Would you consider use of belimumab in a patient with SLE with recurrent anterior uveitis who failed other treatment options?
Patient failed topical ocular therapies, methotrexate, azathioprine.
Answer from: at Community Practice
First, uveitis in SLE certainly happens, but it is rare, occurring in less than .5% of patients. So, we have scant evidence on how to treat it beyond case reports (to my knowledge). I have had SLE patients with uveitis (including anterior uveitis), but all responded fortunately to hydroxychloroquine...
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Answer from: at Community Practice
I agree with Dr. @Thomas' thoughtful and thorough answer. I do not personally follow hydroxychloroquine levels but I also accept that this is an area for legitimate debate.
I am always guided by matching "the punishment to the crime". Belimumab, rituximab, or anti-TNF are expensive punishments, so ...