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Voclosporin

Phase 4FDA approved

Lupus Nephritis | Small molecule | Nephrology |Aurinia Pharmaceuticals Inc|Trials Updated: Mar 27, 2023

Voclosporin development status

FDA approval on record Jan 22, 2021 as Lupkynis
Approval holderAurinia
ApplicationNDA213716
Highest phase Phase 4 (NCT07611214)
Phase scored for AUPHPhase 3
Registered trials 17 across 3 sponsors since Oct 2005

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

Voclosporin target and mechanism

Molecular targetPPP3CA
Target classInhibitor
ModalitySmall molecule

Also known as Voclosporin Ophthalmic Solution, Voclosporin High Dose, ISA247, LUPKYNIS

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials9
Total Enrollment2,685

FDA Designations

No designations recorded

Voclosporin clinical trials

Voclosporin · 9 trials · 4 indications

Phase 3 5Phase 2 4
NCT03597464Aurinia Renal Assessments 2: Aurinia Renal Response in Lupus With VoclosporinLupus Nephritis
COMPLETED216 Analytics
NCT03021499Aurinia Renal Response in Active Lupus With VoclosporinLupus Nephritis
COMPLETED358 Analytics
NCT00408187Randomized, Placebo and Ciclosporin Controlled Study of ISA247 in Plaque Psoriasis PatientsPsoriasis
COMPLETED642 Analytics
NCT00258713A 36-Week Extension to Protocol ISA04-03Psoriasis
COMPLETED309 Analytics
NCT00244842Randomized Placebo-controlled Study of ISA247 in Plaque PsoriasisPsoriasis
COMPLETED451 Analytics
PHASE3COMPLETED
Aurinia Renal Assessments 2: Aurinia Renal Response in Lupus With Voclosporin
Lupus NephritisUnlock trial analytics
PHASE3COMPLETED
Aurinia Renal Response in Active Lupus With Voclosporin
Lupus NephritisUnlock trial analytics
PHASE3COMPLETED
Randomized, Placebo and Ciclosporin Controlled Study of ISA247 in Plaque Psoriasis Patients
PsoriasisUnlock trial analytics
PHASE3COMPLETED
A 36-Week Extension to Protocol ISA04-03
PsoriasisUnlock trial analytics
PHASE3COMPLETED
Randomized Placebo-controlled Study of ISA247 in Plaque Psoriasis
PsoriasisUnlock trial analytics

Study Endpoints

Primary Endpoints

Adverse Events (AE) Profile and Routine Biochemical and Hematological Assessments.
Month 12 (AURORA 2 baseline) to Month 36

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.

Number of Participants With Adjudicated Renal Response at Week 52
52 Weeks

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

Superiority in the proportion of subjects achieving a score of "clear" or "almost clear" in the Static Physician's Global Assessment (SPGA) score
Twelve weeks of treatment
To investigate long-term safety and tolerability of voclosporin
Sixty weeks of continuous treatment
Proportion of Subjects Achieving a PASI-75 at 12 Weeks at Each of the 3 Dose Levels of Voclosporin.
Twelve Weeks

Proportion of subjects achieving a PASI-75 at 12 weeks at each of the 3 dose levels of voclosporin.

Change From Baseline in Drop Discomfort Post Dose Instillation on Day 1
1-minute Post Dose 1 installation (Day 1)

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".

Number of Participants With Reduction or Normalization of Urine Protein/Creatinine Ratio (UPCR)
24 weeks
Number of Participants With Reduction or Normalization of Anti ds DNA
24 weeks
Number of Participants With Reduction or Normalization of C3
24 weeks
Number of Participants With Reduction or Normalization of C4
24 weeks
Number of Subjects Achieving Complete Renal Remission at 24 Weeks
week 24

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.

Biopsy Proven Acute Rejection (BPAR)
Six months

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.

Secondary Endpoints

Number (and Percent) of Subjects in Renal Response
Months 12 (AURORA 2 Baseline), 18, 24, 30 and 36
Number (and Percent) of Subjects in Partial Renal Response
Months 12 (AURORA 2 baseline), 18, 24, 30 and 36
Renal Flare as Adjudicated by the Clinical Endpoints Committee (CEC).
Month 12 (AURORA 2 baseline) to Month 36
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
VoclosporinEXPERIMENTALVoclosporin
Placebo Oral CapsulePLACEBO_COMPARATORPlacebo
1.ACTIVE_COMPARATOR -
3.PLACEBO_COMPARATOR -
2.ACTIVE_COMPARATOR -
1ACTIVE_COMPARATOR -
2ACTIVE_COMPARATOR -
3ACTIVE_COMPARATOR -
Placebo Comparator: 1PLACEBO_COMPARATORPlacebo
Voclosporin 0.2 mg/kg po BIDACTIVE_COMPARATORVoclosporin 0.2 mg/kg po BID
Voclosporin 0.3 mg/kg po BIDACTIVE_COMPARATORVoclosporin 0.3 mg/kg po BID
Voclosporin 0.4 mg/kg po BIDACTIVE_COMPARATORVoclosporin 0.4 mg/kg po BID
Voclosporin ophthalmic solution (VOS)EXPERIMENTAL0.2% VOS, Twice Daily (BID), both eyes for 28 days
ComparatorACTIVE_COMPARATOR0.05% cyclosporine ophthalmic emulsion (Restasis®) BID, both eyes for 28 days
Voclosporin Low DoseEXPERIMENTALVoclosporin, oral, 23.7 mg BID
Voclosporin High DoseEXPERIMENTALVoclosporin, oral 23.7 mg BID until Week 2, then voclosporin, oral, 39.5 mg BID
PlaceboPLACEBO_COMPARATORLow 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 VoclosporinACTIVE_COMPARATORLow dose voclosporin
Mid Dose VoclosporinACTIVE_COMPARATORMid Dose Voclosporin
High Dose VoclosporinACTIVE_COMPARATORHigh Dose Voclosporin
TacrolimusACTIVE_COMPARATORStandard Dose Tacrolimus

Interventions

NameTypeDescription
VoclosporinDRUGCalcineurin inhibitor, oral, 23.7 mg twice daily (BID)
Placebo Oral CapsuleDRUGVoclosporin placebo, oral, 3 capsules twice daily (BID)
CiclosporinDRUGciclosporin 1.5 mg/kg po BID
PlaceboDRUGPlacebo
Voclosporin Ophthalmic SolutionDRUGInvestigational Drug
Restasis®DRUGComparator
Voclosporin High DoseDRUG -
Voclosporin Low DoseDRUG -
tacrolimusDRUGtacrolimus 0.05 mg/kg po BID
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Eligibility Criteria

Age Range18 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites1

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...

Countries:United StatesArgentinaBelarusBrazilBulgariaCanadaChileColombiaCosta RicaCroatiaDominican RepublicGuatemalaJapanMalaysiaMexicoNetherlandsNorth MacedoniaPeruPhilippinesPolandPuerto RicoRussiaSerbiaSouth AfricaSouth KoreaSpainTaiwanThailandTurkey (Türkiye)UkraineVietnamGermanyBangladeshChinaEcuadorGeorgiaSingaporeSri Lanka
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Frequently asked questions about Voclosporin

What is voclosporin?

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.

What does voclosporin target?

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.

Who makes voclosporin?

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.

What phase is voclosporin in?

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.

What clinical trials is voclosporin in?

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.

Is voclosporin the same as voclosporin ophthalmic solution?

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.