Zeitschrift für Rheumatologie

, Volume 72, Issue 5, pp 462–467 | Cite as

Empfehlungen zum Einsatz von Belimumab beim systemischen Lupus erythematodes

  • R. Fischer-Betz
  • M. Schneider
  • Kommission Pharmakotherapie der DGRh
Empfehlungen und Stellungnahmen von Fachgesellschaften

Zusammenfassung

Die zentrale Rolle der B-Lymphozyten in der Pathogenese des systemischen Lupus erythematodes (SLE) hat in den letzten Jahren das Interesse insbesondere auf spezifischere, B-Zell-gerichtete Therapien gelenkt. Belimumab ist ein monoklonaler Antikörper gegen den B-Lymphozytenstimulator BLyS, der 2011 als Zusatztherapie bei erwachsenen Patienten mit SLE zugelassen wurde. Auf Basis des aktuellen Kenntnisstands wird der Einsatz von Belimumab bei Patienten mit klinisch und serologisch aktivem SLE trotz einer individuell angepassten Standardtherapie empfohlen. Diese besteht in der Regel aus Antimalariamitteln, einem Immunsuppressivum (z. B. Azathioprin) und/oder Glukokortikoiden. Auch die Notwendigkeit von regelmäßig höheren Dosierungen von ≥ 7,5 mg Prednisolonäquivalent/Tag kann eine mögliche Indikation für Belimumab darstellen. Aufgrund fehlender Daten kann der Einsatz bei einer aktiven Nieren- und/oder ZNS-Beteiligung zurzeit nicht empfohlen werden.

Schlüsselwörter

Therapie Biologika B-Lymphozyten B-Zell-gerichtete Therapie Autoimmunerkrankung 

Recommendation for use of belimumab for systemic lupus erythematosus

Abstract

The central role of B-lymphocytes in the pathogenesis of systemic lupus erythematosus (SLE) has turned the attention particularly to more specific B-cell targeted therapies in recent years. Belimumab is a monoclonal antibody against the B-lymphocyte stimulator BlyS and was approved in 2011 as additional therapy for adult patients with SLE. Based upon the available data, treatment with belimumab is recommended in patients with clinically and serologically active SLE despite individually adjusted standard therapy. The standard therapy usually consists of antimalarial agents, an immunosuppressive drug (e.g. azathioprine) and/or steroids. Even the necessity for regular higher dosages of ≥ 7.5 mg prednisolone equivalents/day could be a feasible medical indication for belimumab. Due to lacking data the use of belimumab is not recommended for the purpose of treating severe active SLE with renal or central nervous system involvement until efficacy has been shown for these indications.

Keywords

Treatment Biologics B-lymphocytes B cell targeted therapy Autoimmune diseases 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • R. Fischer-Betz
    • 1
  • M. Schneider
    • 1
  • Kommission Pharmakotherapie der DGRh
  1. 1.Klinik für Endokrinologie, Diabetologie und RheumatologieRheumazentrum Rhein-Ruhr, Heinrich Heine Universität DüsseldorfDüsseldorfDeutschland

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