Reason for request

Reassessment

Summary of opinion

Favourable opinion for reimbursement as add-on therapy in patients aged 5 years and older with active, autoantibody-positive systemic lupus erythematosus (SLE) with a high degree of disease activity (e.g., positive anti-dsDNA and low complement) despite standard therapy.


Clinical Benefit

Substantial

The clinical benefit of BENLYSTA 200 mg (belimumab) solution for injection in pre-filled pen is substantial in the MA indication.


Clinical Added Value

minor

Considering:

  • the inadequately met medical need;
  • the efficacy data in adults, which can be extrapolated to children based on similar pharmaco-kinetic data in adults and children for the intravenous route;
  • the absence of data in patients with severe neurological involvement, despite this being an important prognostic factor in the course of juvenile SLE;
  • the absence of robust data on quality of life;
  • the short-term safety profile (follow-up of 1 year) globally similar to that in adults, but with concerns relating to the long-term safety in children due to important identified risks, such as injection-related systemic hypersensitivity reactions that may be delayed in onset, and important potential risks such as serious infections (in particular, progressive multifocal leuko-encephalopathy), malignancies and psychiatric disorders (depression and suicidal behaviour);
  • the absence of data on the growth and development of children;

the Committee considers that, as is the case in adults, the proprietary medicinal products BENLYSTA 120 mg and 400 mg (belimumab) powder for concentrate for solution for infusion provide a minor clinical added value (CAV IV) in the care pathway as add-on therapy in children aged 5 years and older with active, autoantibody-positive systemic lupus erythematosus (SLE) with a high degree of disease activity (e.g., positive anti-dsDNA and low complement) despite standard therapy.

no clinical added value

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