Lupus nephritis is kidney inflammation caused by systemic lupus erythematosus, affecting roughly half of people with lupus. Treatment typically combines immunosuppressants like mycophenolate or cyclophosphamide with corticosteroids. Despite treatment, some people progress to kidney failure requiring dialysis or transplant.
What's actually going on in research
Trials are testing drugs that target specific immune pathways — including BAFF and APRIL inhibitors, complement blockers, and calcineurin inhibitors. Belimumab, an IV infusion, gained FDA approval for lupus nephritis in 2020. Researchers are also studying combinations that might let people use lower steroid doses and ways to predict which kidneys will respond to treatment.
Dual BAFF/APRIL blockers
Drugs that block both BAFF and APRIL — two proteins that keep harmful B cells alive — are in late-stage testing. Early results suggest they may work better than blocking BAFF alone.
Complement inhibitors
The complement system, part of immune defense, can attack the kidney in lupus nephritis. Several trials are testing whether blocking complement proteins can stop kidney damage.
Calcineurin inhibitors
Drugs like voclosporin, FDA-approved in 2021, work differently from traditional immunosuppressants and may offer another option for people who don't respond to standard treatment. Trials continue testing combinations and long-term outcomes.
What to know before you search
Eligibility typically depends on lupus nephritis class from kidney biopsy, protein levels in urine, kidney function tests, and whether you've had recent treatment changes.
What types of trials are currently open
- Induction therapy trials — Testing intensive treatment to bring active kidney inflammation under control, usually over several months.
- Maintenance therapy trials — Testing longer-term treatment to keep lupus nephritis quiet after initial control. Many studies compare new drugs to mycophenolate.
- Combination trials — Testing whether adding a second targeted drug to standard treatment improves outcomes or allows lower steroid doses.
- Biomarker studies — Following people over time to find blood or urine markers that predict flares or treatment response before kidney function changes.
- Steroid-reduction trials — Testing whether new drugs allow people to taper off steroids faster or use lower doses, reducing side effects.
Recently added LUPUS Nephritis trials
Take weekly at-home urine tests to monitor kidney function
Study participants enrolled in the SAMPLE Biorepository (s14-00487) who have provided permission to be contacted for future research will be enrolled and randomized (1:1) two-arm controlled) to either 1) perform weekly home-based proteinuria testing in addition to standard of care or 2) standard of care only. Participants randomized to the home-based proteinuria testing arm will perform weekly home-based proteinuria testing in addition to having standard of care and respond to study team's weekly text messages with urine test results for one year.
Take combination medications to treat lupus kidney disease
The goal of this clinical trial is to learn how different treatments affect immune cells in the kidney in people with active lupus nephritis (LN), a kidney manifestation of systemic lupus erythematosus (SLE). It will also investigate whether early changes in kidney tissue can predict long-term treatment response and whether blood or urine biomarkers can be used to monitor disease activity without the need for repeat kidney biopsies. The main questions it aims to answer are: * Does adding voclosporin to standard treatment with mycophenolate mofetil (MMF) and prednisolone result in greater early improvement of kidney inflammation compared with MMF and prednisolone alone? * Are specific macrophage and monocyte populations associated with treatment response and long-term kidney outcomes? * Can blood- or urine-based biomarkers be identified that reflect kidney inflammation and treatment response? Researchers will compare MMF, prednisolone, and voclosporin (triple therapy) with MMF and prednisolone alone (dual therapy) to determine whether intensified treatment leads to faster and more complete immunological and histological remission. Participants with newly diagnosed or relapsing proliferative lupus nephritis will: * Be randomly assigned to receive either triple therapy (MMF, prednisolone, and voclosporin) or dual therapy (MMF and prednisolone). * Undergo a kidney biopsy before treatment starts and a repeat kidney biopsy after 3 months of treatment. * Provide blood and urine samples during follow-up for immune cell analyses and biomarker studies. * Complete patient-reported outcomes questionnaires * Attend regular study visits and clinical assessments for up to 2 years. In addition, participants with SLE without lupus nephritis and healthy volunteers will provide blood samples to allow comparison of circulating immune cell populations between groups.
Find LUPUS Nephritis trials matched specifically to you
Answer 3 quick questions and we'll show you trials that fit your situation.