Preventing organ damage in systemic lupus erythematosus: the impact of early biological treatment

References

• Weiss JE. Pediatric systemic lupus erythematosus: more than a positive antinuclear antibody. Pediatr Rev. 2012;33(2):62–73.
   PubMedGoogle Scholar
• Rivas-Larrauri F, Yamazaki-Nakashimada MA. Lupus eritematoso sistémico: ¿es una sola enfermedad? Reumatol Clin. 2016;12(5):274–281.
   PubMedGoogle Scholar
• McMurray RW, May W. Sex hormones and systemic lupus erythematosus: review and meta-analysis. Arthritis Rheum. 2003;48(8):2100–2110.
   PubMedGoogle Scholar
• Cortés R, Pego-Reigosa JM, Seoane-Mato D, et al. Prevalence of systemic lupus erythematosus in Spain: higher than previously reported in other countries? Rheumatology (Oxford). 2020;59(9):2556–2562.
   PubMed Web of Science ®Google Scholar
• Nat Carter EE, Barr SG, Clarke AE. The global burden of SLE: prevalence, health disparities and socioeconomic impact. Rev Rheumatol. 2016;12:605–620.
   PubMed Web of Science ®Google Scholar
• Bruce IN, O’Keeffe AG, Farewell V, et al. Factors associated with damage accrual in patients with systemic lupus erythematosus: results from the Systemic Lupus International Collaborating Clinics (SLICC) Inception Cohort. Ann Rheum Dis. 2015;74(9):1706–1713.
   PubMed Web of Science ®Google Scholar
• Arkema EV, Jönsen A, Rönnblom L, et al. Case definitions in Swedish register data to identify systemic lupus erythematosus. BMJ Open. 2016;6(1):e007769.
   PubMed Web of Science ®Google Scholar
• Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011;365(22):2110–2121.
   PubMed Web of Science ®Google Scholar
• Tselios K, Gladman DD, Touma Z, et al. Disease course patterns in systemic lupus erythematosus. Lupus. 2019;28(1):114–122.
   PubMed Web of Science ®Google Scholar
• Gallop K, Nixon A, Swinburn P, et al. Development of a conceptual model of health-related quality of life for systemic lupus erythematosus from the patient’s perspective. Lupus. 2012;21(9):934–943.
   PubMed Web of Science ®Google Scholar
• Mazzoni D, Cicognani E, Prati G. Health-related quality of life in systemic lupus erythematosus: a longitudinal study on the impact of problematic support and self-efficacy. Lupus. 2017;26(2):125–131.
   PubMed Web of Science ®Google Scholar
• Cervera R, Rúa-Figueroa I, Gil-Aguado A, et al. Coste económico directo del control y el tratamiento del lupus eritematoso sistémico activo y sus brotes en España: estudio LUCIE. Rev Clín Esp. 2013;213(3):127–137.
   PubMedGoogle Scholar
• Doria A, Amoura Z, Cervera R, et al. Annual direct medical cost of active systemic lupus erythematosus in five European countries. Ann Rheum Dis. 2014;73(1):154–160.
   PubMed Web of Science ®Google Scholar
• Doria A, Gatto M, Zen M, et al. Optimizing outcome in SLE: treating-to-target and definition of treatment goals. Autoimmun Rev. 2014;13(7):770–777.
   PubMed Web of Science ®Google Scholar
• Jorge AM, Lu N, Zhang Y, et al. Unchanging premature mortality trends in systemic lupus erythematosus: a general population-based study (1999–2014). Rheumatology (Oxford). 2018;57(2):337–344.
   PubMed Web of Science ®Google Scholar
• Ghazali WSW, Daud SMM, Mohammad N, et al. SLICC damage index score in systemic lupus erythematosus patients and its associated factors. Medicine (Baltimore). 2018;97(42):12787.
   Web of Science ®Google Scholar
• Sutton EJ, Davidson JE, Bruce IN. The systemic lupus international collaborating clinics (SLICC) damage index: a systematic literature review. Semin Arthritis Rheum. 2013;43(3):352–361.
   PubMed Web of Science ®Google Scholar
• Doria A, Zen M, Canova M, et al. SLE diagnosis and treatment: when early is early. Autoimmun Rev. 2010;10(1):55–60.
   PubMed Web of Science ®Google Scholar
• Gatto M, Zen M, Iaccarino L, et al. New therapeutic strategies in systemic lupus erythematosus management. Nat Rev Rheumatol. 2019;15(1):30–48.
