Lupus in Argentina. Non-responders to standard treatment and belimumab as a possible option. RELESSAR record data

  • Rosana Quintana Regional Center for Autoimmune and Rheumatic Diseases (CREAR), Rosario, Santa Fe, Argentina
  • Lucila García General Interzonal Acute Hospital General San Martín, La Plata, Buenos Aires, Argentina
  • Carla Gobbi Sanatorium Allende, Cordoba, Argentina
  • Paula Alba Cordoba Hospital, Cordoba, Argentina
  • Susana Roverano Hospital J.M. Cullen, Santa Fe, Argentina
  • Analía Patricia Álvarez Penna Hospital, Autonomous City of Buenos Aires, Argentina
  • César Enrique Graf Miter Medical Center, Paraná, Between Rios, Argentina
  • Cecilia Pisoni Center for Medical Education and Clinical Research Norberto Quirno, Autonomous City of Buenos Aires, Argentina
  • Alberto Spindler Tucumán Medical Research Center, Tucumán, Argentina
  • Catalina Gómez Central Hospital of Formosa, Formosa, Argentina
  • Heber Matías Figueredo High Complexity Hospital Pte. Juan Domingo Perón, Formosa, Argentina
  • Silvia Papasidero General Acute Hospital Dr. Enrique Tornú, Autonomous City of Buenos Aires, Argentina
  • Raúl Paniego Pampas Center for Rheumatology and Rehabilitation (CePReR), Santa Rosa, La Pampa, Argentina
  • María Celina de la Vega Medical Research (CEIM), Autonomous City of Buenos Aires, Argentina
  • Emma Civit Hospital del Carmen, Godoy Cruz, Mendoza, Argentina
  • Luciana González Lucero Angel C. Padilla Hospital, Tucuman, Argentina
  • Victoria Martire Italian Hospital of La Plata, La Plata, Buenos Aires, Argentina
  • Rodrigo Aguila Maldonado General Interzonal Acute Hospital General San Martín, La Plata, Buenos Aires, Argentina
  • Sergio Gordon Interzonal General Acute Hospital Dr. Alende, Mar del Plata, Buenos Aires, Argentina
  • Marina Micelli José María Acute General Hospital Ramos Mejia, Buenos Buenos Aires, Argentina
  • Romina Nieto Provincial Hospital of Rosario, Rosario, Santa Fe, Argentina
  • Gretel Rausch Private Practice, Rio Grande, Tierra del Fuego, Argentina
  • Vanina Gongora San Martin Hospital, Paraná, Between Rios, Argentina
  • Agustina Damico Santa Fe Children's Hospital Dr. Orlando Alassia, Santa Fe, Argentina
  • Gustavo Rodríguez Gil Interzonal Hospital Dr. José Penna, Bahía Blanca, Buenos Aires, Argentina
  • Diana Dubinsky Clinical Hospital, Autonomous City of Buenos Aires, Argentina
  • Alberto Orden Central Aeronautical Hospital, Autonomous City of Buenos Aires, Argentina
  • Johana Zacariaz Italian Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Julia Romero Alvear San Juan Clinic, San Juan, Argentina
  • Mariana Pera General Interzonal Acute Hospital General San Martín, La Plata, Buenos Aires, Argentina
  • Mario Goñi Outpatient Medical Specialties Center of Rosario, Rosario, Santa Fe, Argentina
  • Oscar Rillo Acute General Hospital Dr. Ignacio Pirovano, Autonomous City of Buenos Aires, Argentina
  • Roberto Báez General Roca Hospital, General Roca, Rio Negro, Argentina
  • Valeria Arturi General Interzonal Acute Hospital General San Martín, La Plata, Buenos Aires, Argentina
  • Andrea González Eva Peron Hospital, San Martin, Buenos Aires, Argentina
  • Florencia Vivero Private Community Hospital, Mar del Plata, Buenos Aires, Argentina
  • María Eugenia Bedoya San Martin Hospital, Parana, Entre Rios, Argentina
  • María Marcela Shmid Hospital Angela Church of Llano, Corrientes, Argentina
  • Víctor Caputo Juncal Sanatorium, Temperley, Buenos Aires, Argentina
  • Maria Silvia Larroude Private Practice, Avellaneda, Buenos Aires, Argentina
  • Nadia Domínguez José María Acute General Hospital Ramos Mejia, Buenos Buenos Aires, Argentina
  • Graciela Noemí Gómez Alfredo Lanari Medical Research Institute, Autonomous City of Buenos Aires, Argentina
  • Graciela Nora Rodríguez General Interzonal Acute Hospital General San Martín, La Plata, Buenos Aires, Argentina
  • José Marín Italian Hospital of Buenos Aires, Autonomous City of Buenos Aires, Argentina
  • Victoria Collado Alfredo Lanari Medical Research Institute, Autonomous City of Buenos Aires, Argentina
  • Marisa Jorfen Outpatient Medical Specialties Center of Rosario, Rosario, Santa Fe, Argentina
  • Zaida Bedran Acute Teaching Hospital Dr. Ramón Madariaga, Posadas, Misiones, Argentina
  • Ana Curti Hospital Luis Carlos Lagomaggiore, Mendoza, Argentina
  • María Victoria Gazzoni National Hospital of Clinics, Cordoba, Argentina
  • Judith Sarano Alfredo Lanari Medical Research Institute, Autonomous City of Buenos Aires, Argentina
  • Marcos Zelaya José María Acute General Hospital Ramos Mejia, Buenos Buenos Aires, Argentina
  • Mónica Sacnun Provincial Hospital of Rosario, Rosario, Santa Fe, Argentina
  • Pablo Finucci Curi San Martin Hospital, Paraná, Between Rios, Argentina
  • Romina Rojas Tessel Lord of the Miracle Hospital, Salta, Argentina
  • Maira Arias Saavedra José María Acute General Hospital Ramos Mejia, Buenos Buenos Aires, Argentina
  • María Emilia Sattler Eva Perón Teaching Hospital, Granadero Baigorria, Santa Fe, Argentina
  • Maximiliano Augusto Machado Escobar Eva Peron Hospital, Tucuman, Argentina
  • Pablo Astesana Sanatorium Allende, Cordoba, Argentina
  • Úrsula Paris Acute Teaching Hospital Dr. Ramón Madariaga, Posadas, Misiones, Argentina
  • Belén María Virasoro Center for Medical Education and Clinical Research Norberto Quirno, Autonomous City of Buenos Aires, Argentina
  • María Julia Santa Cruz Acute General Hospital Dr. Enrique Tornú, Autonomous City of Buenos Aires, Argentina
  • Alberto Allievi University of Salvador, Autoimmunity, Autonomous City of Buenos Aires, Argentina
  • Juan Manuel Vandale Private Community Hospital, Mar del Plata, Buenos Aires, Argentina
  • Noelia Giselle Hojberg José María Acute General Hospital Ramos Mejia, Buenos Buenos Aires, Argentina
  • Bernardo Pons-Estel Regional Center for Autoimmune and Rheumatic Diseases (CREAR), Rosario, Santa Fe, Argentina
  • Guillermo Pons-Estel Regional Center for Autoimmune and Rheumatic Diseases (CREAR), Rosario, Santa Fe, Argentina
  • Mercedes Argentina García General Interzonal Acute Hospital General San Martín, La Plata, Buenos Aires, Argentina
Keywords: systemic lupus erythematosus, remission, low disease activity, Belimumab, real-world data

