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

Journal Article (Journal Article;Multicenter Study)

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.

Full Text

Duke Authors

Cited Authors

  • Baker, M; Chaichian, Y; Genovese, M; Derebail, V; Rao, P; Chatham, W; Bubb, M; Lim, S; Hajian, H; Gurtovaya, O; Patel, U; Tumlin, J

Published Date

  • December 2020

Published In

Volume / Issue

  • 6 / 3

PubMed ID

  • 33380521

Pubmed Central ID

  • PMC7780527

Electronic International Standard Serial Number (EISSN)

  • 2056-5933

Digital Object Identifier (DOI)

  • 10.1136/rmdopen-2020-001490


  • eng

Conference Location

  • England