A Phase 3 Clinical Trial of CCX168 (Avacopan) in Patients With ANCA-Associated Vasculitis (ADVOCATE)
Primary Purpose
ANCA-Associated Vasculitis
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Avacopan
Prednisone
Cyclophosphamide
Rituximab
Azathioprine
Sponsored by
About this trial
This is an interventional treatment trial for ANCA-Associated Vasculitis focused on measuring ANCA-associated vasculitis, complement, vasculitis, C5aR, avacopan, CCX168, MPA, GPA
Eligibility Criteria
Inclusion Criteria:
- Clinical diagnosis of granulomatosis with polyangiitis (Wegener's) or microscopic polyangiitis
- Male and female subjects, aged at least 18 years, with newly-diagnosed or relapsed associated vasculitis (AAV) where treatment with cyclophosphamide or rituximab is needed; where approved by Regulatory Agencies, adolescents (12-17 year old) may be enrolled
- Use of adequate contraception
- Positive test for anti-proteinase 3 (PR3) or anti-myeloperoxidase (MPO)
- At least 1 major item, or at least 3 non-major items, or at least the 2 renal items of proteinuria and hematuria on Birmingham Vasculitis Activity Score (BVAS)
- Estimated glomerular filtration rate ≥15 mL/minute/1.73 m^2 at screening
Exclusion Criteria:
- Pregnant or breast-feeding
- Alveolar hemorrhage requiring pulmonary ventilation support at screening
- Any other known multi-system autoimmune disease
- Required dialysis or plasma exchange within 12 weeks prior to screening
- Have a kidney transplant
- Received cyclophosphamide within 12 weeks prior to screening; if on azathioprine, mycophenolate mofetil or methotrexate at the time of screening, these drugs must be withdrawn prior to receiving the cyclophosphamide or rituximab dose on Day 1
- Received intravenous glucocorticoids, >3000 mg methylprednisolone equivalent, within 4 weeks prior to screening
- Have been taking an oral daily dose of a glucocorticoid of more than 10 mg prednisone-equivalent for more than 6 weeks continuously prior to screening
- Received rituximab or other B-cell antibody within 52 weeks of screening or 26 weeks provided B cell reconstitution has occurred (i.e., CD19 count > 0.01x10^9/L); received anti-tumor necrosis factor (TNF) treatment, abatacept, alemtuzumab, intravenous immunoglobulin (IVIg), belimumab, tocilizumab, or eculizumab within 12 weeks prior to screening
- For patients scheduled to receive cyclophosphamide treatment, urinary outflow obstruction, active infection (especially varicella zoster infection), or platelet count <50,000/μL before start of dosing
- Participated previously in a CCX168 study
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Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
Prednisone group
Avacopan group
Arm Description
Avacopan-matching placebo plus cyclophosphamide/azathioprine or rituximab plus a full starting dose of prednisone.
Avacopan plus cyclophosphamide/azathioprine or rituximab plus prednisone-matching placebo.
Outcomes
Primary Outcome Measures
Percentage of Subjects Achieving Disease Remission at Week 26
Disease remission at Week 26 was defined as:
Achieving a BVAS of 0 as determined by the Adjudication Committee;
No administration of glucocorticoids given for ANCA-associated vasculitis within 4 weeks prior to Week 26;
No BVAS >0 during the 4 weeks prior to Week 26 (if collected for an unscheduled assessment).
Percentage of Subjects Achieving Sustained Disease Remission at Week 52
Sustained remission at Week 52 was defined as:
Disease remission at Week 26 as defined above;
Disease remission at Week 52 defined as a BVAS of 0 at Week 52 as determined by the Adjudication Committee and no administration of glucocorticoids for treatment of ANCA-associated vasculitis within 4 weeks prior to Week 52;
No disease relapse between Week 26 and Week 52 as determined by the Adjudication Committee.
