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Lupus NephritisPhase 3AURORA 2NCT03597464

Aurinia Renal Assessments 2: Aurinia Renal Response in Lupus With Voclosporin

A Phase 3 study testing Voclosporin in people with Lupus Nephritis, run by Aurinia Pharmaceuticals Inc. at 1 site in United States.

Completed

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

Official record
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Trial summary

The purpose of this study is 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 lupus nephritis (LN). 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
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
216 participants
Where
1 siteUnited States
Study dates
29 Sep 2019to 7 Oct 2021
Phase
Phase 3
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

  • 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.
  • Written informed consent before any study-specific procedures were performed.
  • In the opinion of the investigator, subject required continued immunosuppressive therapy.
  • Women of childbearing potential must continue to use effective contraception and have a negative urine pregnancy test at Month 12.
  • Subject is willing to continue taking oral mycophenolate mofetil (MMF) for the duration of the study.

Who cannot join

  • Currently taking or known need for any of the medications or food items listed in Section 7.8, Prohibited Therapy and Concomitant Treatment during the study.
  • Subjects currently requiring renal dialysis (hemodialysis or peritoneal dialysis) or expected to require dialysis during the study period.
  • A planned kidney transplant within study treatment period.
  • Subjects with any medical condition which, in the Investigator's judgment, may be associated with increased risk to the subject or may interfere with study assessments or outcomes.
  • Subjects who are pregnant, breast feeding or, if of childbearing potential, not using adequate contraceptive precautions.
  • Vaccines using live organisms, virus or bacterial, while taking the study treatment.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • AURORA Investigative Center

    Oklahoma City, Oklahoma, 73104

Other trials in United States

About this study

Official title: A Randomized, Controlled, Double-blind, Continuation Study Comparing the Long-term Safety and Efficacy of Voclosporin (23.7 mg Twice Daily) With Placebo in Subjects With Lupus Nephritis

The purpose of this study is 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 lupus nephritis (LN).

Read the detailed description

The aim of the Phase 3 continuation study (AURORA 2) is to assess the long-term safety and tolerability of voclosporin, added to the standard of care treatment in LN, for an additional 24 months, following a treatment period of 52 weeks in the AURORA 1 study (AUR-VCS-2016-01). All subjects will continue to receive background therapy of mycophenolate mofetil (MMF) and/or oral corticosteroids starting at the same dose as at the end of the AURORA 1 study. Subjects with LN, who have completed 52 weeks of treatment with study drug in the AURORA 1 study, will be eligible to enter the study. The long-term safety and tolerability of the drug combination will be assessed from its safety profile while demonstrating the continued ability to achieve and maintain long-term renal response.

Conditions
Lupus Nephritis
Being tested
Voclosporin, Placebo Oral Capsule
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.

  • VoclosporinDrug

    Also called ISA247

    Calcineurin inhibitor, oral, 23.7 mg twice daily (BID)

  • Placebo Oral CapsuleDrug

    Voclosporin placebo, oral, 3 capsules twice daily (BID)

Study groups in NCT03597464
Study groupRoleWhat they receive
VoclosporinExperimentalVoclosporin
Receives: Drug: Voclosporin
Placebo Oral CapsulePlacebo comparatorPlacebo
Receives: Drug: Placebo Oral Capsule

What is being measured

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

  1. Adverse Events (AE) Profile and Routine Biochemical and Hematological Assessments.

    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.

    Measured: Month 12 (AURORA 2 baseline) to Month 36

Secondary outcomes (8)
  1. Number (and Percent) of Subjects in Renal Response

    Proportion of subjects in renal response defined as:

    • urine protein creatinine ratio (UPCR) of ≤0.5 mg/mg
    • estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m^2 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 the 8 weeks prior to the renal response assessment.

    Measured: Months 12 (AURORA 2 Baseline), 18, 24, 30 and 36

  2. Number (and Percent) of Subjects in Partial Renal Response

    Partial renal response defined as a 50% reduction from baseline in urine protein creatinine ratio (UPCR).

    Measured: Months 12 (AURORA 2 baseline), 18, 24, 30 and 36

  3. Renal Flare as Adjudicated by the Clinical Endpoints Committee (CEC).

    A patient could experience a flare from the point they achieved a response (or recovery). Renal flares were judged according to the following criteria:

    • A reproducible increase to UPCR >1 mg/mg from a post-response baseline of <0.2 mg/mg or
    • an increase to UPCR >2 mg/mg from a post-response baseline between 0.2 to 1.0 mg/mg or
    • a doubling of UPCR for baseline values of UPCR >1 mg/mg

    Measured: Month 12 (AURORA 2 baseline) to Month 36

  4. Change From AURORA 1 Baseline (i.e., Month 0) in Safety of Estrogens in Lupus Erythematosus National Assessment Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI)

    Participants analyzed included all subjects who were randomized treatment during AURORA 1 AND who consented to continue their treatment in AURORA 2. Baseline values were collected at the start of AURORA 1 but only for those subjects that continued in AURORA 2.

    Assessment of Systemic Lupus Erythematosus (SLE) Disease Activity within the last 10 days. It scores 24 disease descriptors across 9 organ systems which are summed to a minimum of <2 (considered indicative of no activity) and maximum of 105 points. Scores are weighted and a score of 6 is considered clinically significant. Higher scores indicate worse disease activity.

