Are there instances in which you would combine belimumab and rituximab for management of difficult to control SLE?  

While I have not employed this combination in my own practice, I am aware of the proposed rationale that using belimumab and rituximab together could promote more sustained B-cell depression. This approach was tested in the BEAT-LUPUS trial, results published in Lancet Rheumatology in 2022. In this ...