Would you consider use of belimumab in a patient with SLE with recurrent anterior uveitis who failed other treatment options?

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 (HCQ) plus standard immunosuppressant therapy.

I must stand on my soap box and mention what I always mention in "resistant" SLE cases. I like to call them the holy trinity of SLE treatment (HCQ + vit...

I agree with Dr. @Dr. First Last' 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 a lot depends on the severity of the uveitis.

As Dr. Thomas notes, uveitis is rare in SLE. Two common causes of recurrent, unilateral anterior uveitis would be herpes simplex or HLA-B27-related...