Authored By Greg Keenan, Chief Medical Officer, Aurinia

As we wrap up another impactful year at Aurinia, I want to reflect on the progress we’ve made on our journey to break down barriers in one of the toughest conditions in the autoimmune space: lupus nephritis (LN).  

LN, a serious and common complication of systemic lupus erythematosus (SLE), has long posed substantial challenges for patients and physicians alike. Without proper care, LN can lead to irreversible kidney damage, high blood pressure, and an increased risk of heart attack and stroke.  

About 35% of all SLE patients have renal involvement. Yet, a high rate of SLE patients do not receive routine screening for LN. Unfortunately, even with an LN diagnosis, 77%  go untreated and 33% progress to chronic kidney disease or end-stage kidney disease within a year of diagnosis.1   The impacts of LN are devastating on patients and caregivers – which is exactly what motivates us to urgently attempt to improve health outcomes for everyone impacted by LN.  

Putting Passion into Practice   

Driven by our passion to help those who are overlooked, excluded, and misunderstood, we tirelessly pursue novel treatments that redefine standards of care for patients and HCPs. I am tremendously proud of our scientific rigor, which has enabled us to lead one of the largest and longest clinical programs evaluating LN treatments.  

This year, our sustained clinical research has uncovered key insights to help preserve kidney health. Through our collaborative efforts with several leading experts in the nephrology and rheumatology fields, we have been able to develop a deeper understanding of the long-term safety and efficacy of LN treatments.  

These clinical studies and therapeutic advancements also moved LN treatment guidelines forward this year. We applaud the European Alliance of Associations for Rheumatology’s (EULAR) updated recommendations for the management of SLE, as they include a new treatment paradigm for LN.2    

The recommendations highlight the profound repercussions of delaying diagnosis, thus recommending screening for kidney involvement at each doctor's appointment for patients living with lupus. The guidelines now recommend physicians consider combination therapy with a biologic or CNI as a first-line option or in those not responding to other therapies within several months of initiation for patients diagnosed with lupus nephritis.

Importantly, the recommendations suggest that 5 mg/day should serve as the highest acceptable maintenance dose of steroids in SLE or LN. This recommendation to reduce steroid dosing was based on the significantly lower glucocorticoid doses used in recent randomized clinical trials, including Aurinia’s AURORA Clinical Program. 

I am hopeful that this will improve the future management of LN – a major step forward for the entire lupus community.   

Importantly, we have also made great strides in educating both HCPs and patients around the latest scientific and clinical advancements with the hope that, together, they can develop and adopt meaningful treatment plans that vastly improve health outcomes.   

Continuing to Remove Barriers with Conviction   

Looking back on this year, I am filled with gratitude for the dedication and hard work of the entire Aurinia team. With our deep understanding of the challenges that people living with LN face, we will continue to pursue promising science and attempt to eliminate barriers to care in partnership with HCPs and the lupus community at large.   

Looking ahead, we remain steadfast in our effort to create a sense of urgency around early diagnosis, management, and treatment of LN. We will never stop fighting to empower people to take charge of their health, offering education and resources wherever possible. The journey is far from over, but I am confident that together, we’re achieving something better today.   


  1. Patient Journey as a Foundation for Insight: A Lupus Nephritis Case Study." Optum, Accessed 15 September 2023.
  2. Fanouriakis A, Kostopoulou M, Andersen J, et al. EULAR recommendations for the management of systemic lupus erythematosus: 2023 update. Annals of the Rheumatic Diseases. Published Online First: 12 October 2023. doi: 10.1136/ard-2023-224762.