Rheumatologists Shift Toward Lupkynis in Lupus Nephritis as Benlysta Use Expands

Event summary

  • Spherix Global Insights' 2025 report analyzed 1,074 patient charts from 111 rheumatologists and 89 nephrologists in the US.
  • Benlysta (belimumab, GSK) exposure continues to expand, with rheumatologists leading adoption over nephrologists.
  • Lupkynis (voclosporin, Aurinia Pharmaceuticals) is increasingly used by rheumatologists for lupus nephritis, particularly in patients with severe renal involvement.
  • Off-label SGLT2 inhibitor use, primarily Farxiga and Jardiance, is rising among nephrologists but remains minimal among rheumatologists.
  • Physicians anticipate early adoption of Gazyva (obinutuzumab, Roche/Genentech) and potential use of emerging therapies like Saphnelo and ianalumab.

The big picture

The lupus nephritis treatment landscape is evolving toward more targeted and individualized approaches, with biologics and calcineurin inhibitors playing increasingly prominent roles. This shift reflects a broader industry trend toward precision medicine in autoimmune diseases, driven by the need for better renal outcomes and reduced long-term disease progression. The anticipated entry of new therapies and next-generation modalities like CAR-T cell therapy suggests the treatment paradigm will continue to rapidly evolve.

What we're watching

Treatment Intensification
How the growing use of combination therapies, such as biologics and CNIs, will impact patient outcomes in lupus nephritis.
Emerging Therapies
Whether newly approved and pipeline therapies like Gazyva and Saphnelo will accelerate adoption and shift treatment paradigms.
CAR-T Cell Therapy
The pace at which CAR-T cell therapy may become a viable option for refractory lupus nephritis patients.