    Measured: Months 18, 24 and 36

  5. Change From AURORA 1 Baseline (i.e., Month 0) in Urine Protein to Creatinine Ratio (UPCR)

    Participants analyzed included all subjects who were randomized treatment during AURORA 1 AND who consented to continue their treatment in AURORA 2. Baseline values were collected at the start of AURORA 1 but only for those subjects that continued in AURORA 2.

    Reductions in UPCR are indicative of better renal outcomes.

    Measured: Months 12 (AURORA 2 baseline), 18, 24, 30 and 36

  6. Change From AURORA 1 Baseline (i.e., Month 0) in Estimated Glomerular Filtration Rate (eGFR)

    Participants analyzed included all subjects who were randomized treatment during AURORA 1 AND who consented to continue their treatment in AURORA 2. Baseline values were collected at the start of AURORA 1 but only for those subjects that continued in AURORA 2.

    This endpoint incorporated Corrected eGFR values with a ceiling set to 90 mL/min/1.73 m^2

    Increases in eGFR levels are indicative of better renal outcomes.

    Measured: Months 12 (AURORA 2 baseline), 18, 24, 30 and 36

  7. Change From AURORA 1 Baseline (i.e., Month 0) in Urine Protein

    Participants analyzed included all subjects who were randomized treatment during AURORA 1 AND who consented to continue their treatment in AURORA 2. Baseline values were collected at the start of AURORA 1 but only for those subjects that continued in AURORA 2.

    Reductions in Urine Protein levels are indicative of better renal outcomes.

    Measured: Months 12 (AURORA 2 baseline), 18, 24, 30 and 36

  8. Change From AURORA 1 Baseline (i.e., Month 0) in Serum Creatinine (SCr)

    Participants analyzed included all subjects who were randomized treatment during AURORA 1 AND who consented to continue their treatment in AURORA 2. Baseline values were collected at the start of AURORA 1 but only for those subjects that continued in AURORA 2.

    Decreases in SCr levels can be indicative of better renal outcomes.

    Measured: Months 12 (AURORA 2 baseline), 18, 24, 30 and 36

Timeline

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

  1. First posted24 Jul 2018
  2. Study start29 Sep 2019
  3. Primary completion7 Oct 2021
  4. Study completion7 Oct 2021

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
216 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03597464
Sponsor's protocol ID
AUR-VCS-2016-02
Acronym
AURORA 2
Status last verified
Nov 2022
First submitted
25 Jun 2018
Last updated
14 Dec 2022
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Rovin BH, Parikh SV, Hebert LA, Chan TM, Mok CC, Ginzler EM, Hooi LS, Brunetta P, Maciuca R, Solomons N. Lupus nephritis: induction therapy in severe lupus nephritis--should MMF be considered the drug of choice? Clin J Am Soc Nephrol. 2013 Jan;8(1):147-53. doi: 10.2215/CJN.03290412. Epub 2012 Aug 9.

    PubMed 22879439
  • 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
  • Ling SY, Huizinga RB, Mayo PR, Larouche R, Freitag DG, Aspeslet LJ, Foster RT. Cytochrome P450 3A and P-glycoprotein drug-drug interactions with voclosporin. Br J Clin Pharmacol. 2014 Jun;77(6):1039-50. doi: 10.1111/bcp.12309.

    PubMed 24330024
  • Ling SY, Huizinga RB, Mayo PR, Freitag DG, Aspeslet LJ, Foster RT. Pharmacokinetics of voclosporin in renal impairment and hepatic impairment. J Clin Pharmacol. 2013 Dec;53(12):1303-12. doi: 10.1002/jcph.166. Epub 2013 Oct 8.

    PubMed 23996158
  • Mayo PR, Huizinga RB, Ling SY, Freitag DG, Aspeslet LJ, Foster RT. Voclosporin food effect and single oral ascending dose pharmacokinetic and pharmacodynamic studies in healthy human subjects. J Clin Pharmacol. 2013 Aug;53(8):819-26. doi: 10.1002/jcph.114. Epub 2013 Jun 4.

    PubMed 23736966
  • Busque S, Cantarovich M, Mulgaonkar S, Gaston R, Gaber AO, Mayo PR, Ling S, Huizinga RB, Meier-Kriesche HU; PROMISE Investigators. The PROMISE study: a phase 2b multicenter study of voclosporin (ISA247) versus tacrolimus in de novo kidney transplantation. Am J Transplant. 2011 Dec;11(12):2675-84. doi: 10.1111/j.1600-6143.2011.03763.x. Epub 2011 Sep 22.

    PubMed 21943027
  • Avasare R, Drexler Y, Caster DJ, Mitrofanova A, Jefferson JA. Management of Lupus Nephritis: New Treatments and Updated Guidelines. Kidney360. 2023 Oct 1;4(10):1503-1511. doi: 10.34067/KID.0000000000000230.

    PubMed 37528520

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Voclosporin in people with Lupus Nephritis, run by Aurinia Pharmaceuticals Inc. at 1 site in United States.

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 5 inclusion and 6 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 14 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 14 Dec 2022). 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?

Adverse Events (AE) Profile and Routine Biochemical and Hematological Assessments. (time frame: Month 12 (AURORA 2 baseline) to Month 36). 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 NCT03597464, which also lists 7 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 14 Dec 2022.

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