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Obinutuzumab Preserves Kidney Function in Lupus Nephritis

Reduction seen in risk for developing composite kidney outcome

By Elana Gotkine HealthDay Reporter

THURSDAY, Nov. 16, 2023 (HealthDay News) — For patients with lupus nephritis (LN), obinutuzumab treatment results in better preservation of kidney function and prevention of LN flares, according to a study published online Nov. 10 in Arthritis & Rheumatology.

Brad H. Rovin, M.D., of The Ohio State University Wexner Medical Center in Columbus, and colleagues examined whether adding obinutuzumab to standard-of-care LN therapy could improve outcomes in post-hoc analyses of the phase II NOBILITY trial. The time to unfavorable kidney outcome (a composite of treatment failure, doubling of serum creatinine, or death), LN flare, first 30 and 40 percent declines in estimated glomerular filtration rate (eGFR) from baseline, and chronic eGFR slope were compared for those randomly assigned to receive obinutuzumab (63 patients) or placebo (62 patients) in combination with mycophenolate mofetil and glucocorticoids.

The researchers found that the risk for developing the composite kidney outcome, LN flare, and first eGFR decline of 30 and 40 percent decreased by 60, 57, and 80 and 91 percent, respectively, with obinutuzumab. A significantly slower decline in eGFR was seen for patients receiving obinutuzumab than placebo, with an annualized eGFR slope advantage of 4.1 mL/min/1.73 m2/year. At week 76, complete renal response was achieved by 38 and 16 percent of patients receiving obinutuzumab and placebo, respectively, while receiving 7.5 mg or less per day of prednisone. The difference was not significant at week 104.

“These findings suggest that the addition of obinutuzumab to standard of care affords substantial protection to the kidneys in patients with lupus nephritis,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including F. Hoffmann-La Roche, which developed obinutuzumab and funded the study.

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