   PubMed Web of Science ®Google Scholar
• van Vollenhoven RF, Mosca M, Bertsias G, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis. 2014;73(6):958–967.
   PubMed Web of Science ®Google Scholar
• van Vollenhoven R, Voskuyl A, Bertsias G, et al. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis. 2017;76(3):554–561.
   PubMed Web of Science ®Google Scholar
• Wilhelm TR, Magder LS, Petri M. Remission in systemic lupus erythematosus: durable remission is rare. Ann Rheum Dis. 2017;76(3):547–553.
   PubMed Web of Science ®Google Scholar
• van Vollenhoven R, Bertsias G, Doria A, et al. OP0296 The 2021 DORIS definition of remission in sle – final recommendations from an international task force. Ann Rheum Dis. 2021;80(Suppl 1):181–182.
   Google Scholar
• Morand EF, Mosca M. Treat to target, remission and low disease activity in SLE. Best Pract Res Clin Rheumatol. 2017;31(3):342–350.
   PubMed Web of Science ®Google Scholar
• Fanouriakis A, Kostopoulou M, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis. 2019;78(6):736–745.
   PubMed Web of Science ®Google Scholar
• Mok CC. Biological and targeted therapies of systemic lupus erythematosus: evidence and the state of the art. Expert Rev Clin Immunol. 2017;13(7):677–692.
   PubMed Web of Science ®Google Scholar
• Mak A, Cheung MW-L, Chiew HJ, et al. Global trend of survival and damage of systemic lupus erythematosus: meta-analysis and meta-regression of observational studies from the 1950s to 2000s. Semin Arthritis Rheum. 2012;41(6):830–839.
   PubMed Web of Science ®Google Scholar
• Taraborelli M, Cavazzana I, Martinazzi N, et al. Organ damage accrual and distribution in systemic lupus erythematosus patients followed-up for more than 10 years. Lupus. 2017;26(11):1197–1204.
   PubMed Web of Science ®Google Scholar
• Pego-Reigosa JM, Rúa-Figueroa Í, López-Longo FJ, et al. Analysis of disease activity and response to treatment in a large Spanish cohort of patients with systemic lupus erythematosus. Lupus. 2015;24(7):720–729.
   PubMed Web of Science ®Google Scholar
• Doria A, Iaccarino L, Ghirardello A, et al. Long-term prognosis and causes of death in systemic lupus erythematosus. Am J Med. 2006;119(8):700–706.
   PubMed Web of Science ®Google Scholar
• Dubey AK, Handu SS, Dubey S, et al. Belimumab: first targeted biological treatment for systemic lupus erythematosus. J Pharmacol Pharmacother. 2011;2(4):317–319.
   PubMedGoogle Scholar
• Poh YJ, Baptista B, D’ CDP. Subcutaneous and intravenous belimumab in the treatment of systemic lupus erythematosus: a review of data on subcutaneous and intravenous administration. Expert Rev Clin Immunol. 2017;13(10):925–938.
   PubMed Web of Science ®Google Scholar
• Schioppo T, Ingegnoli F. Current perspective on rituximab in rheumatic diseases. Drug Des Devel Ther. 2017;11:2891–2904.
   PubMed Web of Science ®Google Scholar
• Schmajuk G, Yazdany J, Trupin L, et al. Hydroxychloroquine treatment in a community-based cohort of patients with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2010;62(3):386–392.
   PubMed Web of Science ®Google Scholar
• Gatto M, Iaccarino L, Zen M, et al. When to use belimumab in SLE. Expert Rev Clin Immunol. 2017;13(8):737–740.
   PubMed Web of Science ®Google Scholar
• Furie R, Rovin BH, Houssiau F, et al. Two-year, randomized, controlled trial of belimumab in lupus nephritis. N Engl J Med. 2020;383(12):1117–1128.
   PubMed Web of Science ®Google Scholar
• Rovin BH, Furie R, Teng YKO, et al. A secondary analysis of the Belimumab International Study in Lupus Nephritis trial examined effects of belimumab on kidney outcomes and preservation of kidney function in patients with lupus nephritis. Kidney Int. 2022 Feb;101(2):403–413.
   PubMed Web of Science ®Google Scholar
• Feld J, Isenberg D. Why and how should we measure disease activity and damage in lupus? Presse Med. 2014;43(6):151–156.
   Web of Science ®Google Scholar
• Handa R. Chapter 144. Management of systemic lupus erythematosus. In: Medicine update. Vol. 17; 2007. doi:10.5005/jp/books/12086_144.
