The current treatment paradigm in lupus nephritis consists of an initial phase 
aimed at inducing remission and a subsequent remission maintenance phase. With 
this so-called sequential treatment approach, complete renal response is 
achieved in a disappointing proportion of 20-30% of the patients within 6-12 
months, and 5-20% develop end-stage kidney disease within 10 years. 
Treat-to-target approaches are detained owing to uncertainty as to whether the 
target should be determined based on clinical, histopathological, or 
immunopathological features. Until reliable non-invasive biomarkers exist, 
tissue-based evaluation remains the gold standard, necessitating repeat kidney 
biopsies for treatment evaluation and therapeutic decision-making. In this 
viewpoint, we discuss the pros and cons of voclosporin and belimumab as add-on 
agents to standard therapy, the first drugs to be licenced for lupus nephritis 
after recent successful randomised phase III clinical trials. We also discuss 
the prospect of obinutuzumab and anifrolumab, also on top of standard 
immunosuppression, currently tested in phase III trials after initial auspicious 
signals. Undoubtably, the treatment landscape in lupus nephritis is changing, 
with combination treatment regimens challenging the sequential concept. 
Meanwhile, the enrichment of the treatment armamentarium shifts the need from 
lack of therapies to the challenge of how to select the right treatment for the 
right patient. This has to be addressed in biomarker surveys along with 
tissue-level mapping of inflammatory phenotypes, which will ultimately lead to 
person-centred therapeutic approaches. After many years of trial failures, we 
may now anticipate a heartening future for patients with lupus nephritis.