An evaluation of voclosporin for the treatment of lupus nephritis

@article{Sin2018AnEO,
  title={An evaluation of voclosporin for the treatment of lupus nephritis},
  author={Fang En Sin and David A. Isenberg},
  journal={Expert Opinion on Pharmacotherapy},
  year={2018},
  volume={19},
  pages={1613 - 1621}
}
  • F. Sin, D. Isenberg
  • Published 12 September 2018
  • Medicine
  • Expert Opinion on Pharmacotherapy
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… 
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References

SHOWING 1-10 OF 70 REFERENCES
AB0419 Aurion Study: Preliminary Results of Voclosporin in Lupus Nephritis
TLDR
Preliminary data from this this pilot study indicates that MTT using VCS, in combination with MMF and steroids, produced consistent reductions in proteinuria with preservation of renal function in the first 7 subjects enrolled with active LN.
Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis.
TLDR
Although most patients in both treatment groups experienced clinical improvement, the study did not meet its primary objective of showing that MMF was superior to IVC as induction treatment for lupus nephritis.
Immunosuppressive treatment for proliferative lupus nephritis.
TLDR
The effects of all treatment strategies on death (all causes) and ESKD were uncertain and the benefits and harms of different immunosuppressive treatments in people with biopsy-proven lupus nephritis were evaluated.
Tacrolimus use in lupus nephritis: A systematic review and meta-analysis.
Cyclosporine A or intravenous cyclophosphamide for lupus nephritis: the Cyclofa-Lune study
TLDR
Cyclosporine A was as effective as cyclophosphamide in the trial of sequential induction and maintenance treatment in patients with proliferative lupus nephritis and preserved renal function.
20 Aurion study: 24-week data of multi-target therapy with voclosporin, mmf and steroids for active lupus nephritis
TLDR
The results suggest that early response to therapy of VCS in combination with MMF may predict 24 week CR in the presence of low steroids in active LN.
Thirty years of cyclophosphamide: assessing the evidence
TLDR
Intravenous cyclophosphamide is the only therapy with long-term data for reduction of end-stage renal disease and as data on other therapies accumulate, however, it might no longer be considered the standard treatment for lupus nephritis.
A randomized pilot trial comparing cyclosporine and azathioprine for maintenance therapy in diffuse lupus nephritis over four years.
TLDR
For patients with diffuse proliferative lupus nephritis, azathioprine or cyclosporine combined with corticosteroids demonstrated equal efficacy in the prevention of flares.
Tacrolimus versus mycophenolate mofetil for induction therapy of lupus nephritis: a randomised controlled trial and long-term follow-up
TLDR
TAC is non-inferior to MMF, when combined with prednisolone, for induction therapy of active LN, and with azathioprine maintenance for 5 years, a non-significant trend of higher incidence of renal flares and renal function decline is observed with the TAC regimen.
Rituximab is an effective treatment for lupus nephritis and allows a reduction in maintenance steroids.
  • R. Pepper, M. Griffith, T. Cairns
  • Medicine
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2009
TLDR
This data demonstrates the efficacy of a rituximab and MMF based regime in the treatment of lupus nephritis, allowing a reduction or total withdrawal of corticosteroids.
...
...