   Google Scholar
• Urowitz MB, Gladman DD, Ibañez D, et al. Evolution of disease burden over five years in a multicenter inception systemic lupus erythematosus cohort. Arthritis Care Res (Hoboken). 2012;64(1):132–137.
   PubMed Web of Science ®Google Scholar
• Becker-Merok A, Nossent HC. Damage accumulation in systemic lupus erythematosus and its relation to disease activity and mortality. J Rheumatol. 2006;33:1570–1577.
   PubMed Web of Science ®Google Scholar
• Chambers SA, Allen E, Rahman A, et al. Damage and mortality in a group of British patients with systemic lupus erythematosus followed up for over 10 years. Rheumatology (Oxford). 2009;48(6):673–675.
   PubMed Web of Science ®Google Scholar
• Gladman D, Ginzler E, Goldsmith C, et al. Systemic lupus international collaborative clinics: development of a damage index in systemic lupus erythematosus. J Rheumatol. 1992;19(11):1820–1821.
   PubMed Web of Science ®Google Scholar
• Gladman D, Ginzler E, Goldsmith C, et al. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum. 1996;39(3):363–369.
   PubMed Web of Science ®Google Scholar
• Gladman DD, Urowitz MB, Rahman P, et al. Accrual of organ damage over time in patients with systemic lupus erythematosus. J Rheumatol. 2003;30(9):1955–1959.
   PubMed Web of Science ®Google Scholar
• Maddison P, Farewell V, Isenberg D, et al. The rate and pattern of organ damage in late onset systemic lupus erythematosus. J Rheumatol. 2002;29(5):913–917.
   PubMed Web of Science ®Google Scholar
• Mok CC, Ho LY, Cheung MY, et al. Effect of disease activity and damage on quality of life in patients with systemic lupus erythematosus: a 2-year prospective study. Scand J Rheumatol. 2009;38(2):121–127.
   PubMed Web of Science ®Google Scholar
• Piga M, Floris A, Sebastiani GD, et al. Risk factors of damage in early diagnosed systemic lupus erythematosus: results of the Italian multicentre Early Lupus Project inception cohort. Rheumatology (Oxford). 2020;59(9):2272–2281.
   PubMed Web of Science ®Google Scholar
• Danila MI, Pons-Estel GJ, Zhang J, et al. Renal damage is the most important predictor of mortality within the damage index: data from LUMINA LXIV, a multiethnic US cohort. Rheumatology (Oxford). 2009;48(5):542–545.
   PubMed Web of Science ®Google Scholar
• Pego-Reigosa J, Lois-Iglesias A, Mouriño-Rodriguez C, et al. Chronological analysis of damage accrual in patients with systemic lupus erythematosus: results from the Spanish Registry of Patients with SLE of the Spanish Society of Rheumatology (RELESSER). Arthritis Rheumatol. 2016;68:1774.
   Web of Science ®Google Scholar
• Nossent J, Kiss E, Rozman B, et al. Disease activity and damage accrual during the early disease course in a multinational inception cohort of patients with systemic lupus erythematosus. Lupus. 2010;19(8):949–956.
   PubMed Web of Science ®Google Scholar
• Giannakou I, Chatzidionysiou K, Magder LS, et al. Predictors of persistent disease activity and long quiescence in systemic lupus erythematosus: results from the Hopkins Lupus Cohort. Lupus Sci Med. 2018;5(1):e000287.
   PubMed Web of Science ®Google Scholar
• Zen M, Iaccarino L, Gatto M, et al. The effect of different durations of remission on damage accrual: results from a prospective monocentric cohort of Caucasian patients. Ann Rheum Dis. 2017;76(3):562–565.
   PubMed Web of Science ®Google Scholar
• Rahman P, Gladman DD, Urowitz MB, et al. Early damage as measured by the SLICC/ACR damage index is a predictor of mortality in systemic lupus erythematosus. Lupus. 2001;10(2):93–96.
   PubMed Web of Science ®Google Scholar
• McMahon M, Hahn BH, Skaggs BJ. Systemic lupus erythematosus and cardiovascular disease: prediction and potential for therapeutic intervention. Expert Rev Clin Immunol. 2011;7(2):227–241.
   PubMed Web of Science ®Google Scholar
• McCarthy EM, Sutton E, Nesbit S, et al. Short-term efficacy and safety of rituximab therapy in refractory systemic lupus erythematosus: results from the British Isles Lupus Assessment Group Biologics Register. Rheumatology (Oxford). 2018;57(3):470–479.
