{
  "abstract": "Objectives To describe pregnancy outcomes in patients with Systemic Lupus Erythematosus (SLE) treated with belimumab (BEL) before and/or during pregnancy in a real-life clinical setting.Methods Data from 36 prospectively followed pregnancies in 33 SLE patients across 8 Italian centers were analyzed. Patients were categorized into three groups based on BEL discontinuation timing: Group 1 (preconception; n=4), Group 2 (within the 8th week of gestation; n=16), and Group 3 (after the 9th week of gestation; n=16: 5 in the 1st, 7 in the 2nd, and 4 in the 3rd trimester). Discontinuation timing was planned with the patient during preconception counselling.Results Before conception, the median clinical SLEDAI was 0 (0-1.25). Standard treatments during pregnancy included prednisone (83%), antimalarials (86%), azathioprine (47%); calcineurin-inhibitors (22%); low-dose aspirin (86%), and heparin (50%).Overall, 7 pregnancies (19.4%) were complicated by flares: 2 in the 1st trimester (Group 3), 2 in the 2nd (Groups 2 and 3), and 3 in the 3rd (Groups 2 and 3).The overall live-birth rate was 92% (Group 1: 50%; Group 2: 100%; Group 3: 94%). Pregnancy losses included one early and two late miscarriages; among these, one intrauterine death occurred at week 37 (trisomy 21 with atrio-ventricular defect).One perinatal death following eclampsia at week 25 occurred in a patient with complex APS and nephritis who underwent heterologous assisted reproductive technology. Two cases of pre-eclampsia occurred in patients with multiple risk factors.Neonatal complications included one case of interatrial defect with situs inversus and chromosomal aberration (paternal chromosome 10 inversion), and one of congenital cardiac malformation (needing surgical correction) in an unplanned pregnancy with mycophenolate mofetil exposure. Seven other newborns required Intensive Care Unit admission.Abstract LBA:01:24 Table 1Conclusions In this real-life cohort, BEL was continued to maintain disease control during pregnancy in patients with severe phenotypes. Although data are still limited to allow firm conclusions, the high live-birth rate and the lack of evidence of drug-related congenital defects suggest that future studies collecting experiences with BEL are warranted. The occurrence of flares following discontinuation suggests that the timing of BEL discontinuation should be individualized. A patient-centered, risk-benefit evaluation is essential to optimize maternal-fetal outcomes.",
  "authors": [
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, ASST Spedali Civili and University of Brescia, Brescia, Italy"
      ],
      "name": "Francesca Crisafulli"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, ASST Spedali Civili and University of Brescia, Brescia, Italy",
        "Rheumatology Unit, ASST G.O.M. Niguarda, Milan, Milan, Italy"
      ],
      "name": "Maria Chiara Gerardi"
    },
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy"
      ],
      "name": "Maria Letizia Urban"
    },
    {
      "affiliations": [
        "Unit of Rheumatology, Department of Medicine, University of Padova, Padova, Italy"
      ],
      "name": "Margherita Zen"
    },
    {
      "affiliations": [
        "Rheumatology Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy"
      ],
      "name": "Melissa Padovan"
    },
    {
      "affiliations": [
        "Division of Immunology, Transplantation and Infection Disease, IRCCS Ospedale San Raffaele, Milano, Italy"
      ],
      "name": "Valentina Canti"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASL BT, DSS 4, Barletta, Italy"
      ],
      "name": "Emanuela Praino"
    },
    {
      "affiliations": [
        "Unit of Rheumatology, ASST Gaetano Pini-CTO, Milano, Italy"
      ],
      "name": "Maria Gerosa"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, ASST Spedali Civili and University of Brescia, Brescia, Italy"
      ],
      "name": "Cecilia Nalli"
    },
    {
      "affiliations": [
        "Rheumatology Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy"
      ],
      "name": "Francesca Ruffilli"
    },
    {
      "affiliations": [
        "Rheumatology Unit, Department of Medicine, SS: Giovanni e Paolo Hospital, Venezia, Italy"
      ],
      "name": "Francesca Saccon"
    },
    {
      "affiliations": [
        "Academic Rheumatology Centre, Mauriziano Hospital, Department of Clinical and Biological sciences, Universita degli Stud, Torino, Italy"
      ],
      "name": "Elisa Bellis"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, ASST Spedali Civili and University of Brescia, Brescia, Italy"
      ],
      "name": "Micaela Fredi"
    },
    {
      "affiliations": [
        "Department of Medical, Surgery and Health Sciences, University of Trieste, Trieste, Italy"
      ],
      "name": "Giacomo Emmi"
    },
    {
      "affiliations": [
        "Unit of Rheumatology, Department of Medicine, University of Padova, Padova, Italy"
      ],
      "name": "Luca Iaccarino"
    },
    {
      "affiliations": [
        "Unit of Rheumatology, Department of Medicine, University of Padova, Padova, Italy"
      ],
      "name": "Andrea Doria"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASL BT, DSS 4, Barletta, Italy"
      ],
      "name": "Leonardo Santo"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, ASST Spedali Civili and University of Brescia, Brescia, Italy"
      ],
      "name": "Ilaria Cavazzana"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, ASST Spedali Civili and University of Brescia, Brescia, Italy",
        "Danish Center for Expertise in Rheumatology (CeViG), Southern Denmark University, Sønderborg, Denmark"
      ],
      "name": "Laura Andreoli"
    },
    {
      "affiliations": [
        "Rheumatology and Clinical Immunology Unit, ASST Spedali Civili and University of Brescia, Brescia, Italy"
      ],
      "name": "Angela Tincani"
    }
  ],
  "title": "LBA:01:24 Pregnancy in SLE patients treated with belimumab: data from an Italian multicenter cohort",
  "uid": "0212cc17-5e73-5a31-8aa2-0a084c71b3fe"
}