Vasculitis & polymyalgia rheumatica

Efficacy and safety of avacopan for treatment of patients with ANCA-associated vasculitis receiving cyclophosphamide

RMD OpenPublished Secondary analysis of the ADVOCATE randomised trial

Authors' conclusion

This subgroup analysis of patients who received CYC shows similar rates of remission in the avacopan and prednisone taper groups.

Study context

Population
Patients with AAV (granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA)) receiving CYC followed by AZA (or MMF) in the ADVOCATE trial35.2% of 330 treated
Participants
116 patients
Comparison
Avacopan vs prednisone taper in AAV patients receiving CYC
  • Avacopann = 59
  • Prednisone tapern = 57reference
Primary endpoint
Key efficacy outcomes: remission at week 26 and sustained remission at week 52
Follow-up
Week 26; week 52
Methodological detailssubgroup analysis
  • Subgroup analysis

Primary result

As reported in the abstract

Remission · week 26

Further findings

Sustained remission (key efficacy outcome) · week 52

Relapses · over 52 weeks

Estimated glomerular filtration rate (eGFR), albuminuria and GC toxicity

Improvement in eGFR, speed of albuminuria reduction and differences in GC toxicity favoured the avacopan group

Safety

Serious adverse events

Original publication

Efficacy and safety of avacopan for treatment of patients with ANCA-associated vasculitis receiving cyclophosphamide. RMD Open. Published 5 October 2025. doi:10.1136/rmdopen-2025-005743

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