   PubMed Web of Science ®Google Scholar
• Stojan G, Petri M. The Risk Benefit Ratio of Glucocorticoids in SLE: have things changed over the Past 40 years? Curr Treatm Opt Rheumatol. 2017;3(3):164–172.
   PubMedGoogle Scholar
• Luijten RKMAC, Fritsch-Stork RD, Bijlsma JWJ, et al. The use of glucocorticoids in Systemic Lupus Erythematosus. After 60 years still more an art than science. Autoimmun Rev. 2013;12(5):617–628.
   PubMed Web of Science ®Google Scholar
• Apostolopoulos D, Kandane-Rathnayake R, Raghunath S, et al. Independent association of glucocorticoids with damage accrual in SLE. Lupus Sci Med. 2016;3(1):e000157.
   PubMed Web of Science ®Google Scholar
• Frodlund M, Reid S, Wetterö J, et al. The majority of Swedish systemic lupus erythematosus patients are still affected by irreversible organ impairment: factors related to damage accrual in two regional cohorts. Lupus. 2019;28(10):1261–1272.
   PubMed Web of Science ®Google Scholar
• Conti F, Ceccarelli F, Perricone C, et al. The chronic damage in systemic lupus erythematosus is driven by flares, glucocorticoids and antiphospholipid antibodies: results from a monocentric cohort. Lupus. 2016;25(7):719–726.
   PubMed Web of Science ®Google Scholar
• Davidson JE, Fu Q, Rao S, et al. Quantifying the burden of steroid-related damage in SLE in the Hopkins Lupus Cohort. Lupus Sci Med. 2018;5(1):e000237.
   PubMed Web of Science ®Google Scholar
• Sheane BJ, Gladman DD, Su J, et al. Disease outcomes in glucocorticosteroid-naive patients with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2017;69(2):252–256.
   PubMed Web of Science ®Google Scholar
• Tarr T, Papp G, Nagy N, et al. Chronic high-dose glucocorticoid therapy triggers the development of chronic organ damage and worsens disease outcome in systemic lupus erythematosus. Clin Rheumatol. 2017;36(2):327–333.
   PubMed Web of Science ®Google Scholar
• Ruiz-Arruza I, Ugarte A, Cabezas-Rodriguez I, et al. Glucocorticoids and irreversible damage in patients with systemic lupus erythematosus. Rheumatology (Oxford). 2014;53(8):1470–1476.
   PubMed Web of Science ®Google Scholar
• Thamer M, Hernán MA, Zhang Y, et al. Prednisone, lupus activity, and permanent organ damage. J Rheumatol. 2009;36(3):560–564. (REPETIDA A X4).
   PubMed Web of Science ®Google Scholar
• Mok CC, Ho CTK, Wong RWS, et al. Damage accrual in southern Chinese patients with systemic lupus erythematosus. J Rheumatol. 2003;30(7):1513–1519.
   PubMed Web of Science ®Google Scholar
• Bonakdar ZS, Mohtasham N, Karimifar M. Evaluation of damage index and its association with risk factors in patients with systemic lupus erythematosus. J Res Med Sci. 2011;16:427–432.
   Google Scholar
• Ugarte-Gil MF, Acevedo-Vásquez E, Alarcón GS, et al. The number of flares patients experience impacts on damage accrual in systemic lupus erythematosus: data from a multiethnic Latin American cohort. Ann Rheum Dis. 2015;74(6):1019–1023.
   PubMed Web of Science ®Google Scholar
• Legge A, Doucette S, Hanly JG. Predictors of organ damage progression and effect on health-related quality of life in systemic lupus erythematosus. J Rheumatol. 2016;43(6):1050–1056.
   PubMed Web of Science ®Google Scholar
• Schneider M. Pitfalls in lupus. Autoimmun Rev. 2016;15(11):1089–1093.
   PubMed Web of Science ®Google Scholar
• Enocsson H, Wirestam L, Dahle C, et al. Soluble urokinase plasminogen activator receptor (suPAR) levels predict damage accrual in patients with recent-onset systemic lupus erythematosus. J Autoimmun. 2020;106:102340.
   PubMed Web of Science ®Google Scholar
• van Vollenhoven RF, Petri MA, Cervera R, et al. Belimumab in the treatment of systemic lupus erythematosus: high disease activity predictors of response. Ann Rheum Dis. 2012;71(8):1343–1349.
