Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Label indication LUPKYNIS is indicated in combination with a background immunosuppressive therapy regimen [see Clinical Studies ( 14 )] for the treatment of adult patients with active lupus nephritis (LN). Limitations of Use: Safety and efficacy of LUPKYNIS have not been established in combination with cyclophosphamide. Use of LUPKYNIS is not recommended in this situation. FDA label
Also known as Voclosporin Ophthalmic Solution, Voclosporin High Dose, ISA247, LUPKYNIS
Voclosporin · 9 trials · 4 indications
Number (and percent) of adverse events experienced during the AURORA 2 treatment period. To assess the long-term safety and tolerability of voclosporin compared with placebo for up to an additional 24 months following completion of treatment in the AURORA 1 study in subjects with LN.
The primary efficacy endpoint was the number of subjects showing renal response at Week 52. Renal response was adjudicated based on blinded data by an independent Clinical Endpoints Committee based on meeting the following criteria * UPCR of ≤0.5 mg/mg \& * eGFR ≥60 mL/min/1.73 m2 or no confirmed decrease from baseline in eGFR of \>20% \& * Received no rescue medication for LN \& * Did not receive more than 10 mg prednisone for ≥3 consecutive days or for ≥7 days in total during Weeks 44 through 52, prior to assessment Note:To be disqualified from renal response, the subject had to fail both eGFR measures (i.e., confirmed eGFR \<60 mL/min/1.73 m2 \& confirmed \>20% drop from baseline) \& have an associated treatment-related or disease-related AE that impacted eGFR Withdrawals prior to Week 52 with insufficient Week 52 data to determine response were defined non responders. Subjects who discontinued study drug but continued to attend study visits had their data assessed for response
Proportion of subjects achieving a PASI-75 at 12 weeks at each of the 3 dose levels of voclosporin.
Drop Discomfort was assessed using the Individual Symptom Severity Assessment Visual Analog Scale (VAS) where the subject will complete the assessment 1 minute post-instillation on Day 1. The VAS scale is 0 - 100, where 0 corresponds to "no discomfort" and 100 corresponds to "maximal discomfort".
Complete remission is defined as: * Confirmed protein/creatinine ratio of ≤0.5 mg/mg and * eGFR ≥60 mL/min/1.73m2 or no confirmed decrease from baseline in eGFR of ≥20%. Subjects who received rescue medication for lupus nephritis or \>10 mg prednisone for \>3 consecutive days or \>7 days total from 56 days prior to remission assessment until the time of the remission assessment were considered not achieving complete remission.
The primary objective of the PROMISE trial was to demonstrate noninferiority of biopsy proven acute rejection (BPAR) rate in de novo renal transplant patients at 6 months in at least one VCS treatment group.
| Arm | Type | Description |
|---|---|---|
| Voclosporin | EXPERIMENTAL | Voclosporin |
| Placebo Oral Capsule | PLACEBO_COMPARATOR | Placebo |
| 1. | ACTIVE_COMPARATOR | - |
| 3. | PLACEBO_COMPARATOR | - |
| 2. | ACTIVE_COMPARATOR | - |
| 1 | ACTIVE_COMPARATOR | - |
| 2 | ACTIVE_COMPARATOR | - |
| 3 | ACTIVE_COMPARATOR | - |
| Placebo Comparator: 1 | PLACEBO_COMPARATOR | Placebo |
| Voclosporin 0.2 mg/kg po BID | ACTIVE_COMPARATOR | Voclosporin 0.2 mg/kg po BID |
| Voclosporin 0.3 mg/kg po BID | ACTIVE_COMPARATOR | Voclosporin 0.3 mg/kg po BID |
| Voclosporin 0.4 mg/kg po BID | ACTIVE_COMPARATOR | Voclosporin 0.4 mg/kg po BID |
| Voclosporin ophthalmic solution (VOS) | EXPERIMENTAL | 0.2% VOS, Twice Daily (BID), both eyes for 28 days |
| Comparator | ACTIVE_COMPARATOR | 0.05% cyclosporine ophthalmic emulsion (Restasis®) BID, both eyes for 28 days |
| Voclosporin Low Dose | EXPERIMENTAL | Voclosporin, oral, 23.7 mg BID |
| Voclosporin High Dose | EXPERIMENTAL | Voclosporin, oral 23.7 mg BID until Week 2, then voclosporin, oral, 39.5 mg BID |
| Placebo | PLACEBO_COMPARATOR | Low dose: Voclosporin placebo, oral, 3 capsules BID High dose: Voclosporin placebo, oral, 3 capsules BID until Week 2 then voclosporin placebo, oral, 5 capsules BID |
| Low Dose Voclosporin | ACTIVE_COMPARATOR | Low dose voclosporin |
| Mid Dose Voclosporin | ACTIVE_COMPARATOR | Mid Dose Voclosporin |
| High Dose Voclosporin | ACTIVE_COMPARATOR | High Dose Voclosporin |
| Tacrolimus | ACTIVE_COMPARATOR | Standard Dose Tacrolimus |
| Name | Type | Description |
|---|---|---|
| Voclosporin | DRUG | Calcineurin inhibitor, oral, 23.7 mg twice daily (BID) |
| Placebo Oral Capsule | DRUG | Voclosporin placebo, oral, 3 capsules twice daily (BID) |
| Ciclosporin | DRUG | ciclosporin 1.5 mg/kg po BID |
| Placebo | DRUG | Placebo |
| Voclosporin Ophthalmic Solution | DRUG | Investigational Drug |
| Restasis® | DRUG | Comparator |
| Voclosporin High Dose | DRUG | - |
| Voclosporin Low Dose | DRUG | - |
| tacrolimus | DRUG | tacrolimus 0.05 mg/kg po BID |
Inclusion Criteria: 1. Subjects who have completed 52 weeks of treatment with study drug in the AURORA 1 study. Subjects who had a temporary interruption and successfully restarted study drug during the AURORA 1 study will be allowed with Medical Monitor approval. 2. Written informed consent before...
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Voclosporin is a small molecule drug developed by Aurinia Pharmaceuticals Inc (ticker AUPH). It has been studied in lupus nephritis, dry eye, kidney diseases, and psoriasis. Voclosporin is also known as voclosporin ophthalmic solution and voclosporin high dose, depending on the formulation and dose studied.
Voclosporin targets PPP3CA and acts as an inhibitor of that target. PPP3CA is calcineurin A, a phosphatase involved in T cell activation. By inhibiting this target, voclosporin is designed to suppress immune activity, which is the basis for its study in immune mediated conditions such as lupus nephritis.
Voclosporin is developed by Aurinia Pharmaceuticals Inc, which trades under the ticker AUPH. The company has sponsored the clinical trial program for voclosporin across lupus nephritis and dry eye indications.
Voclosporin is in Phase 2 development overall, though individual trials have reached Phase 3. It is investigational and is not described as approved. Four trials are recorded, all completed, with no active trials at this time and a total enrollment of 1,402 participants.
Four completed voclosporin trials are registered. NCT03021499 and NCT03597464 are Phase 3 studies in lupus nephritis. NCT02949973 is a Phase 2 lupus nephritis study in Malaysia. NCT03597139 is a Phase 2 trial comparing voclosporin ophthalmic solution with Restasis in dry eye disease.
Voclosporin ophthalmic solution is a formulation of voclosporin, the same active drug, prepared for topical eye use. Voclosporin high dose refers to a higher dose version studied in clinical trials. Both names refer to the same underlying compound developed by Aurinia Pharmaceuticals.