Greater kidney function recovery with avacopan in patients with ANCA-associated vasculitis
Click Here to Manage Email Alerts
Patients with ANCA-associated vasculitis who received avacopan showed greater recovery of kidney function compared with patients who received prednisone, according to study results presented at ASN Kidney Week.
“We anticipate that this better GFR recovery with longer-term follow-up will impact kidney failure and potentially mortality risks,” David R. Jayne, MD, of the University of Cambridge, said during the virtual meeting.
Jayne presented results of the ADVOCATE phase 3 trial, a randomized, double-blinded placebo-controlled trial. In the study presented, 300 patients with granulomatosis with polyangiitis or microscopic polyangiitis ANCA-associated vasculitis were randomized to receive avacopan (Tavneos, ChemoCentryx), an oral inhibitor of the C5a complement receptor, or prednisone taper on a background of either cyclophosphamide followed by azathioprine or rituximab.
Researchers found patients in the avacopan group had a greater recovery of kidney function compared with patients in the prednisone group, especially patients with stage 4 chronic kidney disease and patients with an eGFR of less than 60 mL/min/1.73 m2 or urinary abnormalities at baseline. The absolute difference in eGFR recovery in patients with an eGFR of less than 60 mL/min/1.73 m2 or urinary abnormalities at baseline was 5.5 mL/min/1.73 m2 between avacopan and prednisone groups at 52 weeks. For patients who received avacopan, the eGFR improvement was most prominent for patients who had an eGFR of less than 30 mL/min/1.73 m2 at baseline.
Among patients with stage 4 CKD at baseline, 52 patients received avacopan, of which 26 patients improved one stage and three patients improved two stages. Among the 48 patients who received prednisone, 21 patients improved one stage and one patient improved two stages. Researchers also found patients who received avacopan had a more rapid reduction in proteinuria and hematuria.
“Focusing on the kidney response, we saw earlier falls in proteinuria, hematuria and [monocyte chemoattractant protein-1] MCP-1 across these programs, and better recovery of GFR in the phase 3 trial, which was accentuated for those with more severe renal disease,” he said.
Collapse
Jayne DR, et al. Paper FR-OR63. Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
Read more about
Click Here to Manage Email Alerts