   PubMed Web of Science ®Google Scholar
• Zhang F, Bae S-C, Bass D, et al. A pivotal phase III, randomised, placebo-controlled study of belimumab in patients with systemic lupus erythematosus located in China, Japan and South Korea. Ann Rheum Dis. 2018;77(3):355–363.
   PubMed Web of Science ®Google Scholar
• Stohl W, Schwarting A, Okada M, et al. Efficacy and Safety of Subcutaneous Belimumab in Systemic Lupus Erythematosus: a Fifty-Two–Week Randomized, Double-Blind, Placebo-Controlled Study. Arthritis Rheumatol. 2017;69(5):1016–1027.
   PubMed Web of Science ®Google Scholar
• Nikolopoulos DS, Kostopoulou M, Pieta A, et al. Transition to severe phenotype in systemic lupus erythematosus initially presenting with non-severe disease: implications for the management of early disease. Lupus Sci Med. 2020;7(1):e000394.
   PubMed Web of Science ®Google Scholar
• Piga M, Floris A, Cappellazzo G, et al. Failure to achieve lupus low disease activity state (LLDAS) six months after diagnosis is associated with early damage accrual in Caucasian patients with systemic lupus erythematosus. Arthritis Res Ther. 2017;19(1):247.
   PubMedGoogle Scholar
• Hanly JG, Sayani A, and Doucette S, et al. Corticosteroids in early treatment pathways in SLE. Abstract Number: 688. 2014 ACR/ARHP Annual Meeting. Boston. Available from: https://acrabstracts.org/abstract/corticosteroids-in-early-treatment-pathways-in-sle
   Google Scholar
• Gatto M, Saccon F, Zen M, et al. Early disease and low baseline damage as predictors of response to belimumab in patients with systemic lupus erythematosus in a real-life setting. Arthritis Rheumatol. 2020;72(8):1314–1324.
   PubMed Web of Science ®Google Scholar
• Fanouriakis A, Bertsias G. Changing paradigms in the treatment of systemic lupus erythematosus. Lupus Sci Med. 2019;6(1):e000310.
   PubMed Web of Science ®Google Scholar
• Zonana-Nacach A, Barr SG, Magder LS, et al. Damage in systemic lupus erythematosus and its association with corticosteroids. Arthritis Rheum. 2000;43(8):1801–1808.
   PubMed Web of Science ®Google Scholar
• Ruiz-Arruza I, Lozano J, Cabezas-Rodriguez I, et al. Restrictive use of oral glucocorticoids in systemic lupus erythematosus and prevention of damage without worsening long-term disease control: an observational study. Arthritis Care Res (Hoboken). 2018;70(4):582–591.
   PubMed Web of Science ®Google Scholar
• Costedoat-Chalumeau N, Dunogué B, Morel N, et al. Hydroxychloroquine: a multifaceted treatment in lupus. Presse Med. 2014;43(6):167–180.
   Web of Science ®Google Scholar
• Floris A, Piga M, Mangoni AA, et al. Protective effects of hydroxychloroquine against accelerated atherosclerosis in systemic lupus erythematosus. Mediators Inflamm. 2018;2018:3424136.
   PubMed Web of Science ®Google Scholar
• James JA, Kim-Howard XR, Bruner BF, et al. Hydroxychloroquine sulfate treatment is associated with later onset of systemic lupus erythematosus. Lupus. 2007;16(6):401–409.
   PubMed Web of Science ®Google Scholar
• Akhavan PS, Su J, Lou W, et al. The early protective effect of hydroxychloroquine on the risk of cumulative damage in patients with systemic lupus erythematosus. J Rheumatol. 2013;40(6):831–841.
   PubMed Web of Science ®Google Scholar
• Collins CE, Dall’Era M, Kan H, et al. Response to belimumab among patients with systemic lupus erythematosus in clinical practice settings: 24-month results from the OBSErve study in the USA. Lupus Sci Med. 2016;3(1):e000118.
   PubMed Web of Science ®Google Scholar
• Terrier B, Amoura Z, Ravaud P, et al. Safety and efficacy of rituximab in systemic lupus erythematosus: results from 136 patients from the French AutoImmunity and Rituximab registry. Arthritis Rheum. 2010;62(8):2458–2466.
   PubMed Web of Science ®Google Scholar
• Bruce IN, Urowitz M, van Vollenhoven R, et al. Long-term organ damage accrual and safety in patients with SLE treated with belimumab plus standard of care. Lupus. 2016;25(7):699–709.
