{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T00:13:45Z","timestamp":1793664825781,"version":"4.5.1"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007013","name":"F. Hoffmann-La Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007013","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether adding obinutuzumab to standard\u2010of\u2010care lupus nephritis (LN) therapy could improve the likelihood of long\u2010term preservation of kidney function and do so with less glucocorticoids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Post hoc analyses of the phase II NOBILITY trial were performed. Time to unfavorable kidney outcome (a composite of treatment failure, doubling of serum creatinine, or death), LN flare, first 30% and 40% declines in estimated glomerular filtration rate (eGFR) from baseline, and chronic eGFR slope during the trial were compared between patients with active LN who were randomized to take obinutuzumab (n\u00a0=\u00a063) or placebo (n\u00a0=\u00a062) in combination with mycophenolate mofetil and glucocorticoids. The number of patients who achieved complete renal response (CRR) on 7.5 mg or less per day of prednisone was also determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Obinutuzumab reduced the risk of developing the composite kidney outcome by 60%, LN flare by 57%, and first eGFR decline of 30% or 40% by 80% and 91%, respectively. Patients receiving obinutuzumab had a significantly slower decline in eGFR than patients receiving\u00a0placebo, with an annualized eGFR slope advantage of 4.1 ml\/min\/1.73 m<jats:sup>2<\/jats:sup>\/year (95% confidence interval 0.14\u20138.08). Overall, 38% of patients receiving obinutuzumab compared with 16% of patients receiving placebo achieved CRR at week 76 while receiving 7.5 mg or less per day of prednisone (<jats:italic>P<\/jats:italic> &lt;\u20090.01); at week 104, the difference did not achieve significance (38% vs 22%; <jats:italic>P<\/jats:italic> =\u20090.06).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Post hoc analyses of NOBILITY demonstrated that compared with standard\u2010of\u2010care therapy, obinutuzumab treatment resulted in superior preservation of kidney function and prevention of LN flares. More patients achieved CRR at week 76 with less glucocorticoid use in the obinutuzumab group.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art42734-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/art.42734","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T08:10:31Z","timestamp":1699603831000},"page":"247-254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Kidney Outcomes and Preservation of Kidney Function With Obinutuzumab in Patients With Lupus Nephritis: A Post Hoc Analysis of the <scp>NOBILITY<\/scp> Trial"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5639-0210","authenticated-orcid":false,"given":"Brad H.","family":"Rovin","sequence":"first","affiliation":[{"name":"The Ohio State University Wexner Medical Center  Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6712-1585","authenticated-orcid":false,"given":"Richard A.","family":"Furie","sequence":"additional","affiliation":[{"name":"Northwell Health  Great Neck New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge A.","family":"Ross Terres","sequence":"additional","affiliation":[{"name":"Genentech, Inc  South San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Giang","sequence":"additional","affiliation":[{"name":"Genentech, Inc  South San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Schindler","sequence":"additional","affiliation":[{"name":"F. Hoffmann\u2010La Roche Ltd  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Turchetta","sequence":"additional","affiliation":[{"name":"Hoffmann\u2010La Roche Ltd  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay P.","family":"Garg","sequence":"additional","affiliation":[{"name":"Genentech, Inc  South San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"William F.","family":"Pendergraft","sequence":"additional","affiliation":[{"name":"Genentech, Inc  South San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Malvar","sequence":"additional","affiliation":[{"name":"Hospital Fernandez  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-023-00722-z"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001180"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00578-X"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNH.0000000000000792"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014460"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39594"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac304"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0141-9"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.39026"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2015-000123"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40724"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.06.009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02418-0"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-218272"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00091-7"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.015"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-216924"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34359"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38037"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2217\/fon-2022-0112"},{"key":"e_1_2_8_22_1","volume-title":"South San Francisco","author":"Gazyva [prescribing information]","year":"2022"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-220920"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01070118"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400928"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.11.023"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1267"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.07.013"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.05.031"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.07.030"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05040513"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2023-000932"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.08.027"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/09612033231160969"}],"container-title":["Arthritis &amp; 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