For U.S. Healthcare Professionals Only

Every nephron counts

In uncontrolled lupus nephritis, nephron loss is accelerated. Addressing the underlying cause of the disease at the earliest opportunity can help preserve essential kidney function.1,2

For illustrative purposes only.

Lupus nephritis can cause cumulative and irreversible kidney damage1,2

People are born with a fixed number of nephrons, which only decreases over time3

Lupus nephritis, one of the most serious manifestations of systemic lupus erythematosus, destroys nephrons when left unchecked.2

The consequences of cumulative nephron destruction are1,2:

Irreversible kidney damage in lupus nephritis

Irreversible kidney damage

Loss of kidney function in lupus nephritis

Loss of kidney function

Warning: burden of lupus nephritis

Greater burden on the remaining functional nephrons

B cells are a key driver of lupus nephritis kidney damage4

Autoreactive, pathogenic B cells perpetuate a cycle of inflammation and injury that progresses to kidney failure4,5

Autoreactive B cells:

The first role of B cells in lupus nephritis

Produce autoreactive antibodies

The second role of B cells in lupus nephritis

Present autoantigens to other immune cells

The third role of B cells in lupus nephritis

Contribute to local inflammatory cytokine production

Feedback loop in lupus nephritis

These processes attract more autoreactive B cells to the kidney, creating a destructive feedback loop

More complete B-cell depletion may be needed to interrupt inflammation and stop lupus nephritis progression.5

IL-6=interleukin-6.

For most patients with lupus nephritis, standard therapy alone is not enough6-8*

70%-80% of patients do not completely respond to standard therapy alone6-8

These patients are left vulnerable to the risks of suboptimal disease control, including:

Lupus nephritis flares

Flares, which cause irreversible nephron loss and can reduce glomerular filtration rate by 40%2,9

Steroid use in lupus nephritis

Excessive steroid use, which can lead to serious short- and long-term side effects2,10,11

  • These complications may hinder adherence, resulting in higher rates of relapse, lower renal response, and increased hospitalizations10,12
Chronic kidney disease in lupus nephritis

Chronic kidney disease, which increases the risk of cardiovascular complications and secondary immunodeficiency13

End-stage renal disease in lupus nephritis

End-stage renal disease, which occurs in up to 30% of patients despite lupus nephritis treatment.10 These patients have a 26-fold increased risk of death vs the general population14

Using add-on treatment from the start may help reduce the burden of active lupus nephritis on patients’ lives.2,6

*Standard therapy: immunosuppressants and steroids.

Which of your patients could benefit from early and effective add-on treatment?

2024 ACR guidelines recommend starting with triple therapy for patients with class III/IV ± V lupus nephritis15

Early, strong responses and reductions in proteinuria are predictors of favorable long-term outcomes1,16

  • 92% of complete responders reach 10-year survival without end-stage kidney disease vs 43% of partial responders and 13% of nonresponders
  • Proteinuria levels below 0.8 g/day one year from starting treatment are linked to favorable long-term kidney function
Early and effective add-on treatment targeting the underlying inflammation in lupus nephritis may be essential to preserving kidney function.2,5,6,10

ACR=American College of Rheumatology.

Lupus nephritis disproportionately impacts an already underserved and higher-risk population of Black, Hispanic, and Asian women12,17

Genentech is committed to helping all patients with lupus nephritis and is actively researching ways to address disparities in care.

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      Parodis I, Tamirou F, Houssiau FA. Prediction of prognosis and renal outcome in lupus nephritis. Lupus Sci Med. 2020;7(1):e000389. doi:10.1136/lupus-2020-​000389

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      Anders HJ, Saxena R, Zhao MH, Parodis I, Salmon JE, Mohan C. Lupus nephritis. Nat Rev Dis Primers. 2020;6(1):7. doi:10.1038/s41572​-019-​0141-9

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      Charlton JR, Baldelomar EJ, Hyatt DM, Bennett KM. Nephron number and its determinants: a 2020 update. Pediatr Nephrol. 2021;36(4):797-807. doi:10.1007/s00467-020-​04534-2

    • Gomez Mendez LM, Casino MD, Garg J, et al. Peripheral blood B cell depletion after rituximab and complete response in lupus nephritis. Clin J Am Soc Nephrol. 2018;13(10):1502-​1509. doi:10.2215/CJN.01070118

      Gomez Mendez LM, Casino MD, Garg J, et al. Peripheral blood B cell depletion after rituximab and complete response in lupus nephritis. Clin J Am Soc Nephrol. 2018;13(10):1502-​1509. doi:10.2215/CJN.01070118

    • Lech M, Anders HJ. The pathogenesis of lupus nephritis. J Am Soc Nephrol. 2013;24(9):1357-​1366. doi:10.1681/ASN.2013010026

