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Lupus Nephritis

Voclosporin effective for lupus nephritis but raises safety concerns

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Voclosporin, when used in combination with mycophenolate mofetil (MMF), demonstrates the highest efficacy as an induction therapy for lupus nephritis (LN), particularly in achieving complete remission (CR), according to a study.

However, there are concerns about the safety profile of this combination, as it is associated with a higher risk of infection and serious infection.

The study employed a systematic review and network meta-analysis approach, analyzing data from 16 randomized controlled trials (RCTs) involving 2444 patients with LN. The primary objective was to compare the efficacy and safety of various treatment protocols using a random effects model.

Results from the analysis indicated that, in terms of partial remission (PR), there was no significant difference between the drugs under consideration. However, when evaluating complete remission (CR), the combination of Voclosporin with MMF exhibited the highest remission rate, closely followed by Tacrolimus (TAC).

Concerns were raised about the safety profile of Voclosporin in combination with MMF. This combination showed the highest risk of infection and serious infection among the treatment regimens studied. Conversely, TAC not only demonstrated efficacy but also presented a lower risk of infection and serious infection, making it a more favorable option in terms of safety.

References
Dong Y, Shi J, Wang S, et al. The efficacy of immunosuppressive drugs induction therapy for lupus nephritis: a systematic review and network meta-analysis. Ren Fail. 2023;45(2):2290365. doi: 10.1080/0886022X.2023.2290365. Epub 2023 Dec 12. PMID: 38087473.

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