Is it okay to use belimumab to treat SLE in a patient who has a history of lymphoma and is on a Bruton's tyrosine kinase inhibitor (such as ibrutinib)?

For patients with ongoing SLE clinical/serologic activity despite ongoing treatment for lymphoma with agents targeting B cell proliferation, it's probably safe to use belimumab if needed in this setting. Thus far, reported experiences and our own using belimumab in patients who have undergone B cell depletion using anti-CD20 monoclonal reagents have not indicated significant infection-related safety concerns. A more systematic study looking at this that is soon to result (BLISS-BELIEVE) will hop...