Would you use voclosporin or belimumab as adjunctive therapy for treatment of lupus nephritis?
How does the presence of extra-renal manifestations influence this decision?
Answer from: at Community Practice
Yes, I would. However, this is not a uniformly accepted practice. Many clinicians believe the effect sizes were not sufficiently large to warrant drugs as initial therapy. The reasons for dual therapy (MMF and belimumab or MMF and voclosporin) go beyond the primary endpoint of the BLISS-LN and Auror...
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at Jerry L Pettis VA Medical Center How about expense and insurance coverage? It took ...
I do not consider voclosporin (VOC) or belimumab (BEL) adjunctive therapies for lupus nephritis (LN). I consider them both important first-line therapies for most proliferative LN patients. In the past 2 decades, numerous lupus nephritis clinical trials failed, not meeting their primary endpoin...
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at Duke University Medical Center Yes, agreed. Usually have a low threshold and ofte...
at Austin Regional Clinic When combining Bel/Voc with MMF do you still use M...
at Uniformed Services University of the Health Sciences (USUHS) @Matthew Dwyer: as you allude to, I do want to bal...
It is too early to say exactly how the treatment of lupus nephritis will change in practice. The combination of voclosporin-MMF seems to increase the overall response rate significantly from the 20s to the 40s. One of the main advantages of the voclosporinMMF combination regimen is that signifi...
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at Atlantic Health Rheumatology Now that voclosporin has been FDA approved for ove...
at Beth Israel Deaconess Medical Center So far, I have been using Belimumab in combination...
at Uniformed Services University of the Health Sciences (USUHS) Dr. @Yuliya Afinogenova: Interesting question. I w...
The timing of your question couldn't be more perfect, @Mithu Maheswaranathan! It is the topic of tomorrow's Great Debate at ACR Convergence with pro-belimumab presented by Dr. Michelle Petri and pro-voclosporin presented by Dr. @Brad Rovin. There are situations when I would choose one over the other...
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at theMednet Great point! Stay tuned as theMednet will plan to ...
I believe we need to address the elephant in the room which is adherence. Belimumab is a weekly SC injection or a monthly infusion, both of which are more palatable to my young LN patients rather than voclosporin which is 3 tablets twice a day. The extra pill burden, added to baseline mycophenolate ...
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at Uniformed Services University of the Health Sciences (USUHS) @Sima Terebelo: From your mouth to God's ears! I'v...
When considering therapy for lupus nephritis, both voclosporin and belimumab are viable options and are endorsed by KDIGO Glomerular disease guidelines.VoclosporinVoclosporin is a calcineurin inhibitor that together with mycophenolate mofetil (MMF) and low dose corticosteroids led to a superior comp...
It is important to remember that there is to date no conclusive evidence of the efficacy of adding either Voclosporin or Belilumab in patients with lupus nephritis where the background treatment is cyclophosphamide as opposed to mycophenolate.In the AURORA trial with Voclosporin, the background ther...
How about expense and insurance coverage? It took ...