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Lupus drug market growing as physicians adopt newer options — and look for more, research finds

With three relatively new drugs, plus a busy pipeline in both systemic lupus erythematosus (SLE) and lupus nephritis (LN), the lupus market has been taking off. The LN arena is especially busy now with two competitors gaining steam, but SLE is also on physicians’ minds with the potential for CAR-T cell therapy treatment on the horizon, according to research from Spherix Global Insights.

While lupus CAR-T studies have been around for a few years, the potential for now almost a dozen in development, mostly in Phase I or Phase II studies for both SLE and LN, is generating some excitement among physicians, said Spherix senior insights analyst Sawyer May.

Spherix’s most recent survey of rheumatologists and nephrologists found that half who are familiar with CAR-T studies in lupus expect them to take either a “leading” or “definite” role in future treatments. Doctors’ comments about CAR-T therapy ranged from “preliminary results look encouraging” to “revolutionary in its ability to generate remission.”

Yet, the other half is not yet swayed, with some calling CAR-T “toxic, expensive therapy” and one doctor predicting that it’s “impossible to get approved.”

Outside of CAR-T therapies, the overall lupus therapy pipeline is robust, with about 30 drugs in development for LN and 60 for SLE, Spherix estimates. AstraZeneca’s Saphnelo, approved for SLE in 2021, is one of those, pursuing an indication for LN now in Phase III studies, although according to Spherix, a small 5-8% of the specialists surveyed are already trying it off-label for the kidney condition.

Uptake of Saphnelo has been slow but steady, according to Spherix data, with currently about 8% of moderate-to-severe SLE patients on the drug.

Meanwhile in LN, both rheumatologists and nephrologists are encouraged by now-multiple choices with Aurinia’s Lupkynis and GSK’s Benlysta, which had been on the market for SLE but added an LN indication in late 2020.

Both specialist groups in Spherix’s survey agreed Lupkynis is both easier to administer and has a quicker onset than Benlysta for LN. However, rheumatologists give Benlysta the edge in other measures including safety, tolerability and efficacy, while nephrologists chose Lupkynis for the same measures.

Overall favorable opinions of both drugs are leading some specialists to prescribe them at the same time, May said. Almost 20% of both specialists surveyed said they have tried them together, and the majority say they’d be willing to do so if insurances would cover both at the same time.

“Over the past few years since these approvals, we’ve just seen in general a large uptake of these medications,” he said, noting adoption has been spurred by a concerted guideline push in 2023 to reduce high levels of steroid use in lupus.

Source: Endpoints News:

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