Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy

Objectives Patients with lupus membranous nephropathy (LMN) are at risk for prolonged proteinuria and progressive chronic kidney disease. There are no proven effective treatments for LMN, and controlled trials are lacking. This trial assessed the preferential Janus kinase 1 (JAK1) inhibitor filgotin...

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Autores principales:	Sam Lim, Matthew Baker, Vimal Derebail, Yashaar Chaichian, Mark Genovese, Panduranga Rao, Winn Chatham, Michael Bubb, Hooman Hajian, Oksana Gurtovaya, Uptal Patel, James Tumlin
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2020
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/c9f79c28f9ee49ac9315662dd767f3a8
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spelling	oai:doaj.org-article:c9f79c28f9ee49ac9315662dd767f3a82021-11-10T19:30:06ZPhase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy10.1136/rmdopen-2020-0014902056-5933https://doaj.org/article/c9f79c28f9ee49ac9315662dd767f3a82020-12-01T00:00:00Zhttps://rmdopen.bmj.com/content/6/3/e001490.fullhttps://doaj.org/toc/2056-5933Objectives Patients with lupus membranous nephropathy (LMN) are at risk for prolonged proteinuria and progressive chronic kidney disease. There are no proven effective treatments for LMN, and controlled trials are lacking. This trial assessed the preferential Janus kinase 1 (JAK1) inhibitor filgotinib and the spleen tyrosine kinase inhibitor lanraplenib in patients with LMN.Methods This was a phase II, randomised, double-blind trial conducted at 15 centres in the USA to evaluate the safety and efficacy of filgotinib or lanraplenib for the treatment of LMN. Eligible patients were randomised 1:1 to receive either filgotinib or lanraplenib in a blinded fashion for up to 52 weeks. The primary endpoint was the per cent change in 24-hour urine protein from baseline to week 16.Results Nine patients were randomised to receive filgotinib (n=5) or lanraplenib (n=4). Four patients in the filgotinib group and one patient in the lanraplenib group completed week 16. There was a median reduction of 50.7% in 24-hour urine protein after 16 weeks of treatment with filgotinib (n=4), and the median Systemic Lupus Erythematosus Disease Activity Index from the Safety of Estrogens in Lupus National Assessment score remained stable. Filgotinib treatment was well tolerated. Limited conclusions can be drawn about treatment with lanraplenib.Conclusion The number of patients treated in this study was small, and only limited conclusions can be drawn. There may be a therapeutic benefit with filgotinib treatment, which may support future investigations with filgotinib or other JAK inhibitors in patients with LMN.Trial registration number NCT03285711.Sam LimMatthew BakerVimal DerebailYashaar ChaichianMark GenovesePanduranga RaoWinn ChathamMichael BubbHooman HajianOksana GurtovayaUptal PatelJames TumlinBMJ Publishing GrouparticleMedicineRENRMD Open, Vol 6, Iss 3 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Sam Lim Matthew Baker Vimal Derebail Yashaar Chaichian Mark Genovese Panduranga Rao Winn Chatham Michael Bubb Hooman Hajian Oksana Gurtovaya Uptal Patel James Tumlin Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy
description	Objectives Patients with lupus membranous nephropathy (LMN) are at risk for prolonged proteinuria and progressive chronic kidney disease. There are no proven effective treatments for LMN, and controlled trials are lacking. This trial assessed the preferential Janus kinase 1 (JAK1) inhibitor filgotinib and the spleen tyrosine kinase inhibitor lanraplenib in patients with LMN.Methods This was a phase II, randomised, double-blind trial conducted at 15 centres in the USA to evaluate the safety and efficacy of filgotinib or lanraplenib for the treatment of LMN. Eligible patients were randomised 1:1 to receive either filgotinib or lanraplenib in a blinded fashion for up to 52 weeks. The primary endpoint was the per cent change in 24-hour urine protein from baseline to week 16.Results Nine patients were randomised to receive filgotinib (n=5) or lanraplenib (n=4). Four patients in the filgotinib group and one patient in the lanraplenib group completed week 16. There was a median reduction of 50.7% in 24-hour urine protein after 16 weeks of treatment with filgotinib (n=4), and the median Systemic Lupus Erythematosus Disease Activity Index from the Safety of Estrogens in Lupus National Assessment score remained stable. Filgotinib treatment was well tolerated. Limited conclusions can be drawn about treatment with lanraplenib.Conclusion The number of patients treated in this study was small, and only limited conclusions can be drawn. There may be a therapeutic benefit with filgotinib treatment, which may support future investigations with filgotinib or other JAK inhibitors in patients with LMN.Trial registration number NCT03285711.
format	article
author	Sam Lim Matthew Baker Vimal Derebail Yashaar Chaichian Mark Genovese Panduranga Rao Winn Chatham Michael Bubb Hooman Hajian Oksana Gurtovaya Uptal Patel James Tumlin
author_facet	Sam Lim Matthew Baker Vimal Derebail Yashaar Chaichian Mark Genovese Panduranga Rao Winn Chatham Michael Bubb Hooman Hajian Oksana Gurtovaya Uptal Patel James Tumlin
author_sort	Sam Lim
title	Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy
title_short	Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy
title_full	Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy
title_fullStr	Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy
title_full_unstemmed	Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy
title_sort	phase ii, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy
publisher	BMJ Publishing Group
publishDate	2020
url	https://doaj.org/article/c9f79c28f9ee49ac9315662dd767f3a8
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Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy

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