Update on Clinical Trials in Systemic Lupus Erythematosus

Sonali Narain; Richard Furie


Curr Opin Rheumatol. 2016;28(5):477-487. 

In This Article

Calcineurin Inhibitors

Cyclosporin A (CsA) and tacrolimus (TAC) inhibit the development and proliferation of T cells by preventing the dephosphorylation of nuclear factor of activated T cells by calcineurin.[46] Several trials have shown the benefit of calcineurin inhibitors in patients with lupus nephritis.[47,48] An extended follow-up of the CYCLOFA-LUNE trial reported noninferiority of CsA in induction and maintenance of proliferative lupus nephritis in SLE patients on SoC when compared with intravenous cyclophosphamide.[49] TAC is favored over CsA because of its tolerability. Two recently published meta-analyses have found evidence to support TAC with or without SoC in patients with lupus nephritis.[50,51] Liu et al.[52] showed the superiority at 24 weeks of TAC and MMF compared with intravenous cyclophosphamide as induction therapy and Mok et al.[53] have demonstrated noninferiority of TAC to MMF as induction therapy for lupus nephritis.