If you’ve been living with lupus, you know how frustrating it can be to find treatment that works. Medications that help someone else may not work for you and finding the right mix of therapies can take years.
For decades, corticosteroids and broad immune-suppressing drugs were the only treatment options. These medications help but they can cause side effects that are tough to live with.
That’s starting to change. New lupus medications offer more options and better quality of life. These breakthrough therapies target specific parts of the immune system, so treatment can be more precise with fewer long-term risks.
“Anifrolumab, voclosporin and belimumab are the newest therapies now available to help treat systemic lupus erythematosus and other types of lupus,” said Ernest Vina, MD, a rheumatologist with Banner - University Medicine.
Here’s what these new medications mean, how they work and what to discuss with your rheumatologist.
New lupus treatments
Lupus medication advances are a big step forward. Instead of treating the whole immune system, they target the specific areas that cause lupus flares. So with them, you could have more precise, long-term control.
Anifrolumab (Saphnelo)
Anifrolumab is a biologic medication that blocks type I interferon, a protein linked to inflammation in lupus. It helps calm the immune system without shutting it down completely. It’s like turning down the volume on your immune system instead of silencing it.
- Who it’s for: Adults with moderate to severe systemic lupus erythematosus (SLE)
- How it’s given: An IV infusion every four weeks
- Benefits: Fewer flares, improvements in skin and joint symptoms like rashes and arthritis and possibly less need for steroids
Voclosporin (Lupkynis)
Voclosporin is a newer lupus nephritis treatment. Lupus nephritis is a type of lupus that causes inflammation in the kidneys. Voclosporin blocks an enzyme (calcineurin) that fuels inflammation in kidney tissue. It’s one of the first drugs created specifically to help keep the kidneys healthy in people with lupus.
- Who it’s for: People with active lupus nephritis
- How it’s given: Taken by mouth and usually combined with mycophenolate (CellCept) and low-dose steroids
- Benefits: Protects kidneys, lowers protein levels in the urine and can reduce the need for dialysis or transplant in the future
Belimumab (Benlysta)
Belimumab is a biologic that targets B cells, the immune cells that produce harmful antibodies in lupus. By reducing the antibodies that mistakenly attack healthy tissue, belimumab helps the immune system act like it should.
- Who it’s for: Adults and children age 5 and older with systemic lupus or lupus nephritis
- How it’s given: Either by IV infusion or weekly injection
- Benefits: Fewer flares, kidney failure prevention, improved energy and less need for steroids
What these new lupus treatments could mean for you
The biggest benefit of these new medications is that you could get better disease control with fewer side effects.
Potential advantages include:
- Fewer flares
- More stable symptoms
- Protection against organ damage, especially in the kidneys
- Less need for long-term steroids
- Improved quality of life and daily functioning
For lupus nephritis patients:
- Slower progression of kidney damage
- Better kidney function
- Less likelihood of dialysis or transplant
While these therapies are signs of real progress, they aren’t cures. Lupus is a lifelong condition and everyone’s treatment works differently. It could take several months to see full benefits.
“You need to communicate with your rheumatologist about your symptoms,” Dr. Vina said. And keep in mind that some symptoms may not be due to lupus. People with lupus are more likely to have fibromyalgia, coronary artery disease and other diseases. If these other conditions are causing symptoms, they need other treatments, not lupus medications.
How these new lupus treatments fit into your plan
New therapies will probably be added to the medications you already take. “They are typically used in combination with other medications for lupus,” Dr. Vina said. Your provider will start slowly, watch how you respond and make careful adjustments over time.
You may be a candidate if:
- You have lupus that isn’t well-controlled with standard treatments
- You have frequent flares
- Lupus is affecting your kidney health
- You would like to take less steroids
- You who meet certain criteria based on your symptoms or lab tests
What to expect during evaluation:
Your rheumatologist will consider your type of lupus, overall health and personal goals before recommending any new therapy. They will:
- Review your symptoms and disease
- Check your kidney function (especially for lupus nephritis)
- Talk to you about the risks, benefits and possible side effects
If you decide to try these medications, your rheumatologist will work closely with you to:
- Manage any side effects, such as mood disorders
- Track your progress with regular lab tests and follow-up visits
- Adjust medications as needed
Most patients tolerate these drugs well when they’re used under expert medical supervision.
Getting these new lupus treatments
For some lupus medications, like anifrolumab and belimumab, you need to get infusions or injections at specialized centers. Voclosporin is taken by mouth, but you still need to be monitored closely.
“I recommend that people take the medicines as instructed by their rheumatologist and be patient, since you may not see a response to these therapies for weeks or even a few months. And some people may only have a partial response,” Dr. Vina said.
Because these are specialty drugs, you may need to get insurance pre-authorization. Cost varies but many pharmaceutical companies have patient assistance programs that can help you afford treatment.
Your next steps
If you’re wondering whether these new lupus treatments could help you, talk to your rheumatologist. Before your next visit:
- Make a list of your symptoms and how they affect your daily life
- Note any side effects or concerns you have about the medication you’re taking now
- Write down questions, such as:
- “Am I a candidate for any of these newer treatments?”
- “Could one of these medications help reduce my steroid use?”
- “What kind of monitoring would I need?”
Never stop taking your current medications without talking to your provider and remember that lupus management is a life-long effort.
If you’re ready to explore new options for managing lupus or lupus nephritis, schedule an appointment with a Banner Health specialist. Our rheumatologists stay up to date on the latest lupus research and treatment options so we can provide the best possible care.
