The human body’s natural defenses include the immune system. When healthy, it helps fight off pathogens like viruses which cause the common cold to more serious cellular changes which can cause cancer. When this system becomes unable to perform properly, illnesses such autoimmune diseases occur. This is what happens in lupus too. The immune system mistakes healthy tissues and organs as foreign and becomes activated against them.
Traditional lupus therapy focuses on medications which can suppress the immune system’s reactions and bring patients into remission. Many lupus patients rely on immunosuppressive medications such as Hydroxychloroquine and corticosteroids. While these medications are effective and safe treatment options, they do have their own side effects with prolonged use.
Hopeful new medications
The race to find safer and more effective medications for various autoimmune conditions is ongoing. Whether it’s lupus or rheumatoid arthritis, the focus on precision medicine seems to be leading the way. Precision medicine hopes to provide therapies which take into account genetic variations seen across patients. This is so important in lupus because patients present with various symptoms, depending on their genes.
Monoclonal antibodies are one such class of drugs. They work by targeting and suppressing the various components of the immune system which cause excessive immune responses and disease. There are more than 80 monoclonal antibodies which are being used in the treatment of many conditions including cancer, psoriatic arthritis, and rheumatoid arthritis.
The release of monoclonal antibody medication called belimumab (Benlysta) which is developed by GlaxoSmithKline (GSK) is especially game changing for lupus because it is the first new treatment for lupus in the past 50 years. Initially released in December of 2011, it is FDA approved for both lupus and lupus nephritis in the following patient populations:
- Patients aged 5 years and older with active, autoantibody-positive lupus who are already receiving standard therapy
- Adult patients with active lupus nephritis who are already receiving standard therapy
Belimumab (benlysta) works by targeting BLyS, which is a protein that helps B cells (a part of the immune system) survive. It has been shown to lower the number of autoreactive B cells in lupus patients. Autoreactive B cells produce auto-antibodies which attack and destroy healthy tissues and organs therefore causing prolonged inflammation. Belimumab can be administered as an intravenous administration or subcutaneous injection.
Years ago, when I was in pharmacy school the term “blockbuster drug” really caught my attention. I used to wonder how something like a drug could be so exciting because in my mind the word blockbuster was always used for films. It was only after being in several clinical practice settings that I saw the power of certain “blockbuster drugs” that it finally clicked.
I realized that medications absolutely can be life and generation changing. Where once, certain conditions quickly overpowered their hosts, now there could be hope to manage them.
The autoimmune community has been waiting a long time for another blockbuster drug, since adalimumab (Humira) was released almost 20 years ago. When belimumab was released in 2009, there was a lot of hope for it to be next and even though, over the years sales have cooled down and some healthy competition has arrived, it is still considered to be a much needed advancement in lupus treatment.
The information provided above is not medical advice. If you are interested in more information about benlysta or belimumab, speak to your rheumatologist. Together, you can determine if changes to your current therapy regimen are appropriate.
By Nadia Bhatti
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