Data Confirm Role of Avacopan as Therapy to Sustain AAV Remission to 52 Weeks

Avacopan is safe and efficacious for patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) receiving background induction therapy with rituximab, investigators reported.

At 52 weeks, avacopan plus rituximab is associated with a higher remission rate and improved recovery of renal function compared with prednisone taper plus rituximab, according to findings from a subgroup analysis of 214 patients in the phase 3 ADVOCATE trial (NCT02994927).

“As a new therapeutic agent, avacopan may be considered as a standard therapy along with rituximab for treatment of ANCA-associated vasculitis to induce and sustain remission,” Duvuru Geetha, MD, of the Johns Hopkins School of Medicine in Baltimore, Maryland, and colleagues wrote in Annals of the Rheumatic Diseases.

Of these, 107 received avacopan plus rituximab and 107 received prednisone taper plus rituximab. Remission at week 26 and sustained remission at week 52 were achieved by 77.6% and 71.0% of patients in the avacopan group, respectively, compared with 75.7% and 56.1% of patients in the prednisone taper group, respectively, the investigators reported.

The relapse rate following remission at any time was 8.7% in the avacopan group compared with 20.2% in the prednisone taper group. The avacopan group had a significant 58% reduction relapse risk at any time following remission compared with the prednisone taper group.

The avacopan group also experienced faster recovery of renal function. At week 52, mean estimated glomerular filtration rate (eGFR; mL/min/1.73m²) increased by 5.8 from 50.8 at baseline in the avacopan group compared with2.8 from 46.8 at baseline in the prednisone taper group.

Serious adverse events occurred in 34.6% and 39.3% of the avacopan and prednisone taper groups, respectively. Avacopan therapy also was associated with more rapid reduction in albuminuria and less glucocorticoid toxicity.

“The results of this subgroup analysis suggest that avacopan with background induction therapy with [rituximab] showed comparable efficacy to a prednisone taper with background [rituximab] in achieving remission at week 26 and a higher rate of sustained remission at week 52,” the authors wrote.

Disclosure: This research was supported by ChemoCentryx (a wholly owned subsidiary of Amgen). Please see the original reference for a full list of disclosures.

This article originally appeared on Renal and Urology News