Victoria Socha

DocwireNews

Black patients with lupus nephritis commonly have more severe disease, are often refractory to treatment, and experience worse long-term outcomes. Treatment with voclosporin in conjunction with low-dose glucocorticoids and mycophenolate mofetil (MMF) has been shown to have significant benefit across ancestries and classes of lupus nephritis.During a poster session at the American Society of Nephrology Kidney Week 2023, Gabriel Contreras and colleagues reported on outcomes of up to 3 years of follow-up in patients identifying as Black who were treated with voclosporin during the phase 3 AURORA studies. The poster was titled Long-term Safety and Efficacy of Voclosporin in Black Patients With Lupus Nephritis.Inclusion criteria for the parent AURORA 1 study were biopsy-proven lupus nephritis, urine protein creatinine ratio (UPCR) &ge;15 g/g (&ge;2 g/g for Class V), and estimated glomerular filtration rate (eGFR) &gt;45 mL/min/1.73 m2. Participants who completed AURORA 1 were eligible to enter AURORA 2, a continuation study on the same blinded therapy of voclosporin or placebo in combination with MMF and glucocorticoids for an additional 2 years.Study outcomes of programmed complete renal response (CRR; UPCR &le;0.5 g/g, stable eGFR, low-dose steroids, and no rescue medication), partial renal response (PRR; reduction in UPCR of &ge;50% from baseline), and safety were assessed in a subgroup of patients who self-identified as Black or mixed Black.In the voclosporin arm of AURORA 1, 14.5% of participants (26/179) self-identified as Black or mixed Black; in the control arm, 10.6% of participants (19/178) self-identified as Black or mixed Black. The two arms were similar in baseline characteristics. At 1 year, CRR rates numerically favored voclosporin (46.2% vs 15.8%; odds ratio [OR], 3.92; P=.0597). PRR rates also favored voclosporin at 1 year (69.2% vs 47.4%; OR, 2.62; P=.1422).A total of 18 patients in the voclosporin arm and seven in the control arm in the Black subgroup continued into AURORA 2. At 3 years, response rates continued to numerically favor voclosporin (CRR, 44.4% vs 14.3%; OR, 4.17; P=.2276 and PRR, 66.7% vs 42.9%; OR, 1.67; P=.6094).Over the 3-year period, there were greater reductions in mean UPCR in the voclosporin arm (change from baseline, &ndash;3.4 g/g vs &ndash;1.5 g/g; P=.0349). Over the 3 years of treatment, mean eGFR remained stable and in the normal range.&ldquo;Black patients treated with a voclosporin-based regimen achieved higher rates of renal response than patients treated with MMF and glucocorticoids alone,&rdquo; the researchers said. &ldquo;For patients entering the continuation study, the response was largely durable for up to 3 years.&rdquo;Source: Contreras G, Baker MG, Hodge LS, Yap E. Long-term safety and efficacy of voclosporin in Black patients with lupus nephritis. SA-PO876. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2023; November 4, 2023; Philadelphia, Pennsylvania. Funding was provided by Aurinia Pharmaceuticals Inc.

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Voclosporin in Black Patients With Lupus Nephritis: AURORA Studies

ASN Kidney Week 2023

Black patients with lupus nephritis commonly have more severe disease, are often refractory to treatment, and experience worse long-term outcomes. 

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