mycophenolate mofetil + glucocorticoids

This standard-of-care treatment refers to the foundational background therapy regimen used in Janssen's clinical development programs for active lupus nephritis, most notably the Phase 2 ORCHID-LN trial (NCT04376827). The regimen consists of an immunosuppressant—either mycophenolate mofetil (MMF) or mycophenolic acid (MPA)—administered in combination with glucocorticoids (steroids). Mycophenolate mofetil is a prodrug of mycophenolic acid, which acts as a potent, selective, uncompetitive, and reversible inhibitor of inosine monophosphate dehydrogenase (IMPDH). This inhibition depletes guanosine nucleotides, which are essential for de novo purine synthesis, thereby suppressing the proliferation of T and B lymphocytes. Glucocorticoids provide broad anti-inflammatory and immunosuppressive effects by binding to the glucocorticoid receptor, modulating gene transcription to decrease the production of pro-inflammatory cytokines. In the context of the ORCHID-LN study, this combination served as the baseline therapy for all participants, to which the investigational IL-23 inhibitor guselkumab was added.

Other names

standard-of-care treatment-Janssen Research & Development, LLC-Lupus Nephritisstandard-of-care treatmentMMF + glucocorticoidsMPA + glucocorticoidsmycophenolate mofetil + steroids