Efficacy and safety of avacopan in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis: A subanalysis of a randomized Phase 3 study

Author:

Harigai Masayoshi1,Kaname Shinya2,Tamura Naoto3ORCID,Dobashi Hiroaki4,Kubono Shinichi5,Yoshida Takumitsu6

Affiliation:

1. Division of Rheumatology, Department of Internal Medicine, Tokyo Women’s Medical University School of Medicine , Tokyo, Japan

2. Department of Nephrology and Rheumatology, Kyorin University School of Medicine , Tokyo, Japan

3. Department of Internal Medicine and Rheumatology, Juntendo University Faculty of Medicine , Tokyo, Japan

4. Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University , Kagawa, Japan

5. Medical Research Department, Kissei Pharmaceutical Co., Ltd. , Tokyo, Japan

6. Clinical Projects Management Department, Kissei Pharmaceutical Co., Ltd. , Tokyo, Japan

Abstract

ABSTRACT Objectives This subgroup analysis of the randomized, double-blind, Phase 3 ADVOCATE study evaluated the efficacy and safety of avacopan compared with tapered prednisone in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis. Methods Patients with microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA) received either avacopan 30 mg twice daily for 52 weeks plus prednisone-matching placebo or tapered prednisone over 20 weeks plus avacopan-matching placebo for 52 weeks. The two primary efficacy endpoints were clinical remission at Week 26 and sustained remission at Week 52. Results Compared with the overall population (N = 330), Japanese patients (N = 21) were older and had worse renal function, and a higher proportion were female and had MPA. The proportion of Japanese patients with clinical remission at Week 26 was 9/11 (81.8%) with avacopan vs. 7/10 (70.0%) with prednisone (overall population: 72.3% vs. 70.1%) and with sustained remission at Week 52 was 8/11 (72.7%) vs. 4/10 (40.0%), respectively (overall population: 65.7% vs. 54.9%). The safety profile of avacopan was similar in Japanese patients and the overall study population. Conclusions The efficacy and safety of avacopan in Japanese patients with MPA or GPA were comparable to that observed in the overall ADVOCATE study population.

Publisher

Oxford University Press (OUP)

Subject

Rheumatology

Reference18 articles.

1. 2012 Revised International Chapel Hill Consensus Conference nomenclature of vasculitides;Jennette;Arthritis Rheum,2013

2. Pathogenesis of antineutrophil cytoplasmic autoantibody-mediated disease;Jennette;Nat Rev Rheumatol,2014

3. Epidemiology and management of interstitial lung disease in ANCA-associated vasculitis;Sebastiani;Clin Exp Rheumatol,2020

4. Comparison of the epidemiology of anti-neutrophil cytoplasmic antibody-associated vasculitis between Japan and the U.K;Fujimoto;Rheumatology,2011

5. 2017 Clinical practice guidelines of the Japan Research Committee of the Ministry of Health, Labour, and Welfare for intractable vasculitis for the management of ANCA-associated vasculitis;Harigai;Mod Rheumatol,2019

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