What is the difference between Benlysta and Saphnelo?
Both Benlysta and Saphnelo are targeted treatments that may be used to treat systemic lupus erythematosus (SLE) in addition to standard therapy. But their approved indications, recommended target age groups, and the way they work, differ. They are the only two medicines to have been approved to treat SLE since the 1950s.
Benlysta is approved to treat adults and children aged 5 years and older with active SLE including active lupus nephritis, whereas Saphnelo is only approved in adults with moderate to severe SLE without severe active lupus nephritis or CNS lupus.
Benlysta can be given as an intravenous infusion over 1 hour every 4 weeks in a healthcare provider's office or adults can self-administer it using a single-dose, subcutaneous (SC) autoinjector or pre-filled syringe once weekly at home. The autoinjector is also approved for SC administration in children 5 years and older with SLE or active lupus nephritis. Saphnelo is only available as an intravenous infusion that is administered over 30 minutes, every 4 weeks.
Benlysta and Saphnelo are both targeted treatments, but they target different parts of the immune system that are particularly overactive in lupus. Benlysta targets and blocks the activity of a type of white blood cell called a B cell, which produces antibodies that attack tissue, causing symptoms of SLE. It is classified as a B-lymphocyte stimulator (BLyS)-specific inhibitor. Saphnelo targets the type I interferon receptor and inhibits the activity of type 1 interferons. Activation of the interferon system is a common underlying characteristic of SLE that leads to the immune system being constantly “switched on”, contributing to SLE symptoms. Saphnelo is classified as a type 1 interferon receptor antagonist. Benlysta was first approved in 2011 and Saphnelo was approved in 2021.
Both Benlysta and Saphnelo can suppress your immune system, which means you should not receive any live vaccines, such as chickenpox and measles, mumps, and rubella (MMR) while receiving these medications.
Neither the IV form of Benlysta nor Saphnelo requires the use of premedications or additional laboratory tests to monitor side effects.
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Benlysta vs Saphnelo for Lupus: Which SLE Treatment is More Effective?
No direct comparison studies exist between Benlysta and Saphnelo for systemic lupus erythematosus (SLE), making it challenging to determine which lupus medication is superior. Both biologic treatments show effectiveness for SLE management, though individual patient responses may vary.
Shared Benefits of Both Lupus Treatments:
- Reduce lupus disease activity, joint pain, and chronic fatigue
- Improve overall quality of life in SLE patients
- Well-tolerated with minimal serious adverse effects
- Act as steroid-sparing medications, allowing corticosteroid dose reduction.
Saphnelo (Anifrolumab) for Lupus:
- Targets interferon type-1 cytokine specifically involved in SLE inflammation
- Clinical trials used BICLA (British Isles Lupus Assessment Group-based Composite Lupus Assessment) measuring 97 body areas
- Reduced inflammation across all organ systems with moderate-to-severe lupus involvement
- May work better for patients with specific autoantibodies (anti-Smith, anti-RNP, anti-Ro, anti-SSA, anti-La, anti-SSB) that increase interferon type-1 levels
- Higher cost compared to IV Benlysta
- Increased shingles (herpes zoster) risk
Benlysta (Belimumab) for Lupus:
- Proven safety and efficacy across at least 8 clinical trials
- Long-term safety data available (13+ years of use)
- Only FDA-approved biologic for lupus nephritis treatment
- Available as IV or subcutaneous SLE treatment and approved for children (age 5+)
- May be more effective for patients with low complement levels (C3, C4) or high anti-dsDNA antibodies (based on Embrace trial data)
- Generally less expensive than Saphnelo
Important Safety Considerations:
Both medications are contraindicated during pregnancy and breastfeeding.
Can you take Saphnelo and Benlysta together?
Benlysta and Saphnelo are both biologics, but because Saphnelo has not been studied in combination with other biologics, it is not recommended to be given with Benlysta.
References
- What you need to know about Saphnelo™ Lupus Foundation of America. https://www.lupus.org/resources/saphnelo-what-you-need-to-know
- How Will I Receive Saphnelo. Saphnelo.com. https://www.saphnelo.com/patient/starting-saphnelo.html#:~:text=Your%20healthcare%20provider%20will%20give,1%20time%20every%204%20weeks
- Levy RA, Gonzalez-Rivera T, Khamashta M, et al. 10 Years of belimumab experience: What have we learnt? Lupus. 2021;30(11):1705-1721. doi:10.1177/09612033211028653
- Saphnelo Prescribing Information https://drd9vrdh9yh09.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/44b6985c-8268-46b1-ba3e-2bb43bfd4d4c/44b6985c-8268-46b1-ba3e-2bb43bfd4d4c_viewable_rendition__v.pdf
- Sergio Guedes Barbosa L, Saxena A, Ginzler E, Furie R, D'Cruz D, Burriss S, Gilbride J, Miller M, Groark J, Roth D, Ji B. Efficacy of Belimumab in Patients of Black Race with Systemic Lupus Erythematosus and High Disease Activity or Renal Manifestations [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/efficacy-of-belimumab-in-patients-of-black-race-with-systemic-lupus-erythematosus-and-high-disease-activity-or-renal-manifestations/
- Benlysta Medication Guide. https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Benlysta/pdf/BENLYSTA-PI-MG-IFU.PDF#nameddest=MG
- FDA Approves Benlysta (belimumab) Autoinjector for Children with Active Lupus Nephritis https://www.drugs.com/newdrugs/fda-approves-benlysta-belimumab-autoinjector-children-active-lupus-nephritis-6558.html
- Benlysta Prescribing Information. https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Benlysta/pdf/BENLYSTA-PI-MG-IFU.PDF
Read next
How long does it take for Benlysta injections to work?
It may take up to 6 or 7 months for Benlysta injections to work because it takes time for Benlysta to reduce the activity of autoreactive B-lymphocytes that contribute to inflammation that causes lupus symptoms. Continue reading
Can Benlysta cause an allergic reaction?
Yes, Benlysta can cause an allergic reaction, but serious and life-threatening allergic reactions are uncommon. Approximately 13% of people will experience a mild to moderate hypersensitivity (allergic) reaction on the day they get their Benlysta infusion. Continue reading
How does Benlysta help lupus?
Benlysta helps lupus by reducing disease activity and flares and decreasing the need for steroid medications by up to 25%. Benlysta works for lupus by binding to a substance called BLyS, which helps B cells to survive for longer. When Benlysta is attached to BLyS, BLyS can no longer bind to and stimulate autoreactive B cells. Continue reading
See also:
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