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Abstract: SA-PO737

Characteristics and Treatment Patterns before Initiation of Avacopan in the United States

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Inguva, Sushmitha, Amgen Inc, Thousand Oaks, California, United States
  • Rane, Pallavi, Amgen Inc, Thousand Oaks, California, United States
  • Trimpe, Darcy, Amgen Inc, Thousand Oaks, California, United States
  • Multani, Jasjit, IQVIA, Wayne, Pennsylvania, United States
  • Chang, Hsiu-Ching, IQVIA, Wayne, Pennsylvania, United States
  • Geetha, Duvuru, Johns Hopkins University, Baltimore, Maryland, United States
  • Merkel, Peter A., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Wallace, Zachary S., Massachusetts General Hospital, Boston, Massachusetts, United States
Background

The FDA approved avacopan to treat adults with severe active granulomatosis with polyangiitis or microscopic polyangiitis in Oct 2021. Real-world data on patients receiving avacopan are sparse.

Methods

In a retrospective cohort study using the United States (US)-based IQVIA open-source pharmacy and medical claims data, patients with ≥1 avacopan claim from Oct 2021 to Sep 2023 were identified, with the first avacopan claim date being the index date. Patients ≥18 years old with ≥12 months of pre-index continuous data were included. Demographics on the index date and clinical characteristics in the 12-month pre-index period are shown.

Results

Overall, 701 patients were identified: mean [SD] age: 55.8 [15.9], 60.6% female, 61.1% commercially insured (Table 1). Index avacopan was mostly prescribed by rheumatologists (66.0%) or nephrologists (23.1%). Before starting avacopan, 92.3% received systemic glucocorticoids (GCs) with a median duration of GC use of 102 days (IQR: 45-210) and a cumulative oral prednisone-equivalent dose of 2660 mg (IQR: 900-4905). 56.6% received other immunosuppressive therapy before avacopan. In the pre-index period, 54.5% had kidney involvement, including chronic kidney disease/end-stage kidney disease (ESKD; 40.7%), glomerulonephritis (26.1%), proteinuria (22.3%), hematuria (21.5%), or dialysis (3.4%). Pulmonary (56.5%), constitutional (40.9%), and ear, nose, or throat (34.4%) involvement was also commonly observed.

Conclusion

Among initial users of avacopan in the US, most had kidney (including ESKD and dialysis) and pulmonary involvement, and used GCs in the year before starting avacopan. Future studies will assess outcomes following treatment with avacopan in a real-world setting.

Funding

  • Commercial Support – Amgen