Smoking reduces the efficacy of belimumab in mucocutaneous lupus. (3rd August 2018)

• Record Type: Journal Article
• Authors: Parodis, Ioannis; Gomez, Alvaro; Frodlund, Martina; Jönsen, Andreas; Zickert, Agneta; Sjöwall, Christopher; Bengtsson, Anders A; Gunnarsson, Iva
• Is Part Of: Expert opinion on biological therapy. Volume 18:Number 8(2018)
• Page Start: 911
• Page End: 920
• Publication Date: 2018-08-03
• Subjects: Belimumab -- biological agents -- drug efficacy -- rheumatology -- systemic lupus erythematosus; Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1080/14712598.2018.1494719
• Languages: English
• ISSNs: 1471-2598

Abstract

ABSTRACT: Objectives : Recently, we demonstrated a negative impact of smoking on belimumab efficacy in patients with systemic lupus erythematosus (SLE). Here, we particularly investigated clinical effects of belimumab and a potential impact of smoking in mucocutaneous and articular SLE. Methods : We surveyed 62 SLE patients treated between 2011 and 2017. Evaluation included the mucocutaneous descriptors of SLEDAI-2K (rash, alopecia, mucosal ulcers; mcSLEDAI-2K), CLASI, the arthritis SLEDAI-2K descriptor (arSLEDAI-2K) and the 28-joint count. Results : mcSLEDAI-2K and CLASI activity decreased from baseline to month 6 and 12 ( P < 0.001 for all). No worsening in CLASI damage was observed. Current or previous smokers displayed a higher probability of unchanged/worsened mcSLEDAI-2K compared to never smokers (OR: 6.4; 95% CI: 1.5–27.4; P = 0.012), also after adjustment for antimalarial agents. arSLEDAI-2K scores had decreased at month 6 ( P < 0.001) and 12 ( P < 0.001). Likewise, tender and swollen 28-joint counts had improved at month 6 ( P = 0.010 and P < 0.001, respectively) and 12 ( P = 0.001 for both). We observed no impact of smoking on belimumab efficacy in articular SLE. Conclusion : We observed a negative impact of smoking on the efficacy of belimumab in mucocutaneous SLE. In contrast, no impact of smoking on belimumab efficacy was seen in patients with articular manifestations.