Blisibimod for treatment of systemic lupus erythematosus: with trials you become wiser

ABSTRACT

Introduction: Blisibimod is a potent and selective inhibitor of B cell activating factor (BAFF), a mediator of differentiation, maturation and survival of B cells. It has a unique tetravalent, ‘peptibody’ structure and resulting high potency, and is currently in clinical evaluation for the treatment of SLE. The importance of BAFF in the pathogenesis of systemic lupus erythematosus (SLE) is under intense investigation. The anti BAFF monoclonal antibody belimumab was approved by the FDA for the treatment of SLE.

Areas covered: The general properties of blisibimod are reviewed including pharmacokinetic and pharmacodynamic properties in patients with SLE, efficacy and safety in the phase 2 PEARL-SC and open-label extension trials, and the focus in the ongoing phase 3 trial (CHABLIS-SC1) on the hypothesized ‘responder’ population. In addition, the rationale for evaluating blisibimod in patients with IgA nephropathy, a common nephritic disease for which there is no approved therapy, is presented.

Expert Opinion: Blisibimod’s unique tetravalent, peptibody structure and resulting high potency, and the deliberate focus of the Phase 3 clinical development program on the ‘responder populations’ identified in completed trials in SLE raise the possibility that blisibimod will become an important medication for treatment of SLE and IgA nephropathy.

KEYWORDS:

• BAFF
• systemic lupus erythematosus
• IgA nephropathy
• B lymphocyte

Article highlights

• B cells are implicated in the pathogenesis of several autoimmune diseases including SLE and IgAN.

• Blisibimod is a biologic therapeutic agent that potently and selectively inhibits signaling of membrane-bound and soluble forms of BAFF.

• Completed Phase 1 and Phase 2 trials with blisibimod demonstrate its safety, pharmacodynamic effects, and efficacy in patients with more severe SLE.

• Completed trials with BAFF inhibitors in over 5000 patients with SLE identify potential ‘responder populations’ for blisibimod in SLE.

• The ongoing Phase 3 trial with blisibimod focusses on the ‘responder populations;’ data are expected in 2016.

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Declaration of interest

This article was written with the support of Anthera Pharmaceuticals Inc. CM Hislop and RS Martin are both employees and shareholders of Anthera Pharmaceuticals Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.