| Lupus Nephritis
Gazyva vs Lupkynis
Side-by-side clinical, coverage, and cost comparison for lupus nephritis.Deep comparison between: Gazyva vs Lupkynis with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsLupkynis has a higher rate of injection site reactions vs Gazyva based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Lupkynis but not Gazyva, including UnitedHealthcare
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Category
Gazyva
Lupkynis
At A Glance
IV infusion
Anti-CD20 monoclonal antibody
Oral
Twice daily
Calcineurin inhibitor
Indications
- Chronic Lymphocytic Leukemia
- Lymphoma, Follicular
- Lupus Nephritis
- Lupus Nephritis
Dosing
Chronic Lymphocytic Leukemia 100 mg IV on day 1 and 900 mg on day 2 of Cycle 1, then 1,000 mg on days 8 and 15 of Cycle 1, and 1,000 mg on day 1 of Cycles 2-6 (28-day cycles) in combination with chlorambucil.
Lymphoma, Follicular 1,000 mg IV on days 1, 8, and 15 of Cycle 1, then 1,000 mg on day 1 of Cycles 2-6 or 2-8 in combination with chemotherapy; responding patients continue on 1,000 mg monotherapy every 2 months for up to 2 years.
Lupus Nephritis 1,000 mg IV at initial infusion (Dose 1), at Week 2 (Dose 2), at Week 24 (Dose 3), at Week 26 (Dose 4), then 1,000 mg every 6 months thereafter, in combination with standard therapy.
Lupus Nephritis 23.7 mg orally twice daily on an empty stomach (minimum 8 hours between doses), in combination with mycophenolate mofetil and corticosteroids; dose adjusted based on eGFR and blood pressure monitoring.
Severe renal impairment (baseline eGFR <45 mL/min/1.73 m2) Recommended starting dose is 15.8 mg twice daily if benefit exceeds risk.
Mild or moderate hepatic impairment (Child-Pugh A or B) Recommended dose is 15.8 mg twice daily; not recommended in severe hepatic impairment (Child-Pugh C).
Dose adjustment with moderate CYP3A4 inhibitors Reduce daily dosage to 15.8 mg in the morning and 7.9 mg in the evening when co-administered with moderate CYP3A4 inhibitors (e.g., verapamil, fluconazole, diltiazem).
Contraindications
- Known hypersensitivity reaction (e.g., anaphylaxis) to obinutuzumab or any excipient
- Serum sickness with prior obinutuzumab use
- Concomitant use of strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin), which significantly increase voclosporin exposure and may increase the risk of nephrotoxicity
- History of serious or severe hypersensitivity reaction, including anaphylaxis, to voclosporin or any of its excipients
Adverse Reactions
Most common (>=10%) Infusion-related reactions, neutropenia, thrombocytopenia, diarrhea, fatigue, upper respiratory tract infection, musculoskeletal pain
Serious Hepatitis B virus reactivation, progressive multifocal leukoencephalopathy, infusion-related reactions, hypersensitivity reactions including serum sickness, tumor lysis syndrome, infections, neutropenia, thrombocytopenia, disseminated intravascular coagulation
Postmarketing Serum sickness
Most common (>=3%) GFR decreased, hypertension, diarrhea, headache, anemia, cough, urinary tract infection, abdominal pain upper, dyspepsia, alopecia, renal impairment, abdominal pain, mouth ulceration, fatigue, tremor, acute kidney injury, decreased appetite
Serious Lymphoma and other malignancies, serious infections (pneumonia, gastroenteritis, urinary tract infections), nephrotoxicity, hypertension, neurotoxicity (seizure, posterior reversible encephalopathy syndrome), hyperkalemia, QTc prolongation, hypersensitivity reactions, pure red cell aplasia
Postmarketing Hypersensitivity reactions including anaphylaxis and angioedema, nausea, vomiting
Pharmacology
Obinutuzumab is a humanized anti-CD20 IgG1 monoclonal antibody with reduced fucose content that mediates B-cell lysis via immune effector cell engagement (ADCC and ADCP), direct intracellular death signaling, and complement activation; its reduced fucose content confers greater ADCC activity than rituximab.
Voclosporin is a calcineurin-inhibitor immunosuppressant that inhibits lymphocyte proliferation, T-cell cytokine production, and T-cell activation surface antigen expression by blocking NFATc dephosphorylation; it also stabilizes actin cytoskeleton and stress fibers in podocytes, increasing podocyte integrity in glomeruli.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Gazyva
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (0/12)
Lupkynis
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (10/12)
UnitedHealthcare
Gazyva
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Lupkynis
- Covered on 4 commercial plans
- PA (5/8) · Step Therapy (0/8) · Qty limit (5/8)
Humana
Gazyva
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Lupkynis
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Chronic Lymphocytic Leukemia (CLL)
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10
Aurinia Alliance: LupkynisCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.