New biologic: Belimumab intravenous injection is a B-lymphocyte stimulator-specific inhibitor approved by FDA to treat systemic lupus erythematosus.
Systemic lupus erythematosus (SLE) is a serious, potentially fatal, autoimmune disease that affects the joints, skin, kidneys, lungs, heart, and the brain. On March 9, 2011, FDA approved belimumab intravenous injection for the treatment of adult patients with active, autoantibody-positive SLE who are currently receiving standard therapy.
Efficacy. Belimumab's efficacy was evaluated in 3 randomized controlled studies involving patients with SLE receiving standard treatment with corticosteroids, anti-malarials, non-steroidal anti-inflammatory drugs, and immunosuppressive agents. The studies excluded patients who had received prior B-cell targeted therapy or intravenous cyclophosphamide, as well as those with active lupus involving the kidneys or central nervous system. The first study of the 3 studies was integral in identifying the target population of autoantibody-positive SLE patients. The 2 subsequent studies randomly assigned a total of 1,684 patients with autoantibody-positive, active disease [defined as a SELENA-SLEDIA score ≥6 (an objective measure in global disease activity)] to receive belimumab 1 mg/kg or 10 mg/kg plus standard therapy or placebo plus standard therapy. In both trials the proportion of patients responding to therapy was significantly higher in the belimumab 10-mg/kg group than the placebo group (study 1: OR=1.5; 95% CI, 1.1–2.2 and study 2: OR=1.8, 95% CI, 1.3–2.6). There was no statically significant difference in response rate between patients receiving belimumab 1 mg/kg and placebo. In exploratory subgroup analysis, the response rate in African-American patients was less with belimumab 10 mg/kg (36%) than in those receiving placebo (44%).
Safety. The most commonly reported adverse reactions were nausea, diarrhea, pyrexia, nasopharyngitis, bronchitis, insomnia, pain in extremity, depression, migraine, and pharyngitis. In these studies, a greater number of deaths were reported with belimumab than with placebo, with a total of 14 deaths occurring during the treatment periods. Explanations for these deaths included infection, cardiovascular disease, and suicide; however, no single cause predominated. Patients being treated for a chronic infection should not begin therapy with belimumab, as serious infections have been reported. Psychiatric events (eg, depression) were reported more frequently in the belimumab groups compared to placebo. As with other immunomodulating agents, belimumab may increase the risk of malignancy.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.