Secondary Outcome Measures
Subject Incidence of Treatment-emergent SAEs, AEs, and Withdrawals Due to AEs
AEs=Adverse events
SAEs=Serious adverse events
TEAE=Treatment-emergent adverse event
Glucocorticoid-induced Toxicity as Measured by Change From Baseline Over the First 26 Weeks in the GTI
GTI-CWS=Glucocorticoid Toxicity Index Cumulative Worsening Score;
GTI-AIS=Glucocorticoid Toxicity Index Aggregate Improvement Score;
The Glucocorticoid Toxicity Index (GTI) was developed to score glucocorticoid toxicity. The GTI includes: the Cumulative Worsening Score (CWS) that captures cumulative toxicity, both permanent and transient, over the course of time (serves as a cumulative record of toxicity); and the Aggregate Improvement Score that captures both improvement and worsening of toxicity over time (serves as a record of both improving and worsening toxicity). Both scores range from 0 (best health) to 100 (worst health).
Percentage of Participants With BVAS of 0 at Week 4, Regardless of Whether the Subjects Received Glucocorticoids During This Period of Time and Based on Assessment by the Blinded AC
AC=Adjudication Committee; BVAS=Birmingham Vasculitis Activity Score;
The BVAS form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health).
Change From Baseline Over 52 Weeks in Health-related Quality of Life as Measured by the Domains and Component Scores of the SF-36v2 and EQ-5D-5L VAS and Index
SF-36v2: Measure of health- related quality of life (Medical Outcomes Survey Short Form-36 version 2)
EQ-5D-5L: EuroQuality of Life-5 Domains-5 Levels
The SF-36v2 component scores and the EQ-5D-5L VAS score range from 0 (worst health) to 100 (best health). The EQ-5D-5L Index Score ranges from 0 (worst health) to 1 (best health).
Percentage of Subjects and Time to Experiencing a Relapse After Previously Achieving Remission at Week 26 in the Study
The median time to relapse was not estimable because of small number of relapsed subjects.
A relapse was defined as occurrence of at least one major item in the BVAS, or three or more minor items in the BVAS, or one or two minor items in the BVAS recorded at two consecutive visits, after:
having achieved remission at Week 26 (BVAS=0 and no glucocorticoids for ANCA-associated vasculitis within 4 weeks) or
having achieved BVAS=0 at any time during the treatment period
ANCA=anti-neutrophil cytoplasmic autoantibody; BVAS=Birmingham Vasculitis Activity Score; The BVAS form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health).
Percentage of Subjects and Time to Experiencing a Relapse After Previously Achieving BVAS=0 at Any Time During the Treatment Period
The median time to relapse was not estimable because of small number of relapsed subjects.
A relapse was defined as occurrence of at least one major item in the BVAS, or three or more minor items in the BVAS, or one or two minor items in the BVAS recorded at two consecutive visits, after:
having achieved remission at Week 26 (BVAS=0 and no glucocorticoids for ANCA-associated vasculitis within 4 weeks) or
having achieved BVAS=0 at any time during the treatment period
The Birmingham Vasculitis Activity Score (BVAS) form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health).
In Subjects With Renal Disease at Baseline (Based in the BVAS Renal Component), the Change in eGFR From Baseline Over 52 Weeks
Change from baseline in kidney function, as measured by eGFR (based on the MDRD equation), was measured in subjects with renal disease based on the BVAS renal component.
eGFR=estimated glomerular filtration rate
BVAS=Birmingham Vasculitis Activity Score
MDRD=Modification of Diet in Renal Disease
In Subjects With Renal Disease and Albuminuria at Baseline (Based in the BVAS Renal Component), the Percent Change in UACR From Baseline Over 52 Weeks
BVAS=Birmingham Vasculitis Activity Score
UACR=Urinary albumin:creatinine ratio
In Subjects With Renal Disease at Baseline (Based in the BVAS Renal Component), the Percent Change in Urinary MCP-1:Creatinine Ratio From Baseline Over 52 Weeks
BVAS=Birmingham Vasculitis Activity Score
MCP-1=monocyte chemoattractant protein-1
Change in the VDI From Baseline Over 52 Weeks, Including the Week 26 and Week 52 Time Points
VDI=Vasculitis Damage Index; The VDI is comprised of 64 items of damage, grouped into 11 organ-based systems or categorizations. Damage is defined as the presence of non-healing scars and does not give any indication of current disease activity. Damage is also defined as having been present or currently present for at least 3 months. Completion of the form provides a numerical score, which ranges from 0 (best health) to 64 (worst health).
