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Lupus NephritisPhase 2AURA-LVNCT02141672

AURA-LV: Aurinia Urinary Protein Reduction Active - Lupus With Voclosporin (AURA-LV)

A Phase 2 study testing Voclosporin High Dose and Voclosporin Low Dose in people with Lupus Nephritis, run by Aurinia Pharmaceuticals Inc. at 86 sites in 20 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

To assess the efficacy of 2 doses of voclosporin compared to placebo in achieving complete remission after 24 weeks of therapy in subjects with active lupus nephritis. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Lupus Nephritis
What is being tested?
Voclosporin High Dose and Voclosporin Low Dose
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
265 participants
Where
86 sitesin 20 countries
Study dates
Jun 2014to Jan 2017
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female subjects aged 18 to 75 years.
  • Diagnosis of systemic lupus erythematosus (SLE) according to the American College of Rheumatology criteria.
  • Kidney biopsy within 6 months prior to Screening (Visit 1) with a histologic diagnosis of lupus nephritis (International Society of Nephrology/Renal Pathology Society 2003 classification of lupus nephritis) Classes III, IV-S or IV-G, (A) or (A/C); or Class V, alone or in combination with Class III or IV.
  • Laboratory evidence of active nephritis at screening, defined as:
  • Class III, IV-S or IV-G: Confirmed proteinuria ≥1,500 mg/24 hours when assessed by 24 hour urine collection, defined by a UPCR of ≥1.5 mg/mg assessed in a first morning void urine specimen (2 samples).
  • Class V (alone or in combination with Class III or IV): Confirmed proteinuria ≥2,000 mg/24 hours when assessed by 24 hour urine collection, defined by a UPCR of ≥2 mg/mg assessed in a first morning void urine specimen (2 samples).

Who cannot join

  • Estimated glomerular filtration rate (eGFR) as calculated by the Chronic Kidney Disease Epidemiology Collaboration equation of ≤45 mL/min/1.73 m2.
  • Currently requiring renal dialysis (hemodialysis or peritoneal dialysis) or expected to require dialysis during the study period.
  • A previous kidney transplant or planned transplant within study treatment period.
  • In the opinion of the Investigator, subject does not require long-term immunosuppressive treatment (in addition to corticosteroids).
  • Current or medical history of:
  • Pancreatitis or gastrointestinal hemorrhage within 6 months prior to screening.
Show all 22Show fewer
  • Active unhealed peptic ulcer within 3 months prior to screening. If an ulcer has healed and the subject is on adequate therapy, the subject may be randomized.
  • Congenital or acquired immunodeficiency.
  • Clinically significant drug or alcohol abuse 2 years prior to screening.
  • Malignancy within 5 years of screening, with the exception of basal and squamous cell carcinomas treated by complete excision. Subjects with cervical dysplasia that is cervical intraepithelial neoplasia 1, but have been treated with conization or loop electrosurgical excision procedure, and have had a normal repeat PAP are allowed.
  • Lymphoproliferative disease or previous total lymphoid irradiation.
  • Severe viral infection (such as CMV, HBV, HCV) within 3 months of screening; or known human immunodeficiency virus infection.
  • Active tuberculosis (TB), or known history of TB/evidence of old TB if not taking prophylaxis with isoniazid.
  • Other known clinically significant active medical conditions, such as:
  • Severe cardiovascular disease including congestive heart failure, history of cardiac dysrhythmia or congenital long QT syndrome.
  • Liver dysfunction (aspartate aminotransferase, alanine aminotransferase, or bilirubin greater than 2.5 times the upper limit of normal) at screening and confirmed before randomization.
  • Chronic obstructive pulmonary disease or asthma requiring oral steroids.
  • Bone marrow insufficiency unrelated to active SLE (according to Investigator judgment) with white blood cell count <2,500/mm3; absolute neutrophil count <1.3 x 103/μL; thrombocytopenia (platelet count <50,000/mm3).
  • Active bleeding disorders.
  • Current infection requiring IV antibiotics.
  • Any overlapping autoimmune condition for which the condition or the treatment of the condition may affect the study assessments or outcomes. Overlapping conditions for which the condition or treatment is not expected to affect assessments or outcomes are not excluded.
  • Subjects who are pregnant, breast feeding or, if of childbearing potential, not using adequate contraceptive precautions.

Trial locations and contacts

86 sites in 20 countries.

