Open Access Open Access  Restricted Access Subscription Access

An Essential Parameters of Voclosporin Include Objectives, Symptoms, Mechanism of Action, Administration, Adverse Effects, Contraindications, Monitoring, Toxicity and Enhancing Healthcare Team Outcomes

Muralinath E., Sony Sharlet E., Madhavi Latha C., Ramadevi Ch., Sheethal U., Guruprasad M., Karthik Jayanth. Y., Renuka. U.

Abstract


Voclosporin, a novel immunosuppressive medication, is approved regarding treatment as well as management of lupus nephritis (LN) within the class of calcineurin inhibitors (CNIs). LN is a common characterization of systemic lupus erythematosus (SLE), an autoimmune disease influencing various organs. Approximately 40% of SLE patients may generate LN. The primary goal of LN treatment is to maintain kidney function, decrease mortality, and promote the patient's quality of life while minimizing treatment-related adverse events. A timely response to therapy, as specified by a reduction in proteinuria, may predict long-term outcomes along with the risk of SLE flares, end-stage kidney disease as well as mortality. In the United States, voclosporin attained FDA approval in 2021 regarding treatment of active LN in adults, combined along with background immunosuppressive therapy. This CME activity explains about the indications, actions, and contraindications for voclosporin. It also specifies the mechanism of action, adverse event profile, and key factors like dosing, pharmacokinetics, contraindications, and monitoring that are essential for healthcare team members involved regarding treatment of patients along with lupus nephritis using voclosporin.


Full Text:

PDF

References


Rovin, B. H., Teng, Y. K. O., Ginzler, E. M., Arriens, C., Caster, D. J., Romero-Diaz, J., Gibson, K., Kaplan, J., Lisk, L., Navarra, S., Parikh, S. V., Randhawa, S., Solomons, N., & Huizinga, R. B. (2021). Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): A double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. The Lancet, 397(10289), 2070–2080. https://doi.org/10.1016/S0140-6736(21)00578-9

McArn, A. C., Nixon, A. R., & Jarrell, K. L. (2022). Voclosporin: A novel calcineurin inhibitor for the treatment of lupus nephritis. Annals of Pharmacotherapy, 56(9), 1048–1058. https://doi.org/10.1177/10600280221075331

Heo, Y. A. (2021). Voclosporin: First approval. Drugs, 81(5), 605–610. https://doi.org/10.1007/s40265-021-01493-4

van Gelder, T., Huizinga, R. B., Lisk, L., & Solomons, N. (2022). Voclosporin: A novel calcineurin inhibitor with no impact on mycophenolic acid levels in patients with systemic lupus erythematosus. Nephrology Dialysis Transplantation, 37(5), 917–922. https://doi.org/10.1093/ndt/gfab343

van Gelder, T., Lerma, E., Engelke, K., & Huizinga, R. B. (2022). Voclosporin: A novel calcineurin inhibitor for the treatment of lupus nephritis. Expert Review of Clinical Pharmacology, 15(5), 515–529. https://doi.org/10.1080/17512433.2022.2071556

National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Voclosporin. In LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. https://www.ncbi.nlm.nih.gov/books/NBK574749/

Ponticelli, C., Reggiani, F., & Moroni, G. (2021). Old and new calcineurin inhibitors in lupus nephritis. Journal of Clinical Medicine, 10(21), Article 4832. https://doi.org/10.3390/jcm10214832

Bankole, A. A., & Nwaonu, J. N. (2022). The shifting landscape of lupus nephritis management: A review. Cureus, 14(1), e20950. https://doi.org/10.7759/cureus.20950

Ross, S. H., & Cantrell, D. A. (2018). Signaling and function of interleukin-2 in T lymphocytes. Annual Review of Immunology, 36, 411–433. https://doi.org/10.1146/annurev-immunol-042617-053352

Feng, D. (2020). Phosphorylation of key podocyte proteins and the association with proteinuric kidney disease. American Journal of Physiology-Renal Physiology, 319(2), F284–F291. https://doi.org/10.1152/ajprenal.00211.2020

Li, Y., Palmisano, M., Sun, D., & Zhou, S. (2020). Pharmacokinetic disposition difference between cyclosporine and voclosporin drives their distinct efficacy and safety profiles in clinical studies. Clinical Pharmacology: Advances and Applications, 12, 83–96. https://doi.org/10.2147/CPAA.S256066

Yap, D. Y. H., & Mok, C. C. (2022). Novel and emerging treatment strategies for lupus nephritis. Expert Review of Clinical Pharmacology, 15(11), 1283–1292. https://doi.org/10.1080/17512433.2022.2140248

Kale, A., Lech, M., Anders, H. J., & Gaikwad, A. B. (2023). Lupus nephritis: New and emerging biologic and targeted therapies. BioDrugs, 37(4), 463–475. https://doi.org/10.1007/s40259-023-00596-4

Alamilla-Sanchez, M. E., Alcala-Salgado, M. A., Alonso-Bello, C. D., & Fonseca-Gonzalez, G. T. (2021). Mechanism of action and efficacy of immunosuppressors in lupus nephritis. International Journal of Nephrology and Renovascular Disease, 14, 441–458. https://doi.org/10.2147/IJNRD.S327104

Ling, S. Y., Huizinga, R. B., Mayo, P. R., Larouche, R., Freitag, D. G., Aspeslet, L. J., & Foster, R. T. (2014). Cytochrome P450 3A and P-glycoprotein drug-drug interactions with voclosporin. British Journal of Clinical Pharmacology, 77(6), 1039–1050. https://doi.org/10.1111/bcp.12292

Dao, K. H., & Bermas, B. L. (2022). Systemic lupus erythematosus management in pregnancy. International Journal of Women's Health, 14, 199–211. https://doi.org/10.2147/IJWH.S294319


Refbacks

  • There are currently no refbacks.