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (1/5)
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (2/5)
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (3/5)
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (4/5)
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (5/5)
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Serum Chemistry (1/2)
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Serum Chemistry (2/2)
Change From Baseline in Vital Signs (1/5)
Change From Baseline in Vital Signs (2/5)
Change From Baseline in Vital Signs (3/5)
Change From Baseline in Vital Signs (4/5)
Change From Baseline in Vital Signs (5/5)
BMI=Body Mass Index
Number of Subjects With Clinically Significant ECG Changes From Baseline
Clinical significance was assessed by the individual reading of the ECGs
ECG=Electrocardiogram
Number of Subjects Where a Relationship Between Avacopan/Placebo, Glucocorticoid Use, Cyclophosphamide, Rituximab, and Azathioprine or Mycophenolate Use to an AE Was Determined by the Investigator
AE=Adverse Event
Certain Safety Endpoints of Interest: Infections, Hepatic System Abnormalities, WBC Count Decreases, and Hypersensitivity
WBC=White Blood Cell
TEAE=Treatment-Emergent Adverse Event
Number of Subjects Experiencing a Relapse After Previously Achieving BVAS=0 During the Study
BVAS=Birmingham Vasculitis Activity Score;
A relapse was defined as occurrence of at least one major item in the BVAS, or three or more minor items in the BVAS, or one or two minor items in the BVAS recorded at two consecutive visits, after:
having achieved remission at Week 26 (BVAS=0 and no glucocorticoids for ANCA-associated vasculitis within 4 weeks) or
having achieved BVAS=0 at any time during the treatment period
The BVAS form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health).
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02994927
Brief Title
A Phase 3 Clinical Trial of CCX168 (Avacopan) in Patients With ANCA-Associated Vasculitis
Acronym
ADVOCATE
Official Title
A Randomized, Double-Blind, Active-Controlled, Phase 3 Study to Evaluate the Safety and Efficacy of CCX168 (Avacopan) in Patients With ANCA-Associated Vasculitis Treated Concomitantly With Rituximab or Cyclophosphamide/Azathioprine
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
March 15, 2017 (Actual)
Primary Completion Date
September 7, 2019 (Actual)
Study Completion Date
November 1, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ChemoCentryx
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The primary objective is to evaluate the efficacy of CCX168 (avacopan) to induce and sustain remission in patients with active anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), when used in combination with cyclophosphamide followed by azathioprine, or in combination with rituximab.
Detailed Description
Complement 5a and its receptor C5aR (CD88) are involved in the pathogenesis of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis.
This is a randomized, double-blind, active-controlled Phase 3 study to evaluate the safety and efficacy of the orally-administered, selective C5aR inhibitor CCX168 (avacopan) in inducing and sustaining remission in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) treated concomitantly with Rituximab or Cyclophosphamide/Azathioprine.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
ANCA-Associated Vasculitis
Keywords
ANCA-associated vasculitis, complement, vasculitis, C5aR, avacopan, CCX168, MPA, GPA
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
This study was double-blind, double-dummy, i.e., placebo capsules were identical in appearance to the avacopan capsules, and prednisone capsules also had matching placebo capsules. To maintain the blind, multiple measures were taken (i.e., randomization code was not accessible to study personnel who had contact with study centers or who were involved in data management and analysis for the duration of the study).
Allocation
Randomized
Enrollment
331 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Prednisone group
Arm Type
Active Comparator
Arm Description
Avacopan-matching placebo plus cyclophosphamide/azathioprine or rituximab plus a full starting dose of prednisone.
Arm Title
Avacopan group
Arm Type
Experimental
Arm Description
Avacopan plus cyclophosphamide/azathioprine or rituximab plus prednisone-matching placebo.
Intervention Type
Drug
Intervention Name(s)
Avacopan
Other Intervention Name(s)
CCX168
Intervention Description
Avacopan 30 mg twice daily orally for 52 weeks (364 days):
- Three 10 mg avacopan capsules in the morning, preferably with food, and three in the evening, preferably with food, approximately 12 hours after the morning dose.