86 sites in 20 countries

Russia15 sites
  • AURA-LV Site

    Kazan', 420012

  • AURA-LV Site

    Kemerovo, 650066

  • AURA-LV Site

    Kemerovo, 65009

  • AURA-LV Site

    Moscow, 111539

  • AURA-LV Site

    Moscow, 119435

  • AURA-LV Site

    Omsk, 644111

  • AURA-LV Site

    Orenburg, 460018

  • AURA-LV Site

    Petrozavodsk, 185019

  • AURA-LV Site

    Rostov-on-Don, 344022

  • AURA-LV Site

    Saint Petersburg, 191015

  • AURA-LV Site

    Saint Petersburg, 197022

  • AURA-LV Site

    Saint Petersburg, 197110

  • AURA-LV Site

    Saratov, 410053

  • AURA-LV Site

    Tolyatti, 445009

  • AURA-LV Site

    Yaroslavl, 150062

Other trials in Russia

United States14 sites
  • AURA-LV Site

    Brooklyn, New York, 11203

  • AURA-LV Site

    Chapel Hill, North Carolina, 27599

  • AURA-LV Site

    Charlotte, North Carolina, 28204

  • AURA-LV Site

    Chattanooga, Tennessee, 37408

  • AURA-LV Site

    Columbus, Ohio, 43210

  • AURA-LV Site

    Dallas, Texas, 75390

  • AURA-LV Site

    Farmington Hills, Michigan, 48334

  • AURA-LV Site

    Gainesville, Florida, 32610

  • AURA-LV Site

    Hershey, Pennsylvania, 17033

  • AURA-LV Site

    Houston, Texas, 77030

  • AURA-LV Site

    Los Angeles, California, 90095

  • AURA-LV Site

    Miami, Florida, 33165

  • AURA-LV Site

    New York, New York, 10016

  • AURA-LV Site

    Palo Alto, California, 94305

Other trials in United States

Philippines8 sites
  • AURA-LV Site

    Angeles City, 2009

  • AURA-LV Site

    Batangas, 4217

  • AURA-LV Site

    Cebu City, 6000

  • AURA-LV Site

    Davao City, 8000

  • AURA-LV Site

    Manila, 10000

  • AURA-LV Site

    Manila, 1000

  • AURA-LV Site

    Manila, 1003

  • AURA-LV Site

    Quezon City, 1102

Other trials in Philippines

Mexico5 sites
  • AURA-LV Site

    Guadalajara, 44280

  • AURA-LV Site

    Mexicali, 21100

  • AURA-LV Site

    Oaxaca City

  • AURA-LV Site

    Tlalpan, 14080

  • AURA-LV Site

    Tlalpan

Other trials in Mexico

South Korea5 sites
  • AURA-LV Site

    Busan, 602-739

  • AURA -LV Site

    Daegu, 705-718

  • AURA-LV Site

    Seoul, 110-744

  • AURA-LV Site

    Seoul, 158-710

  • AURA-LV Site

    Wŏnju, 220-701

Other trials in South Korea

Ukraine5 sites
  • AURA-LV Site

    Kharkiv, 61103

  • AURA-LV Site

    Kyiv, 02125

  • AURA-LV Site

    Kyiv, 04050

  • AURA-LV Site

    Lutsk, 43005

  • AURA-LV Site

    Zaporizhzhya, 69600

Other trials in Ukraine

Belarus4 sites
  • AURA-LV Site

    Minsk, 220037

  • AURA-LV Site

    Minsk, 220116

  • AURA-LV Site

    Minsk, 223040

  • AURA-LV Site

    Vitebsk, 210037

Other trials in Belarus

Bulgaria4 sites
  • AURA-L Site

    Plovdiv, 4001

  • AURA-LV Site

    Sofia, 1431

  • AURA-LV Site

    Sofia, 1527

  • AURA-LV Site

    Varna, 9010

Other trials in Bulgaria

Poland4 sites
  • AURA-LV Site

    Katowice, 40-027

  • AURA-LV Site

    Radom, 26-610

  • AURA-LV Site

    Warsaw, 01-141

  • AURA-LV Site

    Wroclaw, 50-556

Other trials in Poland

Sri Lanka4 sites
  • AURA-LV Site

    Colombo

  • AUR-LV Site

    Kandy, 20000

  • AURA-LV Site

    Nugegoda, 10100

  • AURA-LV Site

    Ragama

Other trials in Sri Lanka

Bangladesh2 sites
  • AURA-LV Site

    Dhaka, 1207

  • AURA-LV Site

    Dhaka

Other trials in Bangladesh

Ecuador2 sites
  • AURA-LV Site

    Guayaquil

  • AURA-LV Site

    Quito

Other trials in Ecuador

Georgia2 sites
  • AURA-LV Site

    Tbilisi, 0144

  • AURA-LV Site

    Tbilisi, 0186

Other trials in Georgia

Serbia2 sites
  • AURA-LV Site

    Belgrade, 11000

  • AURA-LV Site

    Niš, 18000

Other trials in Serbia

Singapore2 sites
  • AURA-LV Site

    Singapore, 169608

  • AURA-LV Site

    Singapore, 529889

Other trials in Singapore

Spain2 sites
  • AURA-LV Site

    Barcelona

  • AURA-LV

    Madrid, 28034

Other trials in Spain

Taiwan2 sites
  • AURA-LV Site

    Kaohsiung City, 83301

  • AURA-LV Site

    Taoyuan City, 333

Other trials in Taiwan

Thailand2 sites
  • AURA-LV Site

    Bangkok, 10400

  • AURA-LV Site

    Chiang Mai, 50200

