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Positive results in lupus study based on UCL pre-clinical research

A clinical trial of a new drug to treat severe lupus which was set up after UCL researchers provided key experimental evidence of its effectiveness has reported positive results.

Pre-clinical evidence from UCL and Southampton University researchers influenced the initiation of the Nobility study, a trial of the drug obinutuzumab for the treatment of severe lupus in patients with kidney problems. The study has reported that the drug was more effective than placebo as an additional therapy to patients’ ongoing conventional treatments.

Obinutuzumab is a new generation drug – known as an ‘antiCD20’ drug – which eliminates a type of white blood cell known as a B cell, which is understood to play an important role in lupus. A previous generation anti-CD20 antibody, rituximab, is currently used to treat people with severe lupus but it does not always eliminate B cells efficiently.

UCL researchers Dr Venkat Reddy, Prof Geraldine Cambridge, Prof David Isenberg and Dr. Maria Leandro led the pre-clinical research, using samples from healthy people and those with lupus receiving treatment at UCLH, in collaboration with Prof Cragg and Prof Martin Glennie from Southampton University and Dr. Christian Klein from Roche (Basel). Together, the group provided compelling experimental evidence to underpin the setup of the Nobility study.

Lupus is a rare autoimmune condition where several parts of the body including vital organs such as the kidney may be affected resulting in poor outcomes. Lupus commonly affects young people, and women in particular. There is no cure. Despite current therapies the outcomes remain poor for some people with lupus.

Nineteen years ago, the UCL rheumatology team led by Professor Jo Edwards pioneered the use of rituximab to treat people with severe lupus, following the initial positive experience in rheumatoid arthritis. However, two major clinical trials did not provide evidence for its efficacy. And experiments using blood samples from people with lupus showed that obinutuzumab was at least twice as efficient than rituximab at eliminating B cells.

Further, larger studies will be needed before obinutuzumab can be considered for use in routine clinical care, but researchers are hopeful that the drug will prove effective in future studies, saying the drug would contribute towards a great unmet need.