Belimumab: First targeted biological treatment for systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder involving multiple organs and having diverse clinical manifestations. Among the rheumatic diseases, it has one of the highest mortality rates. Its prevalence around the world ranges from 20 to 70 per 100,000 person-years. Clinical features of SLE range from mild involvement of skin and joints to severe debilitating complications at later stages, such as infections and problems of renal, cardiovascular, and central nervous system, which are responsible for considerable morbidity and mortality. Being an autoimmune disease, SLE is characterized by the presence of antibodies against the self-antigens. The deposition of autoantibodies and immune complexes in the tissues leads to inflammatory damage of various organ systems of the body. The existing treatment options to relieve symptoms and control the progression of the disease include nonsteroidal anti-inflammatory drugs (NSAIDs), and immunosuppressants, such as hydroxychloroquine, corticosteroids, methotrexate, azathioprine, cyclophosphamide, and mycophenolate mofetil. Till now, we had mainly relied on nonspecific immunosuppression for keeping the disease under control. Recently, a drug has been approved specifically for SLE after a long gap (hydroxychloroquine being the last drug to be approved by the Food and Drug Administration [FDA] 56 years back in 1955). The drug, belimumab, which was approved on March 9, 2011, by FDA, is the first ever targeted biological for the treatment of SLE patients with active, autoantibody-positive disease, who are already on standard therapy. It has been developed by Human Genome Sciences Inc. in collaboration with GlaxoSmithKline.