Other trials in Thailand

China1 site
  • AURA-LV Site

    Hong Kong

Other trials in China

Guatemala1 site
  • AURA-LV Site

    Guatemala City

Other trials in Guatemala

About this study

Official title: A Randomized, Controlled Double-blind Study Comparing the Efficacy and Safety of Voclosporin (23.7 mg BID, or 39.5 mg BID) With Placebo in Achieving Remission in Patients With Active Lupus Nephritis

To assess the efficacy of 2 doses of voclosporin compared to placebo in achieving complete remission after 24 weeks of therapy in subjects with active lupus nephritis.

Read the detailed description

Voclosporin is a next generation CNI intended for use in the prevention of organ graft rejection and for the treatment of autoimmune diseases. The aim of the current study is to investigate whether voclosporin added to the standard of care treatment in active LN is able to reduce disease activity, as measured by a reduction in proteinuria. Two doses of voclosporin will be studied and compared in a placebo controlled trial on a background of MMF and corticosteroids. Patients with active, flaring LN will be eligible to enter the study. They are required to have a diagnosis of LN according to established diagnostic criteria (American College of Rheumatology) and clinical and biopsy features suggestive of active nephritis. Efficacy will be assessed by the ability of the drug combination to reduce the level of proteinuria while demonstrating an acceptable safety profile.

Conditions
Lupus Nephritis
Being tested
Voclosporin High Dose, Voclosporin Low Dose, Placebo
Keywords
lupus nephritis, calcineurin inhibitors, voclosporin
Medical subject headings
Lupus Nephritis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Voclosporin High DoseDrug

    Also called ISA247

  • Voclosporin Low DoseDrug

    Also called ISA247

  • PlaceboDrug

Study groups in NCT02141672
Study groupRoleWhat they receive
Voclosporin Low DoseExperimentalVoclosporin, oral, 23.7 mg BID
Receives: Drug: Voclosporin Low Dose
Voclosporin High DoseExperimentalVoclosporin, oral 23.7 mg BID until Week 2, then voclosporin, oral, 39.5 mg BID
Receives: Drug: Voclosporin High Dose
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
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Subjects Achieving Complete Renal Remission at 24 Weeks

    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.

    Measured: week 24

Secondary outcomes (16)
  1. Number of Subjects Achieving Complete Renal Remission at 48 Weeks

    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.

    Measured: Week 48

  2. Number of Subjects Achieving Complete Renal Remission at 24 and 48 Weeks in the Presence of Low Dose Steroids

    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.

    Low-dose steroids is defined as use of ≤5 mg prednisone for 8 weeks leading up to the Week 24 visit date or for 12 weeks leading up to the Week 48 visit date.

    Measured: Weeks 24 and 48

  3. Time to Complete Remission (Number of Weeks)

    Time to Complete Remission is defined as time from first dose of voclosporin/placebo to UPCR ≤ 0.5mg in the absence of rescue medication.

    Measured: week 48

  4. Time to Sustained Early Complete Remission (Number of Weeks)

    Time to Sustained Complete Remission is defined as time from first dose of voclosporin/placebo to UPCR ≤ 0.5mg occurring at week 24 or earlier and sustained until week 48 in the absence of rescue medication.

    Measured: week 48

  5. Number of Subjects Achieving Sustained Early Complete Remission

    Sustained early complete remission defined as complete remission that occurred on or before Week 24 and was sustained through Week 48

    Measured: week 48

  6. Time to Partial Remission (Number of Weeks)

    Time to partial Remission is defined as time from first dose of voclosporin/placebo to 50% UPCR reduction sustained until week 48 in the absence of rescue medication.

    Measured: week 48

  7. Number of Subjects Achieving Partial Remission

    Partial remission is defined as a 50% reduction in UPCR from baseline at Week 24 and Week 48.

