title: Belimumab: a technological advance for systemic lupus erythematosus patients? Report of a systematic review and meta-analysis.
abstract: OBJECTIVE
  To undertake a systematic review and meta-analysis to investigate clinical effectiveness of belimumab for patients with systemic lupus erythematosus (SLE) and antinuclear and/or anti-double-stranded DNA (dsDNA) autoantibodies.
  
  
  METHODS
  We searched eight electronic databases and reference lists for randomised controlled trials (RCTs) of belimumab against placebo or best supportive care. Quality assessment and random effects meta-analysis were undertaken.
  
  
  METHODS
  A meta-analysis of RCTs.
  
  
  METHODS
  2133 SLE patients.
  
  
  METHODS
  SLE Responder Index (SRI) at week 52.
  
  
  RESULTS
  Three double-blind placebo-controlled RCTs (L02, BLISS-52 BLISS-76) investigated 2133 SLE patients. BLISS-52 and BLISS-76 trials recruited patients with antinuclear and/or anti-dsDNA autoantibodies and demonstrated belimumab effectiveness for the SRI at week 52. Ethnicity and geographical location of participants varied considerably between BLISS trials. Although tests for statistical heterogeneity were negative, BLISS-52 results were systematically more favourable for all measured outcomes. Meta-analysis of pooled 52-week SRI BLISS results showed benefit for belimumab (OR 1.63, 95% CI 1.27 to 2.09). By week 76, the primary SRI outcome in BLISS-76 was not statistically significant (OR 1.31, 95% CI 0.919 to 1.855).
authors.affiliation: Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Ngianga-Bakwin
authors.initials: NB
authors.lastname: Kandala
authors.forename: Martin
authors.initials: M
authors.lastname: Connock
authors.forename: Amy
authors.initials: A
authors.lastname: Grove
authors.forename: Paul
authors.initials: P
authors.lastname: Sutcliffe
authors.forename: Syed
authors.initials: S
authors.lastname: Mohiuddin
authors.forename: Louise
authors.initials: L
authors.lastname: Hartley
authors.forename: Rachel
authors.initials: R
authors.lastname: Court
authors.forename: Ewen
authors.initials: E
authors.lastname: Cummins
authors.forename: Caroline
authors.initials: C
authors.lastname: Gordon
authors.forename: Aileen
authors.initials: A
authors.lastname: Clarke
keywords: Clinical Pharmacology; Epidemiology; Preventive Medicine; Public Health