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An evaluation of voclosporin for the treatment of lupus nephritis

Sin, FE; Isenberg, D; (2018) An evaluation of voclosporin for the treatment of lupus nephritis. Expert Opinion on Pharmacotherapy , 19 (14) pp. 1613-1621. 10.1080/14656566.2018.1516751. Green open access

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Abstract

INTRODUCTION: Lupus nephritis (LN) is associated with significant morbidity and mortality. Current treatment outcomes remain suboptimal. No disease modifying medications are licensed for the treatment of LN. Voclosporin, a novel calcineurin inhibitor, has been investigated as induction therapy in LN in combination with myocophenolate mofetil (MMF) and a glucocorticoid (GC). Two phase II trials of voclosporin were the first trials of a potential treatment of active LN that met their primary endpoints. Areas covered: This article reviews the pharmacology of voclosporin and the efficacy and safety data from the two existing phase II trials. In the phase IIb randomized controlled trial AURA-LV, voclosporin was shown to be superior to placebo, when used in combination with MMF (1-2 g/day) and GC, in achieving remission in active LN. Expert opinion: While the positive outcome of existing trials is promising, further data confirming its efficacy and evaluating its safety are required. A phase III trial is currently recruiting. Importantly, the positive results were achieved despite a novel and rapid GC taper regime, suggesting that rapid taper of GC may be a viable treatment option in active LN which merits further investigation.

Type: Article
Title: An evaluation of voclosporin for the treatment of lupus nephritis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/14656566.2018.1516751
Publisher version: https://doi.org/10.1080/14656566.2018.1516751
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Calcineurin inhibitor, Systemic lupus erythematosus, lupus nephritis, voclosporin
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10056756
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