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voclosporin

Phase 3

Lupus Nephritis | Small molecule | Immunology |Aurinia Pharmaceuticals Inc|Last Updated: Oct 17, 2024

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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials4
Total Enrollment849
FDA Designations
No designations recorded
Clinical trial landscape

voclosporin · 12 trials · 8 indications

Phase 3 5Phase 2 5Phase 1 2
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.

Time to viral clearance of SARS-CoV-2
Day 56

measured by first negative reverse transcription quantitative polymerase chain reaction (RT-qPCR) with a CT value of \>37 over 56 days

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.

Pharmacokinetics of simvastatin and simvastatin acid (Cmax)
9 days

To evaluate the potential effect of multiple oral doses of voclosporin on the single-dose PK of simvastatin and the active metabolite simvastatin acid. Maximum observed concentration (Cmax).

Pharmacokinetics of simvastatin and simvastatin acid (AUC)
9 days

To evaluate the potential effect of multiple oral doses of voclosporin on the single-dose PK of simvastatin and the active metabolite simvastatin acid. Area under the concentration-time curve (AUC) from time zero to infinity.

Incidence of treatment emergent adverse events
21 days

Tolerability of voclosporin after single and multiple oral ascending doses

Mean, median and standard deviation of laboratory parameters. Incidence of laboratory parameters outside of normal range
21 days

Safety of voclosporin after single and multiple oral ascending doses

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 (VCS)EXPERIMENTALPrior to or at study entry, subjects are reduced in their standard immunosuppressive therapy to dual therapy with prednisone and tacrolimus according to current local guidelines. In the experimental arm tacrolimus is switched to voclosporin 6 capsules (of 7.9 mg each) BID for a treatment period of minimal 56 days with a possible extension up to 1 year. Safety drug monitoring will take place during the study to ensure that VCS trough levels are maintained between 30-60 ng/mL. If trough levels are not within these levels, dose adjustments will take place.
Tacrolimus (TAC)ACTIVE_COMPARATORPrior to or at study entry, subjects are reduced in their standard immunosuppressive therapy to dual therapy with prednisone and tacrolimus according to current local guidelines. In the Active comparator arm tacrolimus dosage is maintained. Safety drug monitoring will take place during the study to ensure that TAC trough levels are maintained between 3-7 ng/ml. If trough levels are not within these levels, dose adjustments will take place.
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
Voclosporin/SimvastatinEXPERIMENTALSubjects will receive a single oral dose of 40 mg simvastatin (given as two 20 mg tablets) in the morning of Day 1 and Day 8. Subjects will receive voclosporin administered as an oral 23.7 mg dose (three 7.9 mg capsules) twice-daily for 7 days from the morning of Day 2 until the evening of Day 8.
0.25mg/kg voclosporinEXPERIMENTAL0.25mg/kg voclosporin BID.
0.5mg/kg voclosporinEXPERIMENTAL0.5mg/kg voclosporin BID
1.0mg/kg voclosporinEXPERIMENTAL1.0mg/kg voclosporin BID
1.5mg/kg voclosporinEXPERIMENTAL1.5mg/kg voclosporin BID
Placebo voclosporinPLACEBO_COMPARATORplacebo BID
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
TacrolimusDRUGComparator
Voclosporin Ophthalmic SolutionDRUGInvestigational Drug
Restasis®DRUGComparator
Voclosporin High DoseDRUG -
Voclosporin Low DoseDRUG -
SimvastatinDRUGOral dose 40 mg
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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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