So what to make of the results?
“The EMBRACE efficacy data seems to reinforce what we already know: belimumab doesn’t work in a lot of patients, and it [has] the best chance of working in patients with higher baseline disease activity,” tweeted Dr. Yazdany.
As for prescribing, Sarah Patterson, MD, a postdoctoral fellow in the UCSF Division of Rheumatology, tweeted that the results “support the use of belimumab for black lupus patients with high disease activity” and positive serology.
For those who don’t fit the treatment profile, “we should take care to not over-use it,” said Megan Clowse, MD, an associate professor of rheumatology at Duke University, Durham, N.C., in a tweet.
The HCQ adherence fail
Poor hydroxychloroquine (HCQ) adherence came up next on Twitter. The chat participants agreed it’s a huge problem, but no one knows why. Perhaps it’s because patients don’t feel a therapeutic effect or perhaps because GI problems and other side effects are worse than doctors think. Maybe there’s simply not enough social support to encourage people to stay on the drug, even though it’s the single most important medication in lupus.