An update on belimumab for the treatment of lupus

B-lymphocyte stimulator (BLyS), a homeostatic factor for B-cell differentiation and survival, has a major role in B-cell expansion and autoreactivity that characterize systemic lupus erythematosus (SLE). Belimumab, a BLyS-specific inhibitor, has shown promising evidence of efficacy in several preclinical and clinical studies in SLE. Two recent large randomized controlled trials yielded a significant positive effect of the drug compared to placebo in patients with active disease. In this review, we discuss basic aspects of B-cell and BLyS biology in SLE and summarize the evidence supporting a role of belimumab in SLE, from animal studies to phase III clinical trials.