Oral prednisone-matching placebo tapering regimen over 20 weeks (140 days):
Prednisone-matching placebo capsules equivalent to 60 mg per day if the subject's body weight was ≥55 kg, or 45 mg per day if the subject's body weight was <55 kg, starting on Day 1 with tapering according to a protocol-specified schedule.
Adolescents who weighed ≤37 kg started at a prednisone-matching placebo dose of 30 mg per day.
Intervention Type
Drug
Intervention Name(s)
Prednisone
Intervention Description
Avacopan-matching placebo twice daily orally for 52 weeks (364 days):
- Three avacopan-matching placebo capsules in the morning, preferably with food, and three in the evening, preferably with food, approximately 12 hours after the morning dose.
Oral prednisone tapering regimen over 20 weeks (140 days):
Prednisone 60 mg per day if the subject's body weight was ≥55 kg, or 45 mg per day if the subject's body weight was <55 kg, starting on Day 1 with tapering according to the protocol-specified schedule.
Adolescents who weighed ≤37 kg started at a prednisone dose of 30 mg per day.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Intervention Description
Orally or intravenously administered
Intervention Type
Biological
Intervention Name(s)
Rituximab
Intervention Description
Intravenously administered
Intervention Type
Drug
Intervention Name(s)
Azathioprine
Intervention Description
Orally administered
Primary Outcome Measure Information:
Title
Percentage of Subjects Achieving Disease Remission at Week 26
Description
Disease remission at Week 26 was defined as:
Achieving a BVAS of 0 as determined by the Adjudication Committee;
No administration of glucocorticoids given for ANCA-associated vasculitis within 4 weeks prior to Week 26;
No BVAS >0 during the 4 weeks prior to Week 26 (if collected for an unscheduled assessment).
Time Frame
Week 26
Title
Percentage of Subjects Achieving Sustained Disease Remission at Week 52
Description
Sustained remission at Week 52 was defined as:
Disease remission at Week 26 as defined above;
Disease remission at Week 52 defined as a BVAS of 0 at Week 52 as determined by the Adjudication Committee and no administration of glucocorticoids for treatment of ANCA-associated vasculitis within 4 weeks prior to Week 52;
No disease relapse between Week 26 and Week 52 as determined by the Adjudication Committee.
Time Frame
Week 52
Secondary Outcome Measure Information:
Title
Subject Incidence of Treatment-emergent SAEs, AEs, and Withdrawals Due to AEs
Description
AEs=Adverse events
SAEs=Serious adverse events
TEAE=Treatment-emergent adverse event
Time Frame
From day 1 throughout the study period (day 421/week 60)
Title
Glucocorticoid-induced Toxicity as Measured by Change From Baseline Over the First 26 Weeks in the GTI
Description
GTI-CWS=Glucocorticoid Toxicity Index Cumulative Worsening Score;
GTI-AIS=Glucocorticoid Toxicity Index Aggregate Improvement Score;
The Glucocorticoid Toxicity Index (GTI) was developed to score glucocorticoid toxicity. The GTI includes: the Cumulative Worsening Score (CWS) that captures cumulative toxicity, both permanent and transient, over the course of time (serves as a cumulative record of toxicity); and the Aggregate Improvement Score that captures both improvement and worsening of toxicity over time (serves as a record of both improving and worsening toxicity). Both scores range from 0 (best health) to 100 (worst health).
Time Frame
Baseline, Week 13 and 26
Title
Percentage of Participants With BVAS of 0 at Week 4, Regardless of Whether the Subjects Received Glucocorticoids During This Period of Time and Based on Assessment by the Blinded AC
Description
AC=Adjudication Committee; BVAS=Birmingham Vasculitis Activity Score;
The BVAS form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health).
Time Frame
Week 4
Title
Change From Baseline Over 52 Weeks in Health-related Quality of Life as Measured by the Domains and Component Scores of the SF-36v2 and EQ-5D-5L VAS and Index
Description
SF-36v2: Measure of health- related quality of life (Medical Outcomes Survey Short Form-36 version 2)
EQ-5D-5L: EuroQuality of Life-5 Domains-5 Levels
The SF-36v2 component scores and the EQ-5D-5L VAS score range from 0 (worst health) to 100 (best health). The EQ-5D-5L Index Score ranges from 0 (worst health) to 1 (best health).
