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To the Editor: Effects of belimumab on pregnant patients with systemic lupus erythematosus (SLE) are unknown. To our knowledge, we described the first case of a patient with active SLE who was treated with belimumab throughout her pregnancy1. The patient became pregnant again and we describe its successful outcome here.Ethical board approval for case reports is not required per institution policy. Informed consent was obtained from the patient.A 41-year-old woman with difficult-to-control SLE (antinuclear antibody–positive, SSA, dsDNA, antigranulocyte antibody–positive, and lupus nephritis) reported to be pregnant again while receiving belimumab. Belimumab was used successfully during her first pregnancy because of contraindications or side effects to azathioprine, mycophenolate, rituximab, and cyclophosphamide (Table 1). Her second conception resulted in a miscarriage, which was because of aneuploidy and was not thought to be because of SLE. Her SLE was in remission for 18 months before her third conception (Table 1). She maintained treatment with belimumab 10 mg/kg, hydroxychloroquine 400 mg, prednisone 5 mg, and low molecular weight heparin. She … Address correspondence to Dr. A. Kumthekar, Oregon Health and Science University, Division of Arthritis and Rheumatic Diseases (Mail code: OP09), 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA. E-mail: kumthean{at}ohsu.edu

Use of Belimumab throughout 2 Consecutive Pregnancies in a Patient with Systemic Lupus Erythematosus