Do you continue belimumab throughout pregnancy?

@Dr. First Last: @Dr. First Last is absolutely correct regarding the limitations of our studies regarding using belimumab in pregnancy.

However, how much more evidence do we need?

No one is going to perform a prospective randomized controlled trial. I and some others I know are feeling more comfortabl...

Thank you for your question. Although Belimumab appears to be safe during breastfeeding, pregnancy is a different scenario: it does appear to cross placenta and is detected in cord blood (Bitter et al., PMID 36604152). While there are several case reports and retrospective analyses reporting no incr...

It depends on what else the patient has tried. If they haven't tried azathioprine then I may consider stopping Benlysta and trying azathioprine instead since we have more pregnancy safety data on that, but otherwise, I continue it and discuss what to do with timing towards the end of pregnancy.

The registries to date provide reassurance that belimumab use in pregnancy is likely safe with regard to demonstrable anatomic birth defects. I think the relevant concern going forward is to what extent belimumab exposure impacts the consitution of the immune system during fetal development. As note...