    Measured: week 48

  8. Number of Subjects Achieving, and Remaining in, Complete Remission

    Sustained complete remission defined as the first occurrence of complete remission that was sustained through Week 48

    Measured: week 48

  9. Duration of Complete Remission (Number of Weeks)

    Duration of Complete Remission is defined as time of first occurrence of UPCR ≤ 0.5 mg/mg until the second increase above 0.5 mg/mg (i.e. a single occurrence above 0.5 is permitted) or use of rescue medication.

    Measured: week 48

  10. Number of Subjects Achieving Partial Renal Remission at 24 and 48 Weeks

    Number of patients with partial Remission is defined as time from first dose of voclosporin/placebo to 50% UPCR reduction at week 24 or week 48 in the absence of rescue medication.

    Measured: week 24 and 48

  11. Time to Sustained Partial Remission (Number of Weeks)

    Time to sustained partial Remission is defined as time from first dose of voclosporin/placebo to 50% UPCR reduction sustained until week 48 in the absence of rescue medication.

    Measured: week 48

  12. Number of Subjects Achieving Sustained Partial Remission

    Sustained partial remission defined as the first occurrence of partial remission that was sustained through Week 48

    Measured: week 48

  13. Time to Sustained Early Partial Remission (Number of Weeks)

    Time to sustained early partial Remission is defined as time from first dose of voclosporin/placebo to 50% UPCR reduction occurring at week 24 or earlier and sustained until week 48 in the absence of rescue medication.

    Measured: week 48

  14. Number of Subjects Achieving Sustained Early Partial Remission

    Early partial remission defined as partial remission that occurred on or before Week 24 and was sustained through Week 48

    Measured: week 48

  15. Change From Baseline in UPCR at Weeks 24 and 48

    Change from baseline in urine protein creatinine ratio at weeks 24 and 48

    Measured: Baseline, Week 24 and Week 48

  16. Change From Baseline in Safety of Estrogens in Systemic Lupus Erythematosus National Assessment Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) Score

    The SELENA-SLEDAI assesses disease activity within the last 10 days. Twenty-four items are scored for nine organ systems, and summed to a maximum of 105 points. A score of 6 is considered clinically significant and indicates active disease. For analysis purposes, a score ≥6 was categorized as "high". The 24 items are as follows: seizure, psychosis, organic brain syndrome, visual disturbance, cranial nerve disorder, lupus headache, cerebrovascular accident, vasculitis, arthritis, myositis, urinary casts, hematuria, proteinuria, pyuria, new rash, alopecia, mucosal ulcers, pleurisy, pericarditis, low complement, increased DNA binding, fever, thrombocytopenia, and leukopenia.

    Measured: Baseline, Week 24 and Week 48

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 May 2014 (estimated)
  2. Study startJun 2014
  3. Primary completionJul 2016
  4. Study completionJan 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
265 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02141672
Sponsor's protocol ID
AUR-VCS-2012-01
Acronym
AURA-LV
Status last verified
Apr 2021
First submitted
14 May 2014
Last updated
18 May 2021
Data monitoring committee
Yes

Publications

  • Dooley MA, Jayne D, Ginzler EM, Isenberg D, Olsen NJ, Wofsy D, Eitner F, Appel GB, Contreras G, Lisk L, Solomons N; ALMS Group. Mycophenolate versus azathioprine as maintenance therapy for lupus nephritis. N Engl J Med. 2011 Nov 17;365(20):1886-95. doi: 10.1056/NEJMoa1014460.

    PubMed 22087680
  • Appel GB, Contreras G, Dooley MA, Ginzler EM, Isenberg D, Jayne D, Li LS, Mysler E, Sanchez-Guerrero J, Solomons N, Wofsy D; Aspreva Lupus Management Study Group. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol. 2009 May;20(5):1103-12. doi: 10.1681/ASN.2008101028. Epub 2009 Apr 15.

    PubMed 19369404
  • Anders HJ, Chan TM, Sanchez-Guerrero J, Wofsy D, Bensley K, Kim L, Lo KH, Shu C, Shao J, Karyekar CS, Diamond B. Efficacy and safety of guselkumab in patients with active lupus nephritis: results from a phase 2, randomized, placebo-controlled study. Rheumatology (Oxford). 2025 May 1;64(5):2731-2740. doi: 10.1093/rheumatology/keae647.

    PubMed 39673415

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Voclosporin High Dose and Voclosporin Low Dose in people with Lupus Nephritis, run by Aurinia Pharmaceuticals Inc. at 86 sites in 20 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 May 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 86 sites in Russia, United States, Philippines, Mexico, South Korea and 15 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 May 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Subjects Achieving Complete Renal Remission at 24 Weeks (time frame: week 24). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02141672, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2021.

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