PO:12:317 Is belimumab effective after biological disease-modifying antirheumatic drugs? A subanalysis of the spanish national registry of belimumab in systemic lupus erythematosus

at the standard dosage, while 8 commenced with desensitization.The retention rate for standard induction was approximately 90% at 52 weeks and 80% at 260 weeks.Older age at disease onset (>40 years) and chronic kidney disease (CKD) stage 4-5 were significantly associated with higher risk of discontinuation (age >40 years: HR 1.79, 95% CI 1.04-3.08,p=0.036;CKD stage 4-5: HR 5.09, 95% CI 1.85-14.14,p=0.0018).No associations were observed with immunological profiles, including anti-SSA antibody status.The HCQ desensitization protocol was applied in 26 patients, including 18 who had failed standard induction.After desensitization, 23/26 patients (88.5%) continued HCQ beyond 52 weeks.Long-term retention remained above 80% at 260 weeks, and no significant predictors of discontinuation were identified.Conclusions Long-term HCQ retention was approximately 80% after standard induction, with elderly-onset SLE and advanced CKD associated with poorer outcomes.Importantly, desensitization enabled successful reintroduction in nearly 90% of patients who had failed initial induction, with favorable long-term retention.These findings underscore the value of desensitization as an effective strategy to maintain HCQ therapy in patients otherwise intolerant to the drug.