Everest Medicines has entered into a collaboration and license agreement with Kezar Life Sciences to develop and commercialise Kezar's lead drug candidate zetomipzomib, a novel, first-in-class, selective inhibitor of the immunoproteasome for a range of autoimmune diseases including lupus nephritis (LN), in Greater China, South Korea and some Southeast Asian countries.

Lupus Nephritis is the most common secondary immune-mediated glomerular disease, which may gradually lead to kidney function failure. In China alone, it is estimated that there are 1 million Systemic lupus erythematosus (SLE) patients in total, 40-60% SLE patients have renal disease, and the risk of mortality is significantly increased due to renal disease. Zetomipzomib can modulate innate and acquired immune responses to down regulate inflammation, which is differentiated from direct immunosuppression. This enables its treatment potential in a wide range of autoimmune diseases including LN and SLE.

Under the terms of the agreement, Kezar is entitled to receive an upfront payment of $7 million, and clinical and commercial milestone payments of up to $125.5 million, as well as tiered single-digit to low-teens royalties on net sales of products. Everest will also have the option to localise manufacturing.

Everest will join Kezar on PALIZADE, a global, placebo-controlled Phase 2b clinical trial evaluating the efficacy and safety of two dose-levels of zetomipzomib in patients with active LN. PALIZADE was initiated in mid-2023 and targets to enroll 279 patients. Data generated from prior clinical trials provide evidence that zetomipzomib exhibits a favourable safety and tolerability profile and LN patients showed a clinically meaningful overall renal response after 6 months of treatment with zetomipzomib.