– Nearly half of patients on Gazyva plus
standard therapy achieved a complete renal response (CRR), with a
statistically significant and clinically meaningful improvement,
compared to standard treatment alone –
– Analysis showed consistent CRR benefit across
patient subgroups highlighting potential to treat a broad patient
population with high unmet need –
– Gazyva is the only anti-CD20 monoclonal
antibody in a phase III study to demonstrate CRR benefit, which is
associated with preservation of kidney function and delay or
prevention of end-stage kidney disease –
Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX:
RHHBY), announced today that a detailed analysis of its Phase III
REGENCY trial of Gazyva® (obinutuzumab) in people with active lupus
nephritis (LN) was published in the New England Journal of
Medicine. The trial demonstrated a statistically significant and
clinically meaningful improvement in the primary endpoint of
complete renal response (CRR), showing that 46.4% of people treated
with Gazyva plus standard therapy (mycophenolate mofetil and
glucocorticoids) achieved CRR at 76 weeks compared with 33.1% of
people treated with standard therapy alone (adjusted difference
13.4%, 95% CI, 2.0%-24.8%; p=0.0232). This was accompanied by
clinically meaningful improvements in complement levels and
reductions in anti-dsDNA, markers of disease activity and
inflammation.
Data were presented at the World Congress of Nephrology (WCN)
2025 and are being shared with health authorities, including the
U.S. Food and Drug Administration (FDA) and the European Medicines
Agency.
“The fact that nearly half of lupus nephritis patients achieved
a complete renal response, together with clinically meaningful
benefits observed consistently across subgroups, indicates superior
disease control with Gazyva compared to standard treatment alone,”
said Levi Garraway, M.D., Ph.D., chief medical officer and head of
Global Product Development. “Lupus nephritis disproportionately
affects younger women, mostly women of color, often leading to
end-stage kidney disease. Our goal is to address this urgent need
by providing a more effective treatment option.”
“The positive REGENCY study results confirmed the findings of an
earlier trial that administration of obinutuzumab, a therapy which
targets B cells, benefited patients with lupus nephritis more than
standard treatment alone,” said Dr. Richard Furie, the Marilyn and
Barry Rubenstein Chair in Rheumatology and Chief of the Division of
Rheumatology at Northwell Health. “It is also gratifying to see
that patients who received obinutuzumab were not only more likely
to achieve the desired outcome but were able to taper
corticosteroids at the same time.”
Gazyva’s safety profile was consistent with the
well-characterized profile observed in its hematology-oncology
indications. Key secondary endpoints showed that at week 76,
patients who received Gazyva plus standard therapy were more likely
to achieve CRR, with a successful reduction of corticosteroid use
than standard therapy alone. In addition, a higher proportion of
patients also showed improvement in proteinuric response when
treated with Gazyva plus standard therapy versus standard therapy
alone. These endpoints are important indicators for achieving
better disease control in lupus nephritis. As seen in pre-specified
subgroup analyses, a benefit in CRR with Gazyva over standard
therapy alone was consistent across all subgroups of patients
including indicators of more active lupus nephritis, Class IV lupus
nephritis, concomitant Class V disease, higher baseline proteinuria
levels, and/or greater serologic activity.
Further results for key secondary endpoints can be found in the
table below and additional post hoc analysis is ongoing.
Key secondary endpoints
Obinutuzumab (n=135)
Response % (95% CI)
Placebo (n=136)
Response % (95% CI)
Treatment Difference
(95% CI)
P value
CRR with prednisone taper
(prednisone ≤7.5 mg/day Week 64 through
Week 76)
42.7 (34.3, 51.1)
30.9 (23.1, 38.7)
11.9 (0.6, 23.2)
0.0421
Proteinuric response at Week 76 (UPCR
<0.8 g/g)
55.5 (47.1, 64.0)
41.9 (33.6, 50.2)
13.7 (2.0, 25.4)
0.0227
Change in eGFR from baseline, adjusted
mean
2.31 (2.71)
-1.54 (2.71)
3.84 (-1.83, 9.51)
0.1842
Death or renal-related events through Week
76
18.9 (12.1, 25.6)
35.6 (27.5, 43.8)
-16.83 (-27.4, -6.2)
0.0026*
ORR at Week 50
59.1 (50.8, 67.4)
50.7 (42.2, 59.2)
8.4 (-3.4, 20.1)
0.1670
Change in FACIT-F from baseline, adjusted
mean
1.8 (1.2)
3.1 (1.2)
-1.4 (-3.9, 1.2)
0.2991
*
Statistical significance cannot be
claimed as endpoints earlier in the hierarchy were not met
Lupus nephritis is a potentially life-threatening manifestation
of an autoimmune disease that affects approximately 1.7 million
people worldwide, predominantly women, mostly of color and
childbearing age. Despite current treatment options, up to a third
of people will develop end-stage kidney disease within 10 years,
where dialysis or transplant are the only available options and the
risk of mortality is high.
