What's the difference between Lupkynis and Benlysta?

Benlysta injection is approved to treat adults and children 5 years of age and older with systemic lupus erythematosus (SLE) and active lupus nephritis (lupus-related kidney inflammation) who are receiving other lupus medicines. Lupkynis is an oral medicine only approved to treat lupus nephritis (not systemic lupus erythematosus) in adults. Lupkynis has not yet been approved for use in children.

Benlysta is given by injection into a vein (intravenous or IV) or just under the skin (subcutaneous). It also comes as an autoinjector or prefilled syringe for subcutaneous use only, which is given once a week. If you are an adult, you or a caretaker can learn to give this medicine and you can use it at home. Only the IV infusion form is given to children.

Lupkynis comes as an oral capsule that you take by mouth twice a day, on an empty stomach.

Are Lupkynis or Benlysta steroids? How do they work?

No, Benlysta (belimumab) and Lupkynis (voclosporin) are not steroid treatments; however, they both work in the immune system to help lower inflammation.

Benlysta is a biologic treatment. A biologic is a large, complex molecule that is produced using specialized technology. Benlysta works by inhibiting the survival of B cells (a type of white blood cell) in the immune system. It is classified as a B-lymphocyte stimulator (BLyS)-specific inhibitor.

Lupkynis is a calcineurin-inhibitor that blocks a part of the immune system to help to control lupus nephritis and protect the kidneys from inflammation and further permanent damage. It helps to calm overactive cells in your immune system that may attack the kidney. Lupkynis targets the T cells in the immune system, a type of white blood cell.

When were these drugs first approved?

Benlysta has been on the market for over a decade. It was first approved in March 2011 to treat systemic lupus erythematosus (SLE) in adults. In 2019, the FDA first approved Benlysta for intravenous (IV) use in children 5 years and older with lupus. In 2020 and 2022, the FDA cleared this medicine for adults and children with lupus nephritis, respectively. Benlysta is manufactured by GSK.

Lupkynis was first approved in January 2022 for the treatment of adult patients with active lupus nephritis (LN). It is not yet approved for children. Lupkynis is made by Aurinia Pharmaceuticals.

Does Benlysta or Lupkynis cause hair loss?

Yes, Lupkynis has been associated with hair loss.

• According to the manufacturer, hair loss (alopecia) is a common side effect due to this medicine.
• In studies of patients receiving 23.7 mg of Lupkynis twice a day, 6% of patients experienced hair loss while 3% of those receiving a placebo (an inactive treatment) had hair loss.
• It is important to note that that hair loss itself can be a symptom of lupus disease.

Hair loss is not listed as a side effect for Benlysta.

How do the side effects compare between Benlysta and Lupkynis?

Benlysta and Lupkynis have a few similar side effects, but most of their side effects are different.

Common side effects that occur with both Benlysta and Lupkynis include:

• headache
• diarrhea
• cough

Other common side effects with Benlysta are:

• nausea
• fever
• stuffy or runny nose and sore throat (nasopharyngitis)
• bronchitis
• trouble sleeping (insomnia)
• leg or arm pain
• depression
• migraine headache
• injection site reaction (pain, redness, itching, or swelling when given subcutaneously)

Other common side effects with Lupkynis are:

• glomerular filtration rate decreased (kidney function declining)
• hypertension (high blood pressure)
• anemia
• urinary tract infection
• abdominal (stomach) pain
• dyspepsia (heartburn)
• alopecia (hair loss)
• kidney impairment
• mouth ulceration
• fatigue
• tremor
• acute kidney injury
• decreased appetite

Are there any food interactions with Benlysta or Lupkynis?

There are several important food interactions with Lupkynis, but Benlysta has no known food or alcohol interactions. This does not necessarily mean no interactions exist. Always consult your healthcare provider.

Lupkynis food interactions

Food can slow down the absorption of Lupkynis, which may lead to lower blood levels and reduced effectiveness of the medicine. Lupkynis should be taken on an empty stomach at least 1 hour before or 2 hours after eating. This will make it easier for your body to absorb the medication.

You should avoid eating grapefruit and drinking grapefruit juice with Lupkynis. Grapefruit can increase the blood levels of Lupkynis in your body and lead to side effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

If you are taking Lupkynis do not take potassium-containing salt substitutes or over-the-counter potassium supplements without first talking to your doctor. Taking Lupkynis with salt substitutes or supplements may cause high levels of potassium in your blood. High levels of potassium can cause weakness, irregular heartbeat, confusion, tingling or numbness of the extremities, or feelings of heaviness in the legs. Call your healthcare provider right away if you have any of these symptoms.

It is important to tell your doctor and pharmacist about all of the medications you use, including prescription drugs, over-the-counter (OTC) medicines, vitamins, herbs and dietary supplements. Do not stop using any medications without first talking to your doctor.

This is not all the information you need to know about Lupkynis and Benlysta for safe and effective use and does not take the place of your doctor’s directions. Review the full consumer medication guide and discuss this information and any questions you have with your doctor or other health care provider.