Vasculitis & polymyalgia rheumatica
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
Authors' conclusion
These data support the efficacy and safety of an avacopan-based regimen to treat patients with GPA or MPA aged ≥65.
Study context
- Population
- Patients aged ≥65 years with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) in the ADVOCATE trial (subgroups 65–74 and ≥75)109 aged 65–74
- Participants
- 160 patients
- Comparison
- Avacopan vs prednisone taper, plus either RTX or CYC
- Primary endpoint
- Key efficacy outcomes: remission at week 26 and sustained remission at week 52
- Follow-up
- Week 26
Methodological detailsdescriptive, stratified by age
- Descriptive
- Stratified by age
Primary result
As reported in the abstract
Remission at week 26, by age subgroup
Aged 65-74: Avacopan vs Prednisone taper
71.7% vs 69.4%
Aged ≥75: Avacopan vs Prednisone taper
73.1% vs 72.0%
Further findings
Sustained remission at week 52, by age subgroup
- Aged 65-74: Avacopan vs Prednisone taper
- 65.0% vs 55.1%
- Aged ≥75: Avacopan vs Prednisone taper
- 65.4% vs 56.0%
Relapse, by age subgroup
- Aged 65-74: Avacopan vs Prednisone taper
- 12.3% vs 18.8%
- Aged ≥75: Avacopan vs Prednisone taper
- 3.8% vs 20.8%
eGFR and health-related quality of life
- Improvements observed in both treatment groups
Mean GC dose, Avacopan vs Prednisone taper
- Reduction in mean GC dose, aged 65-74
- 61%
- Reduction in mean GC dose, aged ≥75
- 49%
- Lower GC toxicity with avacopan
Safety
Adverse events
- Proportions of patients with AEs similar between treatment groups within each age subgroup
Original publication
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. Rheumatology (Oxford). Published 3 March 2025. doi:10.
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