Benlysta (belimumab) is safe and effective for lupus
Benlysta is amazing. There are very good reasons why it has achieved 3 FDA approvals for lupus (SLE, pediatric lupus, and lupus nephritis) in the past 10 years. It is safe and effective.
How the target (BLyS) of Benlysta normally works in the immune system:
BLyS is B-cell fertilizer
There is an immune system chemical messenger (a cytokine) called BLyS (B Lymphocyte Stimulator) also called BAFF (B cell activating factor). B-cells that make antibodies require this BLyS (BAFF) to stay alive.
For Example: Suppose you get pneumonia from a bacteria called Pneumococcus pneumoniae (pneumococcus). B-cells are called upon to produce pneumococcal antibodies. The immune system makes a lot of BLyS to keep the pneumococcal antibody producing B-cells alive. When the infection is gone, the immune system stop making BLyS. The B-cells then retire and die because we don't need them any more. When cells of the body retire and die a natural death when not needed, it is called apoptosis. Think of BLyS as "B-cell fertilizer." Without BLyS, B-cells go through apoptosis, which is an important process of the body so that younger, newer cells can replace old, unneeded cells.
The tiny pink things floating around are cytokines (like BLyS) ready to attach to the purple white blood cell and tell it what to do (stay alive in the case of antibody producing B-cells) photo credit: Wikipedia and Scientific Animations at https://commons.wikimedia.org/wiki/File:Cytokine_release.jpg
Benlysta (belimumab) attaches to BLyS and takes it away so B-cells can die
Lupus patients constantly make too much BLyS, so those bad B-cells that make autoantibodies that attack your own body's cells (ANA, anti-dsDNA, etc) stay alive, and can even be immortal. Benlysta binds to BLyS and takes it away. The bad B-cells can then retire, die, and go away (go through apoptosis).
Yet, during infections, the immune system can still make lots of BLyS so that the important, needed B-cells can fight off the infection.
After studying Benlysta patients for over 20 years, we are not seeing any more infections in our Benlysta patients than we do in those taking placebo plus "standard of care" therapies.
Think of Benlysta as balancing out the immune system, achieving homeostasis, rather than suppressing it.
COMMENT above. Are you on Benlysta? How are you doing on it?
Don Thomas, MD, author of "The Lupus Encyclopedia" and "The Lupus Secrets"
Note that Dr. Thomas' posts are for informational purposes only, and are not meant to be specific medical advice for individuals. Always seek the advice of your healthcare provider with any questions regarding your own medical situation.
DONALD THOMAS, MD