Belimumab is the first drug in more than 50 years approved by the Food and Drug Administration (FDA) to treat lupus and lupus nephritis. Belimumab is used in combination with other lupus drugs such as hydroxychloroquine and steroids. Belimumab treats people with mild or moderate lupus affecting the immune system, skin, joints, and kidneys. It works against a protein that triggers certain cells in the immune system to attack different parts of the body.
Belimumab can be given as an infusion or injection. When given by infusion, the medication is administered through a needle that is inserted into a vein. The infusion is given in a healthcare facility and lasts about one hour. The dose is based on your weight. Infusions are every two weeks for the first four weeks and then every four weeks, thereafter. Usually, belimumab takes effect in 12 weeks, but it can take longer in some patients.
Belimumab is also available in a self-injection form (I.e., pre-filled syringe and autoinjector). This means you can give it to yourself by injecting the medication under the skin once a week. The dose for the self-injection is 200 mg and is pre-loaded into a syringe or device for you. The injection dose is based on the treatment of lupus or lupus nephritis.
Belimumab can cause certain side effects, although many of these are mild. The most common side effects include headache, fever, diarrhea, nausea, muscle aches, trouble sleeping, and infections, such as colds, bronchitis, and urinary tract infections. You may also experience redness, itching, or swelling at the site of your injection.
Having fluid and/or a needle put into your veins (infusion) can also cause fevers, muscle aches, headaches, and infections.
Belimumab can lower the number of white blood cells in the blood of some people. It can also cause you to feel down and have thoughts of harming yourself, especially if you have a history of depression.
To know if belimumab is causing side effects, keep track of how long the symptoms last and whether they come back after your next infusion or injection. If so, discuss this with your rheumatology provider.
Before taking belimumab, tell your rheumatology provider if you plan to become pregnant. It is unknown if belimumab is safe for pregnant women to take. You should not try to become pregnant or breastfeed while taking this drug. If you do become pregnant, immediatelytell your doctor.
Tell your rheumatology provider if you have an infection, a history of cancer, or a history of depression. Belimumab can increase the risk of getting cancer, infections, and depression. Your rheumatology provider will talk to you about your own risks. Make sure your doctor knows if you have any concerns or new symptoms while taking belimumab.
Many vaccines, such as the flu shot, the pneumonia shot, and the new shingles vaccine (Shingrix), are safe to get while taking belimumab, but some others, such as live vaccines (Zostrix), are not. Talk to your doctor about getting vaccines before starting belimumab. To keep yourself safe and healthy while taking belimumab, tell your doctor if you have any of the following side effects:
Updated February 2022 by Nina Washington, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.
This information provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.