The AURORA 1 study reports that low-dose voclosporin added to standard immunosuppressive treatment improved rate of remission in patients with lupus nephritis. Further studies are needed to investigate the long-term efficacy and tolerability of voclosporin and to compare the effects of this treatment with those of low doses of tacrolimus or ciclosporin.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Rovin, B. H. et al. Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 397, 2070–2080 (2021).
Yap, D. Y. H., Tang, C. S. O., Ma, M. K. M., Lam, M. F. & Chan, T. M. Survival analysis and causes of mortality in patients with lupus nephritis. Nephrol. Dial. Transplant. 27, 3248–3254 (2012).
Fanouriakis, A. et al. 2019 Update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. Ann. Rheum. Dis. 79, 713–772 (2020).
Naesens, M., Kuypers, D. R. & Sarwall, M. Calcineurin inhibitor nephrotoxicity. Clin. J. Am. Soc. Nephrol. 4, 481–508 (2009).
Ling, S. Y. et al. Cytochrome P450 3A and P-glycoprotein drug-drug interactions with voclosporin. Br. J. Clin. Pharmacol. 77, 1039–1050 (2014).
Birsan, T., Dambrin, C., Freitag, D. G., Yatscoff, R. W. & Morris, R. E. The novel calcineurin inhibitor ISA247: a more potent immunosuppressant than cyclosporine in vitro. Transpl. Int. 17, 767–771 (2005).
Li, Y., Palmisano, M., Sun, D. & Zhou, S. Pharmacokinetic disposition difference between cyclosporine and voclosporin drives their distinct efficacy and safety profiles in clinical studies. Clin. Pharmacol. 12, 83–96 (2020).
Niaudet, P. & Habib, R. Cyclosporine in the treatment of idiopathic nephrosis. J. Am. Soc. Nephrol. 5, 1049–1056 (1994).
Shiahb, F. S. Cyclosporine nephropathy: pathophysiology and clinical impact. Semin. Nephrol. 16, 536–547 (1996).
Faul, C. The actin cytoskeleton of podocytes is a direct target of antiproteinuric effect of cyclosporine. Nat. Med. 14, 931–938 (2008).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Rights and permissions
About this article
Cite this article
Moroni, G., Ponticelli, C. AURORA 1 reports efficacy of voclosporin in lupus nephritis. Nat Rev Nephrol 17, 637–638 (2021). https://doi.org/10.1038/s41581-021-00460-0
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41581-021-00460-0