Abstract

Introduction: lupus is a complex disease and often difficult to approach. Achieving remission is one of the objectives, incorporating therapeutic options. Objectives: to describe the characteristics of the patients and the use of belimumab, according to the status of the disease. Materials and methods: cross-sectional study. Patients of the RELESSAR registry. Stratification: Remission: SLEDAI=0 and without corticosteroids. Low disease activity SLEDAI> 0 and ≤4 and without corticosteroids and non-optimal control: SLEDAI>4 and any dose of corticosteroids. Results: a total of 1,277 patients were included, 23.4% in remission, 12.6% in low disease activity and 63.8% in non-optimal control. The last group was younger and had a shorter duration of the disease. They had higher activity and chronicity indices and greater use of immunosuppressants. Only 22.3% of the patients with potential criteria for the use of belimumab (activity disease despite standard treatment) were receiving it. The variables associated with hospitalizations were: corticosteroids, cyclophosphamide and higher SLICC. Those associated with severe infection: mycophenolate mofetil, azathioprine, corticosteroids, and higher SLICC. Conclusions: the complexity of the management of these patients is reflected, visualizing structural aspects such as inequality. The use of belimumab could be beneficial in selected patients.

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Published
2022-03-09
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1.
Quintana R, García L, Gobbi C, Alba P, Roverano S, Álvarez AP, Graf CE, Pisoni C, Spindler A, GómezC, Figueredo HM, Papasidero S, Paniego R, de la Vega MC, Civit E, González LuceroL, Martire V, Aguila Maldonado R, Gordon S, Micelli M, Nieto R, Rausch G, Gongora V, Damico A, Rodríguez GilG, Dubinsky D, Orden A, Zacariaz J, Romero J, Pera M, GoñiM, Rillo O, BáezR, Arturi V, GonzálezA, Vivero F, Bedoya ME, Shmid MM, Caputo V, Larroude MS, DomínguezN, GómezGN, RodríguezGN, Marín J, Collado V, Jorfen M, Bedran Z, Curti A, Gazzoni MV, Sarano J, Zelaya M, Sacnun M, Finucci Curi P, Rojas Tessel R, Arias Saavedra M, Sattler ME, Machado Escobar MA, Astesana P, Paris U, Virasoro BM, Santa Cruz MJ, Allievi A, Vandale JM, Hojberg NG, Pons-Estel B, Pons-Estel G, GarcíaMA. Lupus in Argentina. Non-responders to standard treatment and belimumab as a possible option. RELESSAR record data. Rev. Argent. Reumatol. [Internet]. 2022Mar.9 [cited 2025Jan.15];33(1):14 -25. Available from: https://ojs.reumatologia.org.ar/index.php/revistaSAR/article/view/602
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