{
  "abstract": "Objectives Cardiovascular disease is a leading cause of morbidity and mortality in systemic lupus erythematosus (SLE), largely driven by endothelial dysfunction. Belimumab, a monoclonal antibody targeting soluble B-lymphocyte stimulator (BLyS/BAFF), effectively reduces disease activity, but its vascular effects remain poorly defined. We aimed to assess the longitudinal effects of belimumab on biomarkers of endothelial activation and systemic inflammation in patients with SLE in a real-world setting.Methods This longitudinal observational study included adult patients diagnosed with SLE according to the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria, treated with intravenous belimumab for at least 6 months at a single centre, the Karolinska University Hospital. Demographic characteristics, clinical data, and laboratory test results were collected. Serum levels of biomarkers related to endothelial activation and systemic inflammation were measured at baseline, month 3, and month 6 after treatment initiation using NUcleic acid Linked Immuno-Sandwich Assay (NULISA); those included E-selectin, P-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor A (VEGFA), angiopoietin-2 (ANGPT2), tumour necrosis factor (TNF), C-reactive protein (CRP). Longitudinal changes were analysed using linear mixed-effects models.Results We enrolled 63 patients with SLE (female:male ratio: 9.5:1; mean ± SD age: 41.5 ± 12.9 years). Baseline demographic and clinical characteristics are presented in table 1.At the 6-month follow-up, compared with baseline, we observed significant reductions in E-selectin (from 12.319 ± 0.754 to 12.089 ± 0.798 Normalised Protein Quantification [NPQ]; p=0.0014), ICAM-1 (from 12.678 ± 0.538 to 12.547 ± 0.512 NPQ; p=0.0496), VCAM-1 (from 13.556 ± 0.598 to 13.345 ± 0.552; p=0.0002), ANGPT2 (from 13.038 ± 0.797 to 12.811 ± 0.707 NPQ; p=0.0016), TNF (from 14.475 ± 1.096 to 13.976 ± 0.856 NPQ; p<0.0001), and CRP (from 12.466 ± 1.912 to 12.056 ± 1.936 NPQ; p=0.0172) levels. No significant changes in P-selectin, VEGFA, or MMP-9 levels wereobserved.Abstract PO:02:059 Table 1Baseline demographic and clinical characteristics of the patientsConclusions In this real-world setting of SLE patients, belimumab treatment was associated with decreases in levels of key mediators of endothelial dysfunction and vascular inflammation, suggesting vasoprotective beyond immunosuppressive drug effects. Further studies are warranted to assess long-term cardiovascular outcomes.",
  "authors": [
    {
      "affiliations": [
        "Rheumatology Unit, Department of Medical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"
      ],
      "name": "Letizia Caruso"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and CMM, Stockholm, Sweden"
      ],
      "name": "Alexander Tsoi"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and CMM, Stockholm, Sweden"
      ],
      "name": "Dionysis Nikolopoulos"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, and CMM, Stockholm, Sweden",
        "Department of Rheumatology, Faculty of Medicine and Health, Orebro University, Orebro, Sweden"
      ],
      "name": "Ioannis Parodis"
    }
  ],
  "title": "PO:02:059 Effects of belimumab on markers of endothelial function in systemic lupus erythematosus",
  "uid": "7f1b5cf9-1b42-5431-b569-8a6b4dd82766"
}