Marcondes F, et al. - This evidence-based review was conducted to provide an update regarding the current shift related to use of belimumab as a treatment option for real-life patients with persistent active systemic lupus erythematous while on conventional therapies. Researchers concluded, based on the currently published evidence regarding belimumab's use in clinical practice, that belimumab will be gradually incorporated in the armamentarium of treatment not necessarily on refractory patients. Furthermore, they believed that the scope of considering belimumab in first line combination set ups should be widened with the upcoming of the subcutaneous route in the near future.

• As per the evidence, the observations from phase 3 trials corroborated the observations on the large series of patients (over 50 patients) followed for at least 6 months.
• Nearly two-thirds of the patients continued belimumab in clinical practice and discontinuation was observed in one third mostly due to no detectable positive response as assessed by the doctor or the patient or both.
• Considerably low presence of adverse events was reported and the subgroups with skin and joint manifestations appeared to benefit the most.
• Data reported that on comparing with the intake before introduction of the biologic, daily steroid use was usually reduced to a significantly low.
• Not evident on trials but in real life, it is being reported that several patients are being treated for lupus nephritis with belimumab added to the conventional therapy.
• With respect to its use, one of the barriers that still can not be overlooked is the cost of the medication.
• Investigation is currently being carried out on the further evidence of its use in certain specific groups and its results should shed light on additional indications.