Gazyva is the only anti-CD20 monoclonal antibody to demonstrate
a CRR benefit in a randomized phase III study in lupus nephritis.
Based on data from the Phase II NOBILITY study, Gazyva was granted
Breakthrough Therapy Designation by the U.S. FDA in 2019. In
addition to REGENCY, Gazyva is being investigated in children and
adolescents with lupus nephritis, people with membranous
nephropathy, childhood-onset idiopathic nephrotic syndrome and
systemic lupus erythematosus (SLE), an autoimmune disease that
commonly affects the kidneys and can lead to lupus nephritis.
About Gazyva in Kidney Diseases
Gazyva® (obinutuzumab) is a Type II engineered humanized
monoclonal antibody designed to attach to CD20, a protein found on
certain types of B cells. In lupus nephritis, disease-causing B
cells drive persistent inflammation that damages the kidneys. We
can target an underlying cause of lupus nephritis to help gain
better control of the disease by depleting disease-causing B cells
with Gazyva, aiming to protect the kidneys from further damage and
potentially prevent or delay progression to end-stage kidney
disease.
Gazyva is already approved in 100 countries for various types of
lymphoma. In the United States, Gazyva is part of a collaboration
between Genentech and Biogen.
About the REGENCY Study
REGENCY [NCT04221477] is a Phase III, randomized, double-blind,
placebo-controlled, multicenter study investigating the efficacy
and safety of Gazyva® (obinutuzumab) plus standard therapy
(mycophenolate mofetil and glucocorticoids) in people with
active/chronic International Society of Nephrology/Renal Pathology
Society 2003 proliferative Class III or IV lupus nephritis, with or
without Class V. The study enrolled 271 people, who were randomized
1:1 to receive either biannual intravenous dosing of Gazyva plus
standard therapy or placebo plus standard therapy. REGENCY was
designed based on robust Phase II data and conducted during the
COVID-19 pandemic. The study population was representative of the
real-world population of people with lupus nephritis. The primary
endpoint was the proportion of people who achieved complete renal
response (CRR) at 76 weeks. Key secondary endpoints included the
proportion of people who achieved CRR at week 76 with successful
reduction of corticosteroid use (prednisone taper); the proportion
who achieved proteinuric response at 76 weeks; mean change in
estimated glomerular filtration rate at 76 weeks; death or renal
related events through week 76 and overall renal response at 50
weeks. Safety and tolerability were also assessed.
About Lupus Nephritis
Lupus nephritis is a potentially life-threatening manifestation
of systemic lupus erythematosus, an autoimmune disease that
commonly affects the kidneys. Lupus nephritis affects approximately
1.7 million people worldwide. Lupus nephritis has a profound impact
on the lives and outlook of those affected and even with the latest
treatments, the damage caused to the kidneys usually gets worse
over time, with up to a third of people progressing to end-stage
kidney disease within 10 years, where the only options are dialysis
or transplant. Lupus nephritis predominantly affects women, mostly
women of color and usually of childbearing age. Currently, there is
no cure.
Gazyva U.S. Indications
Gazyva® (obinutuzumab) is a prescription medicine used:
- With the chemotherapy drug, chlorambucil, to treat chronic
lymphocytic leukemia (CLL) in adults who have not had previous CLL
treatment.
