Treatment that includes both belimumab and antimalarials offers stronger protection against renal flares than either agent alone in patients with systemic lupus erythematosus (SLE), a new analysis suggests.

Investigators pooled data from the BLISS-52 (NCT00424476), BLISS-76: (NCT00410384), BLISS-SC (NCT01484496), and BLISS-NEA (NCT01345253) trials involving 3225 patients.

The risk for renal flares declined by a significant 38% and 58% among patients receiving intravenous belimumab 10 mg/kg and 1 mg/kg, respectively. No significant association was found for subcutaneous belimumab 200 mg. Use of antimalarials alone significantly reduced the risk for flares by 34%.

When belimumab 1 mg/kg and antimalarials were administered together, the renal flare rate dropped the lowest to 18.5 cases per 1000 person-years, whereas belimumab 1 mg/kg alone had a flare rate of 34 cases per 1000 person-years, Ioannis Parodis, MD, PhD, of Karolinska University Hospital in Stockholm, Sweden, and colleagues reported in Rheumatology. According to Dr Parodis’ team, “combination regimens may constitute optimal therapeutical approaches towards favourable renal outcomes in SLE.”

In Current Rheumatology Reports, Aggelos Banos, MD, PhD, of ‘Asklepieion’ General Hospital in Athens, Greece, and colleagues discussed possible strategies to prevent renal flares based on non-randomized and randomized studies. Thus far, evidence suggests that reducing proteinuria to less than 700-800 mg/24 h by 12 months, using mycophenolate rather than azathioprine, adding belimumab to standard therapy, using hydroxychloroquine, and maintaining immunosuppressive/biological treatment for at least 3 to 5 years may help reduce flare risk.

This article originally appeared on Renal and Urology News