      Lech M, Anders HJ. The pathogenesis of lupus nephritis. J Am Soc Nephrol. 2013;24(9):1357-​1366. doi:10.1681/ASN.2013010026

    • Parodis I, Depascale R, Doria A, Anders HJ. When should targeted therapies be used in the treatment of lupus nephritis: early in the disease course or in refractory patients? Autoimmun Rev. 2024;23(1):103418. doi:10.1016/j.autrev.2023.103418

      Parodis I, Depascale R, Doria A, Anders HJ. When should targeted therapies be used in the treatment of lupus nephritis: early in the disease course or in refractory patients? Autoimmun Rev. 2024;23(1):103418. doi:10.1016/j.autrev.2023.103418

    • Ginzler EM, Dooley MA, Aranow C, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med. 2005;353(21):2219-​2228. doi:10.1056/NEJMoa043731

      Ginzler EM, Dooley MA, Aranow C, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med. 2005;353(21):2219-​2228. doi:10.1056/NEJMoa043731

    • Appel GB, Contreras G, Dooley AM, et al; Aspreva Lupus Management Study Group. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol. 2009;20(5):1103-​1112. doi:10.1681/ASN.2008101028

      Appel GB, Contreras G, Dooley AM, et al; Aspreva Lupus Management Study Group. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol. 2009;20(5):1103-​1112. doi:10.1681/ASN.2008101028

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      Thompson JC, Mahajan A, Scott DA, Gairy K. The economic burden of lupus nephritis: a systematic literature review. Rheumatol Ther. 2022;9:25-47. doi:10.1007/s40744-​021-​00368-y

    • Almaani S, Meara A, Rovin BH. Update on lupus nephritis. Clin J Am Soc Nephrol. 2017;12(5):825-​835. doi:10.2215/CJN.05780616

      Almaani S, Meara A, Rovin BH. Update on lupus nephritis. Clin J Am Soc Nephrol. 2017;12(5):825-​835. doi:10.2215/CJN.05780616

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      Enríquez-Merayo E, Cuadrado MJ. Steroids in lupus: enemies or allies. J Clin Med. 2023;12(11):3639. doi:10.3390/jcm12113639

    • Hoover PJ, Costenbader KH. Insights into the epidemiology and management of lupus nephritis from the US rheumatologist’s perspective. Kidney Int. 2016;90(3):487-​492. doi:10.1016/j.kint.2016.03.042

      Hoover PJ, Costenbader KH. Insights into the epidemiology and management of lupus nephritis from the US rheumatologist’s perspective. Kidney Int. 2016;90(3):487-​492. doi:10.1016/j.kint.2016.03.042

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    • Yap DYH, Tang CSO, Ma MKM, Lam MF, Chan TM. Survival analysis and causes of mortality in patients with lupus nephritis. Nephrol Dial Transplant. 2012;27(8):3248-​3254. doi:10.1093/ndt/gfs073

      Yap DYH, Tang CSO, Ma MKM, Lam MF, Chan TM. Survival analysis and causes of mortality in patients with lupus nephritis. Nephrol Dial Transplant. 2012;27(8):3248-​3254. doi:10.1093/ndt/gfs073

    • American College of Rheumatology. 2024 American College of Rheumatology (ACR) guideline for the screening, treatment, and management of lupus nephritis. Guideline summary. Published online November 18, 2024. Accessed November 21, 2024. https://assets.contentstack.io/v3/assets/bltee37abb6b278ab2c/blt4db6d0b451e88caf/lupus-nephritis-guideline-summary-2024.pdf

      American College of Rheumatology. 2024 American College of Rheumatology (ACR) guideline for the screening, treatment, and management of lupus nephritis. Guideline summary. Published online November 18, 2024. Accessed November 21, 2024. https://assets.contentstack.io/v3/assets/bltee37abb6b278ab2c/blt4db6d0b451e88caf/lupus-nephritis-guideline-summary-2024.pdf

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      Chen YE, Korbet SM, Katz RS, Schwartz MM, Lewis EJ; Collaborative Study Group. Value of a complete or partial remission in severe lupus nephritis. Clin J Am Soc Nephrol. 2008;3(1):46-53. doi:10.2215/CJN.03280807

    • Parikh SV, Almaani S, Brodsky S, Rovin BH. Update on lupus nephritis: core curriculum 2020. Am J Kidney Dis. 2020;76(2):265-​281. doi:10.1053/j.ajkd.2019.10.017

      Parikh SV, Almaani S, Brodsky S, Rovin BH. Update on lupus nephritis: core curriculum 2020. Am J Kidney Dis. 2020;76(2):265-​281. doi:10.1053/j.ajkd.2019.10.017