Exton, PA, March 06, 2026 (GLOBE NEWSWIRE) -- New findings from Spherix Global Insights’ Patient Chart Dynamix™: Lupus Nephritis (US), 2025 report reveal a treatment landscape in transition as specialists increasingly incorporate biologics, calcineurin inhibitors, and other targeted therapies into lupus nephritis care. This audit, based on the analysis of 1,074 patient charts contributed by 111 rheumatologists and 89 nephrologists across the United States and published in December, examines real-world treatment patterns among adults with Class III, IV, or V LN receiving maintenance therapy, providing a detailed look at how specialists are incorporating biologics, calcineurin inhibitors (CNIs), and emerging therapies into patient care.
Across both specialties, treatment of LN remains anchored by conventional immunosuppressive therapy. Hydroxychloroquine, mycophenolate mofetil, and oral corticosteroids continue to form the backbone of most maintenance regimens, reflecting long-standing guideline-based management strategies. At the same time, physicians are increasingly layering advanced therapies onto these foundational regimens in an effort to improve renal outcomes, reduce long-term disease progression, and limit glucocorticoid use. Overall treatment patterns reflect meaningful differences between the two specialties. Rheumatologists are much more likely than nephrologists to prescribe regimens that include either a biologic and/or CNI.
Specialists’ use of Benlysta (belimumab, GSK) continues to expand in lupus nephritis. The 2025 audit shows that exposure to Benlysta continues to increase, with a growing share of LN patients having received the therapy at some point during their treatment journey. While nephrologists have increased their use of Benlysta, adoption still trails significantly behind rheumatologists. Among patients without prior exposure, specialists report moderate willingness to initiate therapy over the next 12 months, suggesting continued but measured growth potential as physicians continue to treat this complication of lupus more aggressively.
CNIs are also playing an increasingly visible role in treatment strategies. About one in five LN patients managed by nephrologists, and slightly more among rheumatologists, are currently receiving a CNI, with Lupkynis (voclosporin, Aurinia Pharmaceuticals) accounting for the majority of use within the class.
While nephrologists have historically driven adoption of CNIs in LN, Spherix data reveal a notable increase in uptake among rheumatologists, marking a relatively new shift in prescribing dynamics. Rheumatologists report increased use of Lupkynis compared with prior years, suggesting increasing comfort initiating targeted renal therapies rather than deferring treatment decisions to nephrology. The data further indicate that rheumatologists are particularly likely to incorporate CNIs into regimens for patients presenting with higher levels of proteinuria, reinforcing the perception of the class as a useful option for patients with more severe renal involvement.
The data also highlight early signs of treatment intensification in LN management. Approximately 7% of rheumatology-managed patients are currently receiving both a biologic and a CNI. While still representing a small minority of patients, this combination use suggests a growing willingness among some specialists to layer targeted mechanisms of action in an effort to improve patient outcomes in this difficult-to-treat condition.
The study also highlights the continued expansion of off-label SGLT2 inhibitor use in lupus nephritis, driven primarily by nephrologists. Approximately four in ten nephrology-managed LN patients are now receiving an SGLT2 inhibitor, a steady increase over the past several years, compared with minimal adoption among rheumatologists. Most physicians report prescribing these agents primarily to address LN-related renal outcomes despite the class not having FDA approval for the indication. Among the agents used, Farxiga (dapagliflozin, AstraZeneca) and Jardiance (empagliflozin, Boehringer Ingelheim and Eli Lilly) account for the majority of prescriptions.
Looking ahead, physicians anticipate additional shifts as newly approved and pipeline therapies enter the market. Gazyva (obinutuzumab, Roche/Genentech), which received FDA approval for lupus nephritis after the study fielding period, is expected to see early adoption among a subset of patients over the next year. Specialists indicate they are most likely to initiate Gazyva in patients already receiving advanced therapies such as Lupkynis or rituximab, while patients naïve to advanced therapy appear less likely to receive the drug initially.
Physicians also see potential for other emerging therapies in the lupus nephritis pipeline. Saphnelo (anifrolumab, AstraZeneca), currently approved for systemic lupus erythematosus but occasionally used off-label in LN, is viewed as a candidate for a meaningful share of patients, while investigational agents such as ianalumab (Novartis) are also cited as possible future options.
Beyond currently available treatments, physicians are also beginning to consider the potential role of next-generation modalities. Specialists report that up to one quarter of LN patients may ultimately be candidates for CAR-T cell therapy, particularly those who have progressed through multiple lines of advanced treatment. While the approach remains investigational, physicians see the greatest potential for cell therapy in later-line settings for patients with refractory disease.
“These findings highlight a lupus nephritis treatment landscape that is gradually becoming more targeted and individualized,” said Sawyer May, Insights Director at Spherix Global Insights. “While traditional immunosuppressants remain foundational, physicians are increasingly integrating biologics, calcineurin inhibitors, and even off-label renal therapies into treatment strategies. At the same time, the anticipated arrival of new targeted therapies and potentially transformative modalities such as CAR-T cell therapy means the LN treatment paradigm will likely continue evolving rapidly in the years ahead.”
The Patient Chart Dynamix™: Lupus Nephritis (US), 2025 report provides comprehensive analysis of real-world treatment patterns, patient characteristics, and physician decision-making across more than a thousand audited patient charts, offering detailed insight into how specialists are managing this complex autoimmune kidney disease in clinical practice.
About Patient Chart Dynamix™
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.
About Spherix Global Insights
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Jim Hickey Spherix Global Insights 484-879-4284 james.hickey@spherixglobalinights.com
