Efficacy and safety of avacopan in patients aged 65 years and older with ANCA-associated vasculitis: a post hoc analysis of data from the ADVOCATE trial
| Title: | Efficacy and safety of avacopan in patients aged 65 years and older with ANCA-associated vasculitis: a post hoc analysis of data from the ADVOCATE trial |
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| Authors: | Geetha D.; Pagnoux C.; Sattui S. E.; Merkel P. A.; Weiner M.; Draibe J.; Faguer S.; Bray S.; Gurlin R. E.; Balcells-Oliver M.; Bruchfeld A.; Jayne D. R.; Au Peh C.; Chakera A.; Cooper B.; Kurtkoti J.; Langguth D.; Levidiotis V.; Luxton G.; Mount P.; Mudge D.; Noble E.; Phoon R.; Ranganathan D.; Ritchie A.; Ryan J.; Suranyi M.; Rosenkranz A.; Lhotta K.; Kronbichler A.; Demoulin N.; Bovy C.; Hellemans R.; Hougardy J.; Sprangers B.; Wissing K.; Barbour S.; Brachemi S.; Cournoyer S.; Girard L.; Laurin L.; Liang P.; Philibert D.; Walsh M.; Tesar V.; Becvar R.; Horak P.; Rychlik I.; Szpirt W.; Dieperink H.; Gregersen J.; Ivarsen P.; Krarup E.; Lyngsoe C.; Rigothier C.; Augusto J.; Belot A.; Chauveau D.; Cornec D.; Jourde-Chiche N.; Ficheux M.; Karras A.; Klein A.; Maurier F.; Mesbah R.; Moranne O.; Neel A.; Quemeneur T.; Saadoun D.; Terrier B.; Zaoui P.; Schaier M.; Benck U.; Bergner R.; Busch M.; Floege J.; Grundmann F.; Haller H.; Haubitz M.; Hellmich B.; Henes J.; Hohenstein B.; Hugo C.; Iking-Konert C.; Arndt F.; Kubacki T.; Kotter I.; Lamprecht P.; Lindner T.; Halbritter J.; Mehling H.; Schonermarck U.; Venhoff N.; Vielhauer V.; Witzke O.; Szombati I.; Szucs G.; Garibotto G.; Alberici F.; Brunetta E.; Dagna L.; De Vita S.; Emmi G.; Gabrielli A.; Manenti L.; Pieruzzi F.; Roccatello D.; Salvarani C.; Harigai M.; Dobashi H.; Atsumi T.; Fujimoto S.; Hagino N.; Ihata A.; Kaname S.; Kaneko Y.; Katagiri A.; Katayama M.; Kirino Y.; Kitagawa K.; Komatsuda A.; Kono H.; Kurasawa T.; Matsumura R.; Mimura T.; Morinobu A.; Murakawa Y.; Naniwa T.; Nanki T.; Ogawa N.; Oshima H.; Sada K.; Sugiyama E.; Takeuchi T.; Taki H.; Tamura N.; Tsukamoto T.; Yamagata K.; Yamamura M.; Van Daele P.; Rutgers A.; Teng Y.; Walker R.; Chua I.; Collins M.; Rabindranath K.; De Zoysa J.; Svensson M.; Grevbo B.; Kalstad S.; Little M.; Clarkson M.; Molloy E.; Agraz Pamplona I.; Anton J.; Barrio Lucia V.; Ciggaran S.; Cinta Cid M.; Diaz Encarnacion M.; Fulladosa Oliveras X.; Jose Soler M.; Marco Rusinol H.; Praga M.; Quintana Porras L.; Segarra A.; Segelmark M.; Soveri I.; Thomaidi E.; Westman K.; Neumann T.; Burnier M.; Daikeler T.; Dudler J.; Hauser T.; Seeger H.; Vogt B.; Jayne D.; Burton J.; Al Jayyousi R.; Amin T.; Andrews J.; Baines L.; Brogan P.; Dasgupta B.; Doulton T.; Flossmann O.; Griffin S.; Harper J.; Harper L.; Kidder D.; Klocke R.; Lanyon P.; Luqmani R.; Mclaren J.; Makanjuola D.; Mccann L.; Nandagudi A.; Selvan S.; O'riordan E.; Patel M.; Patel R.; Pusey C.; Rajakariar R.; Robson J.; Robson M.; Salama A.; Smyth L.; Sznajd J.; Taylor J.; Merkel P.; Sreih A.; Belilos E.; Bomback A.; Carlin J.; Chang Chen Lin Y.; Derebail V.; Dragoi S.; Dua A.; Forbess L.; Gipson P.; Gohh R.; Greenwood G. T.; Hugenberg S.; Jimenez R.; Kaskas M.; Kermani T.; Kivitz A.; Koening C.; Langford C.; Marder G.; Mohamed A.; Monach P.; Neyra N.; Niemer G.; Niles J.; Obi R.; Owens C.; Parks D.; Podoll A.; Rovin B.; Sam R.; Shergy W.; Silva A.; Specks U.; Spiera R.; Springer J.; Striebich C.; Swarup A.; Thakar S.; Tiliakos A.; Tsai Y.; Waguespack D.; Chester Wasko M. |
