PT - JOURNAL ARTICLE AU - Matthew Baker AU - Yashaar Chaichian AU - Mark Genovese AU - Vimal Derebail AU - Panduranga Rao AU - Winn Chatham AU - Michael Bubb AU - Sam Lim AU - Hooman Hajian AU - Oksana Gurtovaya AU - Uptal Patel AU - James Tumlin TI - Phase II, randomised, double-blind, multicentre study evaluating the safety and efficacy of filgotinib and lanraplenib in patients with lupus membranous nephropathy AID - 10.1136/rmdopen-2020-001490 DP - 2020 Dec 01 TA - RMD Open PG - e001490 VI - 6 IP - 3 4099 - http://rmdopen.bmj.com/content/6/3/e001490.short 4100 - http://rmdopen.bmj.com/content/6/3/e001490.full SO - RMD Open2020 Dec 01; 6 AB - 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.No data are available.