   PubMed Web of Science ®Google Scholar
• Urowitz MB, Ohsfeldt RL, Wielage RC, et al. Organ damage in patients treated with belimumab versus standard of care: a propensity score-matched comparative analysis. Ann Rheum Dis. 2019;78(3):372–379.
   PubMed Web of Science ®Google Scholar
• van Vollenhoven RF, Navarra SV, Levy RA, et al. Long-term safety and limited organ damage in patients with systemic lupus erythematosus treated with belimumab: a phase III study extension. Rheumatology (Oxford). 2020;59(2):281–291.
   PubMed Web of Science ®Google Scholar
• Parodis I, Gomez A, Emamikia S, et al. Established organ damage reduces belimumab efficacy in systemic lupus erythematosus. Ann Rheum Dis. 2019;78(7):1006–1007.
   PubMed Web of Science ®Google Scholar
• Clinical Trial [Internet]. Trial of belimumab in early lupus. Available from: https://clinicaltrials.gov/ct2/show/NCT03543839
   Google Scholar
• Condon MB, Ashby D, Pepper RJ, et al. Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids. Ann Rheum Dis. 2013;72(8):1280–1286.
   PubMed Web of Science ®Google Scholar
• Asif S, Bargman J, Auguste B. A review of the Aurora and BLISS trials: will it revolutionize the treatment of lupus nephritis? Curr Opin Nephrol Hypertens. 2022;31(3):278–282.
   PubMed Web of Science ®Google Scholar
• Gracia-Tello B, Ezeonyeji A, Isenberg D. The use of rituximab in newly diagnosed patients with systemic lupus erythematosus: long-term steroid saving capacity and clinical effectiveness. Lupus Sci Med. 2017;4(1):e000182.
   PubMed Web of Science ®Google Scholar
• Cobo-Ibáñez T, Loza-Santamaría E, Pego-Reigosa JM, et al. Efficacy and safety of rituximab in the treatment of non-renal systemic lupus erythematosus: a systematic review. Semin Arthritis Rheum. 2014;44(2):175–185.
   PubMed Web of Science ®Google Scholar
• Finckh A, Bansback N, Marra CA, et al. Treatment of very early rheumatoid arthritis with symptomatic therapy, disease-modifying antirheumatic drugs, or biologic agents: a cost-effectiveness analysis. Ann Intern Med. 2009;151(9):612–621.
   PubMed Web of Science ®Google Scholar
• Castro-Rueda H, Kavanaugh A. Biologic therapy for early rheumatoid arthritis: the latest evidence. Curr Opin Rheumatol. 2008;20(3):314–319.
   PubMed Web of Science ®Google Scholar
• Schwarting A, Dooley MA, Roth DA, et al. Impact of concomitant medication use on belimumab efficacy and safety in patients with systemic lupus erythematosus. Lupus. 2016;25(14):1587–1596.
   PubMed Web of Science ®Google Scholar
• Cortés J, Andreu JL, Calvo J, et al. Evaluation of use of belimumab in clinical practice settings (Observe Study) in Spain: health resource utilization and labour absenteeism. Value Health. 2014;17(7):534.
   PubMed Web of Science ®Google Scholar
• Cevey M, Calvo-Alén J, Crespo C, et al. Budget impact analysis of subcutaneous belimumab in patients with systemic lupus erythematosus in Spain. Clinicoecon Outcomes Res. 2019;11:757–765.
   PubMed Web of Science ®Google Scholar
• Deeks ED. Anifrolumab: first approval. Drugs. 2021;81(15):1795–1802.
   Google Scholar
• Liossis SN, Staveri C. What’s new in the treatment of systemic lupus erythematosus. Front Med (Lausanne). 2021;8:655100.
   PubMed Web of Science ®Google Scholar
• Keyes E, Grinnell M, Jacoby D, et al. Assessment and management of the heightened risk for atherosclerotic cardiovascular events in patients with lupus erythematosus or dermatomyositis. Int J Women’s Dermatol. 2021 Sep 9;7(5):560–575.
   PubMedGoogle Scholar
• Liu Z, Zhang H, Liu Z, et al. Multitarget therapy for induction treatment of lupus nephritis: a randomized trial. Ann Intern Med. 2015;162(1):18–26.
   PubMed Web of Science ®Google Scholar
• Rovin BH, Teng YKO, Ginzler EM, et al. Efficacy and safety of voclosporin versus placebo for lupus nephritis (Aurora 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2021;397(10289):2070–2080.
   PubMed Web of Science ®Google Scholar