- With the chemotherapy drug, bendamustine, followed by Gazyva
alone for follicular lymphoma (FL) in adults who did not respond to
a rituximab-containing regimen, or whose FL returned after such
treatment.
- In combination with chemotherapy, followed by Gazyva alone in
those who responded, to treat stage II bulky, III, or IV FL in
adults who have not had previous FL treatment.
Important Safety Information
The most important safety information patients should know
about Gazyva
Patients must tell their doctor right away about any side effect
they experience. Gazyva can cause side effects that can become
serious or life-threatening, including:
- Hepatitis B Virus (HBV): Hepatitis B can cause liver
failure and death. If the patient has a history of hepatitis B
infection, Gazyva could cause it to return. Patients should not
receive Gazyva if they have active hepatitis B liver disease. The
patient’s doctor or healthcare team will need to screen them for
hepatitis B before, and monitor the patient for hepatitis during
and after, their treatment with Gazyva. Sometimes this will require
treatment for hepatitis B. Symptoms of hepatitis include: worsening
of fatigue and yellow discoloration of skin or eyes.
- Progressive Multifocal Leukoencephalopathy (PML): PML is
a rare and serious brain infection caused by a virus. PML can be
fatal. The patient’s weakened immune system could put them at risk.
The patient’s doctor will watch for symptoms. Symptoms of PML
include: confusion, difficulty talking or walking, dizziness or
loss of balance, and vision problems.
Who should not receive Gazyva:
Patients should NOT receive Gazyva if they have had an
allergic reaction (e.g., anaphylaxis or serum sickness) to Gazyva.
Patients must tell their healthcare provider if they have had an
allergic reaction to obinutuzumab or any other ingredients in
Gazyva in the past.
Additional possible serious side effects of Gazyva:
Patients must tell their doctor right away about any side effect
they experience. Gazyva can cause side effects that may become
severe or life threatening, including:
- Infusion Reactions: These side effects may occur during
or within 24 hours of any Gazyva infusion. Some infusion reactions
can be serious, including, but not limited to, severe allergic
reactions (anaphylaxis), acute life-threatening breathing problems,
or other life-threatening infusion reactions. If the patient has a
reaction, the infusion is either slowed or stopped until their
symptoms are resolved. Most patients are able to complete infusions
and receive medication again. However, if the infusion reaction is
life-threatening, the infusion of Gazyva will be permanently
stopped. The patient’s healthcare team will take steps to help
lessen any side effects the patient may have to the infusion
process. The patient may be given medicines to take before each
Gazyva treatment. Symptoms of infusion reactions may include: fast
heartbeat, tiredness, dizziness, headache, redness of the face,
nausea, chills, fever, vomiting, diarrhea, rash, high blood
pressure, low blood pressure, difficulty breathing, and chest
discomfort.
- Hypersensitivity Reactions Including Serum Sickness:
Some patients receiving Gazyva may have severe or life-threatening
allergic reactions. This reaction may be severe, may happen during
or after an infusion, and may affect many areas of the body. If an
allergic reaction occurs, the patient’s doctor will stop the
infusion and permanently discontinue Gazyva.
- Tumor Lysis Syndrome (TLS): Tumor lysis syndrome,
including fatal cases, has been reported in patients receiving
Gazyva. Gazyva works to break down cancer cells quickly. As cancer
cells break apart, their contents are released into the blood.
These contents may cause damage to organs and the heart, and may
lead to kidney failure requiring the need for dialysis treatment.
The patient’s doctor may prescribe medication to help prevent TLS.
The patient’s doctor will also conduct regular blood tests to check
for TLS. Symptoms of TLS may include nausea, vomiting, diarrhea,
and tiredness.
- Infections: While the patient is taking Gazyva, they may
develop infections. Some of these infections may be fatal and
severe, so the patient should be sure to talk to their doctor if
they think they have an infection. Patients administered Gazyva in
combination with chemotherapy, followed by Gazyva alone are at a
high risk of infections during and after treatment. Patients with a
history of recurring or chronic infections may be at an increased
risk of infection. Patients with an active infection should not be
treated with Gazyva. Patients taking Gazyva plus bendamustine may
be at higher risk for fatal or severe infections compared to
patients taking Gazyva plus CHOP or CVP.
