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Objectives To analyze the efficacy and safety of voclosporin in a multicenter Spanish cohort of patients with class III, IV, and V lupus nephritis.Methods Multicenter, retrospective, observational study of patients with class III, IV, and V lupus nephritis treated with voclosporin in Spain. Treatment was initiated between January 2024 and February 2025. Statistical analysis was performed using paired-sample t-tests and Wilcoxon signed-rank testsResults A total of 35 patients were included; 74.3% were women, with a mean age of 39 years. The cohort comprised 62.9% Hispanic and 31.4% Caucasian patients. Hypertension was present in 65.7%, dyslipidemia in 45.7%, and type 2 diabetes mellitus in 8.6%. Regarding histological class, 31.4% had class IV LN, 22.9% class V, 8.9% class III, and the remaining cases were classified as mixed forms. The mean activity index was 6.4 (SD 5.4) and the chronicity index 2.6 (SD 2.5).Voclosporin was used as initial therapy for active LN in 7 cases, as rescue therapy for refractory disease in 10, as a switch from another calcineurin inhibitor (CNI) in 13, and for other reasons in 5 patients. The median time from the last flare to voclosporin initiation was 9.4 months.The median follow-up was 9.4 months (IQR [6.5–12.4]). We observed a significant improvement in proteinuria and hematuria after voclosporin treatment, with stable eGFR (p < 0.05). Significant reductions were also found in total cholesterol, LDL cholesterol, and anti-dsDNA antibody levels.During follow-up, there was only one relapse, and no patients required renal replacement therapy. One death occurred, attributed to cardiac causes.Adverse events were reported in five patients: gingival hyperplasia (n=1*), renal function deterioration (n=2, both with baseline eGFR <45 mL/min), upper respiratory tract infection (n=1*), and hirsutism (n=1). Two of these events (*) led to permanent treatment discontinuation.Among the 13 switch cases, 5 reported improved tolerability compared with their previous CNI (less tremor, alopecia, diarrhea, and palpitations).Abstract PO:11:296 Table 1Conclusions In this real-world Spanish cohort, voclosporin appeared to demonstrate efficacy and safety in the treatment of lupus nephritis.