| Contributors: | Geetha, D; Pagnoux, C; Sattui, S; Merkel, P; Weiner, M; Draibe, J; Faguer, S; Bray, S; Gurlin, R; Balcells-Oliver, M; Bruchfeld, A; Jayne, D; Au Peh, C; Chakera, A; Cooper, B; Kurtkoti, J; Langguth, D; Levidiotis, V; Luxton, G; Mount, P; Mudge, D; Noble, E; Phoon, R; Ranganathan, D; Ritchie, A; Ryan, J; Suranyi, M; Rosenkranz, A; Lhotta, K; Kronbichler, A; Demoulin, N; Bovy, C; Hellemans, R; Hougardy, J; Sprangers, B; Wissing, K; Barbour, S; Brachemi, S; Cournoyer, S; Girard, L; Laurin, L; Liang, P; Philibert, D; Walsh, M; Tesar, V; Becvar, R; Horak, P; Rychlik, I; Szpirt, W; Dieperink, H; Gregersen, J; Ivarsen, P; Krarup, E; Lyngsoe, C; Rigothier, C; Augusto, J; Belot, A; Chauveau, D; Cornec, D; Jourde-Chiche, N; Ficheux, M; Karras, A; Klein, A; Maurier, F; Mesbah, R; Moranne, O; Neel, A; Quemeneur, T; Saadoun, D; Terrier, B; Zaoui, P; Schaier, M; Benck, U; Bergner, R; Busch, M; Floege, J; Grundmann, F; Haller, H; Haubitz, M; Hellmich, B; Henes, J; Hohenstein, B; Hugo, C; Iking-Konert, C; Arndt, F; Kubacki, T; Kotter, I; Lamprecht, P; Lindner, T; Halbritter, J; Mehling, H; Schonermarck, U; Venhoff, N; Vielhauer, V; Witzke, O; Szombati, I; Szucs, G; Garibotto, G; Alberici, F |
| Publisher Information: | GB; Oxford University Press |
| Publication Year: | 2025 |
| Collection: | Università degli Studi di Milano-Bicocca: BOA (Bicocca Open Archive) |
| Subject Terms: | AAV; age; avacopan; GPA; MPA |
| Description: | Objectives: To evaluate the efficacy and safety of avacopan in patients aged ≥65 years with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) in the phase 3 ADVOCATE trial of avacopan vs a prednisone taper, plus either rituximab or cyclophosphamide. Methods: In this descriptive, post hoc analysis, patients receiving avacopan or a prednisone taper were stratified by age. Key efficacy outcomes included the rate of remission at week 26 and sustained remission at week 52. Results: Of 160 patients aged ≥65, 109 were aged 65-74 and 51 were ≥75. Remission at week 26 was achieved in 71.7% vs 69.4% of patients aged 65-74 and 73.1% vs 72.0% aged ≥75 in the avacopan vs prednisone taper groups, respectively. Sustained remission at week 52 was observed in 65.0% vs 55.1% of patients aged 65-74 and 65.4% vs 56.0% aged ≥75. Relapse rates in the avacopan vs prednisone taper groups were 12.3% vs 18.8% and 3.8% vs 20.8% in the 65-74 and ≥75 subgroups, respectively. Improvements in estimated glomerular filtration rate and health-related quality of life were observed in both treatment groups. Use of avacopan compared with a prednisone taper was associated with a 61% and 49% reduction in mean glucocorticoid dose in the 65-74 and ≥75 subgroups, respectively, and lower glucocorticoid toxicity. The proportions of patients with adverse events were similar between treatment groups within each age subgroup. Conclusion: These data support the efficacy and safety of an avacopan-based regimen to treat patients with GPA or MPA aged ≥65. |
| Document Type: | article in journal/newspaper |
| File Description: | STAMPA |
| Language: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/40037556; info:eu-repo/semantics/altIdentifier/wos/WOS:001446921000001; volume:64; issue:6; firstpage:3863; lastpage:3871; numberofpages:9; journal:RHEUMATOLOGY; https://hdl.handle.net/10281/593724 |
| DOI: | 10.1093/rheumatology/keaf122 |
| Availability: | https://hdl.handle.net/10281/593724; https://doi.org/10.1093/rheumatology/keaf122 |
| Rights: | info:eu-repo/semantics/openAccess ; license:Creative Commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: | edsbas.37A67ECD |
| Database: | BASE |