As treatment strategies evolve, rheumatologists are refining SLE care with targeted biologics, driving a paradigm shift in lupus management, according to Spherix Global Insights.
EXTON, PA., June 13, 2024 – Since 2021, the treatment options for systemic lupus erythematosus (SLE) and lupus nephritis (LN) have expanded with the approval of AstraZeneca’s Saphnelo (anifrolumab) for SLE, a label extension for GSK’s Benlysta (belimumab) for LN in addition to its established SLE label, and the introduction of Aurinia Pharmaceuticals’ Lupkynis (voclosporin) for LN. These developments have changed how rheumatologists approach lowering disease activity and inducing remission in their lupus patients.
Spherix Global Insights’ latest findings from the fourth annual Patient Chart Dynamix™: Systemic Lupus Erythematosus (US) audit and the third annual Patient Chart Dynamix™: Systemic Lupus Erythematosus (EU) audit highlight these shifts in treatment strategies. Given the heterogeneity of lupus, it is essential to understand how physicians manage different types of patients—from those with LN to those with cutaneous lupus erythematosus (CLE).
The US study reveals that rheumatologists are now treating SLE more aggressively. Back in 2021, 60% of moderate-to-severe US patients received combination therapy; today, that number has risen to 83%. Additionally, the use of biologics in treating SLE has surged, with about half of moderate-to-severe patients in the US now on these therapies. This trend is also observed in the EU5.
Rheumatologists are also refining their use of biologics to target specific lupus manifestations, with notable advancements in treatments like Benlysta and Saphnelo. Benlysta remains the gold standard biologic for LN following its expanded indication in 2020; however, its use extends beyond LN, as it is frequently prescribed for those with joint or skin involvement. Saphnelo, launched in 2021, is emerging as a strong option for patients with CLE, particularly discoid lupus erythematosus (DLE) and subacute cutaneous lupus (SCLE). Recent data shows a decline in Benlysta share in the US for SLE, while Saphnelo’s use has steadily increased. This decline in Benlysta’s share can be partially attributed to patients switching from Benlysta to Saphnelo, often due to Benlysta’s lack of efficacy or insufficient reduction in steroid use. These shifts reflect a change in treatment patterns, with rheumatologists increasingly tailoring biologic therapy to specific SLE patient presentation.
The proportion of patients on corticosteroids has not significantly changed in the past four years in the US or EU, with many patients still dependent on use for managing their lupus. While the average steroid dose has fallen in the US and EU, many patients are still on dosages exceeding 5mg per day – the maximum maintenance dosage recommended by EULAR.
Despite the increased use of advanced therapies and multi-agent regimens, many patients, especially those with renal involvement, continue to experience moderate-to-high disease activity. Currently, only half of these significantly affected patients are being treated with a biologic in the US, underscoring a substantial opportunity for current and future manufacturers to expand the biologic market. There is much anticipation among specialists for the next wave of advanced therapies in lupus– including Roche’s Gazyva (obinutuzumab) for SLE/LN, AZ’s Saphnelo in LN, Biogen’s litifilimab in SLE, and BMS’ Sotyktu (deucravacitinib) in SLE.
Spherix will continue to monitor the SLE markets in the US and EU on a quarterly and semiannual basis, respectively, through its RealTime Dynamix™ service.
Patient Chart Dynamix™ is an independent, data-driven service unveiling real patient management patterns through rigorous analysis of large-scale patient chart audits. Insights reveal the “why” behind treatment decisions, include year over year trending to quantify key aspects of market evolution, and integrate specialists’ attitudinal & demographic data to highlight differences between stated and actual treatment patterns.
RealTime Dynamix™ is an independent service providing strategic guidance through quarterly or semiannual reports, which include market trending and a fresh infusion of event-driven and variable content with each wave. The reports provide an unbiased view of the competitive landscape within rapidly evolving specialty markets, fueled by robust HCP primary research and our in-house team of experts.
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The seasoned team of Spherix experts provides an unbiased and holistic view of the landscape within rapidly evolving specialty markets, including dermatology, gastroenterology, rheumatology, nephrology, neurology, and ophthalmology. Spherix clients stay ahead of the curve with the perspective of the extensive Spherix Physician Community.
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Spherix Global Insights Contact
Maxine Yarnall, Rheumatology Franchise Head
maxine.yarnall@spherixglobalinsights.com
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