Spherix Global Insights

June 17, 2022

Spherix Research Reveals Rheumatologists Taking the Lead Over Nephrologists in Both BENLYSTA (GlaxoSmithKline) and LUPKYNIS (Aurinia) Patient Initiations in Lupus Nephritis

Nephrologists and rheumatologists are approaching the new products from very different perspectives

EXTON, Pa., June 17, 2022 /PRNewswire/ —With the approvals of GlaxoSmithKline’s Benlysta in lupus nephritis (LN) at the end of 2020 and Aurinia’s Lupkynis at the beginning of 2021, practitioners now have valuable new treatment options to battle this complex condition.

Spherix has been closely tracking these new agents in their Launch Dynamix™ service, which couples monthly performance benchmarking with quarterly deep dive reports to understand perceptions of each brand, their evolving places in the treatment paradigm, and projections for future use. This research, in collaboration with 50 US nephrologists and 50 US rheumatologists each month, reveals that specialists are responding differently to Benlysta and Lupkynis in both perception and use.

The just-released seventeenth monthly tracking update highlights the latest trajectories for these agents. Analysis also includes insights on patient demographics, patient initiations, and discontinuations, while exploring co-management between nephrologists and rheumatologists.

Given their history of using the drug in systemic lupus erythematosus (SLE), rheumatologists tend to gravitate towards Benlysta and deem more of their LN patients as candidates for the drug over Lupkynis – according to the latest Spherix report. Alternatively, nephrologists often report a slight favoring towards Lupkynis (due to their familiarity with the calcineurin inhibitor drug class) and generally see their patients as better suited for Aurinia’s brand.

Specialists are divided on key performance metrics between the two products. Benlysta prevails with rheumatologists on patient adherence, tolerability, and safety, while nephrologists give the edge to Lupkynis on those exact same metrics. However, both specialists agree Lupkynis is easier to administer (oral versus IV) and has a quicker onset of action. A desire to reduce a patient’s steroid burden is also a clear driver towards use of both drugs.

Of note, nephrologists’ view on Benlysta’s “overall benefit” to LN patients versus Lupkynis has improved in the past six months. Indeed, rheumatologists increasingly choose Benlysta over Lupkynis as the winning drug on this measure, with physicians often citing the drug’s broad application in both SLE and LN as moving the needle on these perceptions. One surveyed rheumatologist states, “I use a shotgun approach by treating pretty much everybody with nephritis with Benlysta.”

At well over a year of use in LN, physicians are starting to settle on patient types for the new drugs; Benlysta is seen as best for more moderate LN patients given its perceived slower onset of action, while many view Lupkynis as more appropriate for moderate/severe cases to aggressively treat proteinuria and manage progression. As one nephrologist calls out, “the patient for Lupkynis is going to be someone I want to put more of an emphasis on preserved renal function.”

Although accelerated prescribing of Benlysta has been observed in the past six months among nephrologists, with nearly three-quarters in the study sample now having ever used the product (hitting a high in June 2022), they remain much more hesitant to initiate patients on Benlysta given their limited familiarity and lack of experience with infused biologics.

Nephrologists also show a somewhat muted urgency to prescribe Lupkynis as well, due to cost- and risk-benefit uncertainty compared to other options like tacrolimus. On the other hand, while the Lupkynis user base is slightly lower overall for rheumatologists, they continue to initiate more patients on Lupkynis than their nephrology counterparts (in relation to user base). Furthermore, rheumatologists now see a higher percentage of their LN patients as appropriate for Lupkynis when compared to nephrologists as of June 2022.

Spherix is tracking both prior product use, as well as concomitant drug use and line of therapy, to understand where both Benlysta and Lupkynis are competing (and with each other) in LN treatment and prescribing patterns.

GSK has markedly increased its detailing of nephrologists on Benlysta in the past year and has moved the needle on overall perception of the brand launch (among other key performance metrics). Still, there is room to grow with the specialty. Aurinia representatives are visiting both specialties more frequently since launch; however, nearly one-third of physicians in the study sample have yet to be detailed.

Nephrologists and rheumatologists predict that in the future, a substantial percentage of their patients may be candidates for the new treatment options. Though, the perceived unmet need for new therapies in the LN market (while still substantial) has diminished since the approval of Lupkynis and Benlysta. This is of high note given the robust pipeline for LN products, including Novartis’s Cosentyx (secukinumab) and iscalimab, Roche-Genentech’s Gazyva (obinutuzumab), BMS’ deucravacitinib, Janssen’s Tremfya (guselkumab), ChemoCentryx’s Tavneos (avacopan), and Horizon’s daxdilimab (HZN-7734). Understanding how well Benlysta and Lupkynis are addressing the unmet needs and where pipeline agents can expect to play is critical as new products enter the space.

Data released just days after fielding each month in Spherix’s Launch Dynamix™ service will give a real-time analysis on uptake, perceptions, and experiences across both nephrologists and rheumatologists. The next monthly update releases July 15, 2022.

About Our Services
Launch Dynamix™ is an independent service providing monthly benchmarking of newly launched products for the first eighteen months of commercial availability, augmented by a quarterly deep dive into promotional activity, barriers to uptake, and patient types gravitating to the launch brand.

Learn more about our services here.

About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select dermatology, gastroenterology, nephrology, neurology, and rheumatology markets.

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