently reduced or discontinued OGC. Median OGC doses decreased throughout follow-up, maintaining a reduction to <5 mg/day between 12 and 24 months post-BEL initiation in line with EULAR and ACR recommendations for LN.
Funding
- Commercial Support – GSK