ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 0857

Change in Albuminuria in Patients with ANCA-Associated Vasculitis Treated with Avacopan

Duvuru Geetha1, Frank Cortazar2, alexandre Karras3, Annette Bruchfeld4, Huibin Yue5, Peter Merkel6 and David Jayne7, 1Johns Hopkins University, Baltimore, MD, 2New York Nephrology, Watervliet, NY, 3HEGP - APHP, Paris, France, 4Karolinska Institutet, Stockholm, Sweden, 5Amgen, Inc., Thousand Oaks, CA, 6University of Pennsylvania, Philadelphia, PA, 7University of Cambridge, Cambridge, United Kingdom

Meeting: ACR Convergence 2023

Keywords: ANCA associated vasculitis, complement, Granulomatosis with Polyangiitis (GPA), Microscopic Polyangiitis, Renal

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, November 12, 2023

Title: Abstracts: Vasculitis – ANCA-Associated I

Session Type: Abstract Session

Session Time: 4:00PM-5:30PM

Background/Purpose: Urinary albumin:creatinine ratio (UACR) is an important biomarker of active glomerulonephritis, a common complication of antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV). In most glomerular diseases, high UACR levels and low estimated glomerular filtration rate are associated with the long-term risk of end-stage kidney disease, cardiovascular disease, and death (Levey AS et al, N Engl J Med 2022).In the double-dummy, double-blind, controlled ADVOCATE Phase 3 trial (Jayne DRW et al, N Engl J Med 2021), patients were randomized to receive avacopan, an oral C5a receptor (C5aR) antagonist that blocks C5a-mediated neutrophil activation and migration, or a prednisone taper. All patients received background immunosuppression with either cyclophosphamide followed by azathioprine, or rituximab. Primary endpoints were remission at week 26 and sustained remission at week 52. Prespecified secondary endpoints included the evaluation of kidney function. The effect of avacopan on UACR in patients with AAV is described.

Methods: This post hoc analysis compared the time to achieve the maximum mean difference in percent change in UACR from baseline between the avacopan and prednisone taper groups using Kaplan-Meier survival analysis. Change in UACR from baseline was a prespecified secondary endpoint but was not adjusted for multiplicity. This analysis included patients from the ADVOCATE trial with kidney involvement (based on the Birmingham Vasculitis Activity Score) and a UACR of at least 10 mg/g at baseline.

Results: The baseline geometric mean UACR mg/g (range) in the avacopan group (n=125) and the prednisone taper group (n=128) was 433 (20 to 6461) and 312 (11 to 5367), respectively. A statistically significant UACR reduction (based on least-square means) in the avacopan group compared to the prednisone taper group occurred as early as week 2 (-25% vs. 6%, p=0.0068, difference between groups: -29%, 95% confidence interval (CI) [-45%, -9%]). UACR continued to decrease at week 4 to the maximum difference between the two groups (-40% vs. 0%, p< 0.0001, difference between groups: -40%, 95% CI [-53%, -22%]) (Figure 1). UACR was comparable between the two groups by week 13 (-55% vs. -49%, p=0.3028, difference between groups: -12%, 95% CI [-32%, 13%]). During the 52-week treatment period, 84% (105/125) of patients in the avacopan group achieved a 40% UACR reduction from baseline within a median time of 29 days (95% CI [29, 88]), compared to 83% (106/128) of patients in the prednisone taper group within a median time of 92 days (95% CI [91, 180]) (logrank p=0.0450) (Figure 2). There was an overall mean improvement in estimated glomerular filtration rate (eGFR) of 7.6 mL/min/1.73 m2 in the avacopan group and 4.6 mL/min/1.73 m2 in the prednisone taper group at week 52.

Conclusion: In the ADVOCATE trial, UACR, an important early indicator of improving kidney function, improved three times faster in the avacopan group compared to the prednisone taper group. The rapid reduction in UACR seen in patients with AAV receiving avacopan suggests more rapid control of glomerular inflammation which may have contributed to the observed subsequent improvement in eGFR.

Supporting image 1

Supporting image 2


Disclosures: D. Geetha: Amgen, 2, Aurinia, 2, calliditas, 2, chemocentryx, 2, GlaxoSmithKlein(GSK), 2; F. Cortazar: Amgen, 2, 6, Aurinia, 2, 6, Calliditas, 6, Travere, 2, Valenza Bio, 2; a. Karras: AstraZeneca, 6, GlaxoSmithKlein(GSK), 4, Novartis, 2, Pfizer, 6; A. Bruchfeld: Amgen, 2, AstraZeneca, 2, 12, Investigator fees, Bayer, 2, ChemoCentryx, 1, 12, Investigator fees, CSL Vifor, 2, 12, Investigator fees, Fresenius, 2, 12, Investigator fees, Merck/MSD, 2, 12, Investigator fees; H. Yue: Amgen, 3, 11, ChemoCentryx, 3, 11; P. Merkel: AbbVie/Abbott, 5, Amgen, 2, 5, ArGenx, 2, AstraZeneca, 2, 5, Boehringer-Ingelheim, 2, 5, Bristol-Myers Squibb(BMS), 2, 5, Cabaletta, 2, CSL Behring, 2, Eicos, 5, Electra, 5, Genentech, 5, GlaxoSmithKlein(GSK), 2, 5, HiBio, 2, InflaRx, 2, 5, Janssen, 2, Jubilant, 2, Kyverna, 2, 11, MiroBio, 2, Neutrolis, 5, Novartis, 2, NS Pharma, 2, Q32, 2, Regeneron, 2, Sanofi, 2, Sparrow, 2, Takeda, 2, 5, UpToDate, 9, Visterra, 2; D. Jayne: AstraZeneca, 2, Aurinia, 4, Boehringer Ingelheim, 2, Chinook, 2, CSL Vifor, 2, Roche, 2.

To cite this abstract in AMA style:

Geetha D, Cortazar F, Karras a, Bruchfeld A, Yue H, Merkel P, Jayne D. Change in Albuminuria in Patients with ANCA-Associated Vasculitis Treated with Avacopan [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/change-in-albuminuria-in-patients-with-anca-associated-vasculitis-treated-with-avacopan/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2023

ACR Meeting Abstracts - https://acrabstracts.org/abstract/change-in-albuminuria-in-patients-with-anca-associated-vasculitis-treated-with-avacopan/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology