Inhibition of B cell activating factor (BAFF) in the management of systemic lupus erythematosus (SLE).
The anti-BAFF monoclonal antibody, belimumab, was approved 5+ years ago by the US Food and Drug Administration for the treatment of adult SLE patients. Although BAFF is now a proven therapeutic target in SLE, the limited clinical efficacy both in the clinical trials setting and in 'real-life' experience begs for further therapeutic improvement. Areas covered: In addition to belimumab, three other BAFF antagonists (atacicept, blisibimod, tabalumab) that biologically differ from belimumab are being or have been evaluated in SLE late-stage clinical trials. Literature search was performed using the search words/phrases, 'BAFF', 'BLyS', 'APRIL', 'BCMA', 'TACI', 'BR3', 'belimumab', 'atacicept', 'blisibimod', 'tabalumab', 'lupus clinical trial' along with papers from the author's personal library. Expert commentary: The reasons underlying current lack of enthusiasm among clinicians for BAFF antagonism are discussed, and speculation if offered regarding the use of a BAFF antagonist as part of sequential therapy and regarding the utility of individual or pairs of BAFF receptors as therapeutic targets.
a Division of Rheumatology, Department of Medicine , University of Southern California Keck School of Medicine , Los Angeles , CA , USA.
William
W
Stohl
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D053264:B-Cell Activating Factor / Q000276:immunology*; D002986:Clinical Trials as Topic; D017277:Drug Approval; D005104:Expert Testimony; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000628:therapy*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D016896:Treatment Outcome
C573858:AMG623 peptibody; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D053264:B-Cell Activating Factor; D011993:Recombinant Fusion Proteins; C505719:TNFSF13B protein, human; C511911:belimumab; C524618:TACI receptor-IgG Fc fragment fusion protein; C575974:tabalumab
APRIL; BAFF; BCMA; BR3; TACI; atacicept; belimumab; blisibimod; tabalumab