- Low White Blood Cell Count: When the patient has an
abnormally low count of infection-fighting white blood cells, it is
called neutropenia. While the patient is taking Gazyva, their
doctor will do blood work to check their white blood cell count.
Severe and life-threatening neutropenia can develop during or after
treatment with Gazyva. Some cases of neutropenia can last for more
than one month. If the patient’s white blood cell count is low,
their doctor may prescribe medication to help prevent
infections.
- Low Platelet Count: Platelets help stop bleeding or
blood loss. Gazyva may reduce the number of platelets the patient
has in their blood; having low platelet count is called
thrombocytopenia. This may affect the clotting process. While the
patient is taking Gazyva, their doctor will do blood work to check
their platelet count. Severe and life-threatening thrombocytopenia
can develop during treatment with Gazyva. Fatal bleeding events
have occurred in patients treated with Gazyva. If the patient’s
platelet count gets too low, their treatment may be delayed or
reduced.
- Disseminated Intravascular Coagulation (DIC): Fatal and
severe DIC has been reported in people receiving GAZYVA. DIC is a
rare and serious abnormal blood clotting condition that should be
monitored and managed by your doctor as it can lead to
uncontrollable bleeding
The most common side effects of Gazyva in CLL were
infusion-related reactions and low white blood cell counts.
The most common side effects seen with GAZYVA in a study that
included relapsed or refractory NHL, including FL patients were
infusion-related reactions, fatigue, low white blood cell counts,
cough, upper respiratory tract infection, and joint or muscle
pain.
The most common side effects seen with GAZYVA in a study that
included previously untreated FL patients were infusion-related
reactions, low white blood cell count, upper respiratory tract
infections, cough, constipation and diarrhea.
Before receiving Gazyva, patients should talk to their doctor
about:
- Immunizations: Before receiving Gazyva therapy, the
patient should tell their healthcare provider if they have recently
received or are scheduled to receive a vaccine. Patients who are
treated with Gazyva should not receive live vaccines.
- Pregnancy: The patient should tell their doctor if they
are pregnant, think that they might be pregnant, or plan to become
pregnant. Gazyva may harm their unborn baby. The patient should
speak to their doctor about using Gazyva while they are pregnant.
The patient should talk to their doctor or their child’s doctor
about the safety and timing of live virus vaccinations to their
infant if they received Gazyva during pregnancy. Patients of
childbearing potential should use effective contraception while
taking Gazyva and for 6 months after your Gazyva treatment.
- Breastfeeding: Because of the potential risk of serious
side reactions in breastfed children, patient should not breastfeed
while taking Gazyva and for 6 months after your last dose.
Patients should tell their doctor about any side effects.
These are not all of the possible side effects of Gazyva. For
more information, patients should ask their doctor or
pharmacist.
Gazyva is available by prescription only.
Report side effects to the FDA at (800) FDA-1088, or
http://www.fda.gov/medwatch. Report side effects to
Genentech at (888) 835-2555.
Please visit https://www.Gazyva.com for the
Gazyva full Prescribing Information, including BOXED WARNINGS, for
additional Important Safety Information.
About Genentech in Kidney Diseases
For 20 years, we have combined innovation, scientific expertise
and commitment to patients to address unmet needs in kidney
diseases. Our industry-leading pipeline includes several ongoing
Phase I-III clinical studies of immune-mediated investigational
therapies with the aim of bringing innovative new treatment options
to people living with kidney and kidney-related diseases, including
lupus nephritis, membranous nephropathy, immunoglobulin A
nephropathy, atypical hemolytic uremic syndrome, childhood-onset
idiopathic nephrotic syndrome and systemic lupus erythematosus, an
autoimmune disease that can lead to lupus nephritis.
About Genentech
Founded more than 40 years ago, Genentech is a leading
biotechnology company that discovers, develops, manufactures and
commercializes medicines to treat patients with serious and
life-threatening medical conditions. The company, a member of the
Roche Group, has headquarters in South San Francisco, California.
For additional information about the company, please visit
http://www.gene.com.
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