{
  "abstract": "Objectives Following the successful AURORA-1 and AURORA-2 trials, voclosporin was incorporated into the KDIGO 2024 clinical guidelines for the management of active Class III or IV lupus nephritis, with or without a membranous component.Methods We present the outcomes of a retrospective cohort study involving 12 female patients who underwent 52 weeks of voclosporin therapy for active lupus nephritis. The distribution of biopsy class is shown in graph 1. The mean age was 39 years, and the mean disease duration was 9 years. The racial distribution included 50% Black, 42% White, and one Asian patient. All patients initiated voclosporin at the standard dose of 23.7 mg twice daily between August 2023 and October 2024. Before voclosporin initiation, eleven patients (91.7%) were on prednisolone with an average dose of 15 mg once daily.Results After 52 weeks of therapy, seven patients (58.3%) achieved complete renal response with proteinuria reduction < 50 mg/mmol and stable kidney function. One patient achieved a partial renal response, whilst three did not demonstrate a kidney response. Due to the small patient cohort, no statistically significant correlation was observed between the biopsy class and response to voclosporin treatment. There was a decrease in mean uPCR from 329 mg/mmol to 159 mg/mmol ( graph 2). Mean values of kidney function and serological lupus markers at baseline and at week 52 are summarised in table 1. Importantly, the mean prednisolone use was reduced to 5.8 mg. Two patients were able to discontinue corticosteroid therapy. Nine patients developed hypertension and were subsequently initiated on antihypertensive therapy. During the 52-week treatment, voclosporin was discontinued in one patient after 9 months due to hospitalisation for sepsis, which was deemed unrelated to the medication.Abstract PO:13:335 Table 1Abstract PO:13:335 Graph 1–2Conclusions Voclosporin was well tolerated, and the majority of the patients demonstrated satisfactory medication compliance. The therapy showed a significant reduction in proteinuria and lupus serology markers, allowing a decrease in steroid use. However, the patient developed hypertension after voclosporin initiation, requiring closer blood pressure monitoring. Our real-world use of voclosporin outside a clinical trial setting shows positive renal outcomes similar to those demonstrated in large-scale trials and enables dose reduction in steroids.",
  "authors": [
    {
      "affiliations": [
        "Barts Health NHS Trust, Departments of Renal Medicine and Transplantation, Rheumatology, and Dermatology, London, UK"
      ],
      "name": "Khoanh Iien Nhuien"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, Departments of Renal Medicine and Transplantation, Rheumatology, and Dermatology, London, UK"
      ],
      "name": "Luxme Nadarajah"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, Departments of Renal Medicine and Transplantation, Rheumatology, and Dermatology, London, UK"
      ],
      "name": "Andrea Cove-Smith"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, Departments of Renal Medicine and Transplantation, Rheumatology, and Dermatology, London, UK"
      ],
      "name": "Dev Pyne"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, Departments of Renal Medicine and Transplantation, Rheumatology, and Dermatology, London, UK"
      ],
      "name": "Angela Pakozdi"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, Departments of Renal Medicine and Transplantation, Rheumatology, and Dermatology, London, UK"
      ],
      "name": "Malvina Cunningham"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, Departments of Renal Medicine and Transplantation, Rheumatology, and Dermatology, London, UK"
      ],
      "name": "Sarah Mehren"
    },
    {
      "affiliations": [
        "Barts Health NHS Trust, Departments of Renal Medicine and Transplantation, Rheumatology, and Dermatology, London, UK"
      ],
      "name": "Ravindra Rajakariar"
    }
  ],
  "title": "PO:13:335 Real-world use of voclosporin in lupus nephritis",
  "uid": "114b0f0d-cacb-5b9a-9ce4-db2aad92a295"
}