Considering belimumab during pregnancy: A more viable option over time

Area of Science:

• Rheumatology
• Immunology
• Maternal-Fetal Medicine

Background:

• Systemic lupus erythematosus (SLE) poses risks during pregnancy.
• Limited data exists on the safety and efficacy of biologic therapies like belimumab in pregnant lupus patients.
• Managing lupus during pregnancy requires careful consideration of maternal and fetal outcomes.

Purpose of the Study:

• To report on the use of belimumab in pregnant women with lupus.
• To review existing literature on belimumab's use in pregnancy.
• To assess maternal and fetal outcomes associated with belimumab treatment during gestation.

Main Methods:

• Prospective observational study of pregnant lupus patients.
• Systematic literature search of MEDLINE and EMBASE databases.
• Descriptive analysis of included studies and case reports.

Main Results:

• Belimumab was used in 8 pregnancies across 6 women, with 1 miscarriage and 7 live births.
• In a broader literature review of 41 pregnancies, risks included preterm birth and pre-eclampsia, but no malformations were reported.
• Neonatal outcomes were generally favorable, with normal Apgar scores, though some newborns had low birth weight and increased risk of infection.

Conclusions:

• Belimumab may be a viable treatment option for pregnant women with refractory lupus.
• While initial data is encouraging, further research is essential to definitively establish the safety profile of belimumab concerning fetal development.
• Long-term studies are needed to fully understand the implications of belimumab exposure during pregnancy.