Summary

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• Voclosporin (Lupkynis) is used in combination with a background immunosuppressive therapy regimen to treat adult patients with active lupus nephritis. It has been highlighted for the best improvement in complete remission rate among various combinations studied, presenting a significant advancement in treatment.
• Four studies were reviewed that discuss different aspects of lupus nephritis treatment, including the use of Lupkynis (voclosporin) combined with mycophenolate mofetil (MMF).
• When compared directly, Tacrolimus + MMF was found to be more effective than voclosporin + MMF at inducing complete remission. This suggests that tacrolimus may be more effective when aiming for total disease remission.
• In terms of safety, voclosporin + MMF carried the highest risk of infection and serious infection among treatments analyzed. Multitarget therapy groups showed numerically higher cases of infection and pneumonia than monotherapy groups but did not significantly increase overall adverse event rates.
• Monotherapy was suggested as safest based on severe event rates; however, voclopsporin + MMF followed closely behind while Tacrolimus + MMF posed greater risks for serious adverse events.
• The studies highlight the complexity involved in choosing an appropriate treatment regimen due to varying efficacy levels and potential risks associated with each drug combination. Special attention should be given to patient subgroups most at risk, such as those who have had previous infections, so as to tailor their approach towards optimizing both safety and effectiveness.