What factors do you weigh most heavily when choosing between belimumab and voclosporin as part of a triple therapy regimen for newly diagnosed class IV LN?

When I would choose belimumab:

• If the urine protein creatinine ratio (UPCR) is < 3 gm/gm and if there are significant extra-renal manifestations.
• In patients with adherence problems with oral medications, especially noting the high pill burden of voclosporin.
• In patients with severe renal dysfuncti...

I will start immediately by saying I think of belimumab as more relevant for "maintenance" than "initial" therapy. I like that belimumab seems to prevent flare and stabilize GFR, and that is needed for long-term kidney health. I also think that the post-hoc analysis suggests that belimumab is less e...