Active Ingredient: Belimumab
Belimumab is indicated in combination with background immunosuppressive therapies for the treatment of adult patients with active lupus nephritis.
For this indication, competent medicine agencies globally authorize below treatments:
For:
Subcutaneous, 400 milligrams belimumab, once weekly, 4 doses in total. Afterwards, subcutaneous, 200 milligrams belimumab, once weekly.
In patients initiating therapy with belimumab for active lupus nephritis, the recommended dosage regimen is a 400 mg dose once weekly for 4 doses, then 200 mg once weekly thereafter. In patients continuing therapy with belimumab for active lupus nephritis, the recommended dosage is 200 mg once weekly. Belimumab should be used in combination with corticosteroids and mycophenolate or cyclophosphamide for induction, or mycophenolate or azathioprine for maintenance. The patient’s condition should be evaluated continuously.
If a dose is missed, it should be administered as soon as possible. Thereafter, patients can resume dosing on their usual day of administration, or start a new weekly schedule from the day that the missed dose was administered.
If patients wish to change their weekly dosing day, a new dose can be given on the newly preferred day of the week. Thereafter the patient should continue with the new weekly schedule from that day, even if the dosing interval may be temporarily less than a week.
If a patient with lupus nephritis is being transitioned from belimumab intravenous administration to subcutaneous administration, the first dose of 200 mg subcutaneous injection should be administered 1 to 2 weeks after the last intravenous dose. This transition should occur any time after the patient completes the first 2 intravenous doses.
Data on patients ≥65 years are limited. Belimumab should be used with caution in the elderly. Dose adjustment is not required.
The recommended injection sites are the abdomen or thigh. When injecting in the same region, patients should be advised to use a different injection site for each injection; injections should never be given into areas where the skin is tender, bruised, red, or hard. When a 400 mg dose is administered at the same site, it is recommended that the 2 individual 200 mg injections are administered at least 5 cm (approximately 2 inches) apart.
For:
Intravenous, 10 milligrams belimumab per kilogram of body weight, one dose, over the duration of 7 days. Afterwards, intravenous, 10 milligrams belimumab per kilogram of body weight, one dose, over the duration of 14 days. Afterwards, intravenous, 10 milligrams belimumab per kilogram of body weight, one dose, over the duration of 4 weeks.
Premedication including an antihistamine, with or without an antipyretic, may be administered before the infusion of belimumab.
The recommended dose regimen is 10 mg/kg belimumab on Days 0, 14 and 28, and at 4-week intervals thereafter. The patient’s condition should be evaluated continuously.
In patients with active lupus nephritis, belimumab should be used in combination with corticosteroids and mycophenolate or cyclophosphamide for induction, or mycophenolate or azathioprine for maintenance.
If a patient with lupus nephritis is being transitioned from belimumab intravenous administration to subcutaneous administration, the first dose of 200 mg subcutaneous injection should be administered 1 to 2 weeks after the last intravenous dose. This transition should occur any time after the patient completes the first 2 intravenous doses.
Data on patients ≥65 years are limited. Belimumab should be used with caution in the elderly. Dose adjustment is not required.
Belimumab should be infused over a 1-hour period.
Belimumab must not be administered as an intravenous bolus.
The infusion rate may be slowed or interrupted if the patient develops an infusion reaction. The infusion must be discontinued immediately if the patient experiences a potentially life-threatening adverse reaction.
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