Time Frame
Baseline, Week 26 and 52
Title
Percentage of Subjects and Time to Experiencing a Relapse After Previously Achieving Remission at Week 26 in the Study
Description
The median time to relapse was not estimable because of small number of relapsed subjects.
A relapse was defined as occurrence of at least one major item in the BVAS, or three or more minor items in the BVAS, or one or two minor items in the BVAS recorded at two consecutive visits, after:
having achieved remission at Week 26 (BVAS=0 and no glucocorticoids for ANCA-associated vasculitis within 4 weeks) or
having achieved BVAS=0 at any time during the treatment period
ANCA=anti-neutrophil cytoplasmic autoantibody; BVAS=Birmingham Vasculitis Activity Score; The BVAS form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health).
Time Frame
Week 52
Title
Percentage of Subjects and Time to Experiencing a Relapse After Previously Achieving BVAS=0 at Any Time During the Treatment Period
Description
The median time to relapse was not estimable because of small number of relapsed subjects.
A relapse was defined as occurrence of at least one major item in the BVAS, or three or more minor items in the BVAS, or one or two minor items in the BVAS recorded at two consecutive visits, after:
having achieved remission at Week 26 (BVAS=0 and no glucocorticoids for ANCA-associated vasculitis within 4 weeks) or
having achieved BVAS=0 at any time during the treatment period
The Birmingham Vasculitis Activity Score (BVAS) form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health).
Time Frame
Week 52
Title
In Subjects With Renal Disease at Baseline (Based in the BVAS Renal Component), the Change in eGFR From Baseline Over 52 Weeks
Description
Change from baseline in kidney function, as measured by eGFR (based on the MDRD equation), was measured in subjects with renal disease based on the BVAS renal component.
eGFR=estimated glomerular filtration rate
BVAS=Birmingham Vasculitis Activity Score
MDRD=Modification of Diet in Renal Disease
Time Frame
Baseline, Week 26 and 52
Title
In Subjects With Renal Disease and Albuminuria at Baseline (Based in the BVAS Renal Component), the Percent Change in UACR From Baseline Over 52 Weeks
Description
BVAS=Birmingham Vasculitis Activity Score
UACR=Urinary albumin:creatinine ratio
Time Frame
Baseline, Week 4, 26 and 52
Title
In Subjects With Renal Disease at Baseline (Based in the BVAS Renal Component), the Percent Change in Urinary MCP-1:Creatinine Ratio From Baseline Over 52 Weeks
Description
BVAS=Birmingham Vasculitis Activity Score
MCP-1=monocyte chemoattractant protein-1
Time Frame
Baseline, Week 26 and 52
Title
Change in the VDI From Baseline Over 52 Weeks, Including the Week 26 and Week 52 Time Points
Description
VDI=Vasculitis Damage Index; The VDI is comprised of 64 items of damage, grouped into 11 organ-based systems or categorizations. Damage is defined as the presence of non-healing scars and does not give any indication of current disease activity. Damage is also defined as having been present or currently present for at least 3 months. Completion of the form provides a numerical score, which ranges from 0 (best health) to 64 (worst health).
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (1/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (2/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (3/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (4/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Hematology (5/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Serum Chemistry (1/2)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline and Shifts From Baseline in All Safety Laboratory Parameters - Serum Chemistry (2/2)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline in Vital Signs (1/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline in Vital Signs (2/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline in Vital Signs (3/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline in Vital Signs (4/5)
Time Frame
Baseline, Week 26 and 52
Title
Change From Baseline in Vital Signs (5/5)
Description
BMI=Body Mass Index
Time Frame
Baseline, Week 26 and 52
Title
Number of Subjects With Clinically Significant ECG Changes From Baseline
Description
Clinical significance was assessed by the individual reading of the ECGs
ECG=Electrocardiogram
Time Frame
From day 1 throughout the study period (day 421/week 60)
Title
Number of Subjects Where a Relationship Between Avacopan/Placebo, Glucocorticoid Use, Cyclophosphamide, Rituximab, and Azathioprine or Mycophenolate Use to an AE Was Determined by the Investigator
Description
AE=Adverse Event
Time Frame
From day 1 throughout the study period (day 421/week 60)
Title
Certain Safety Endpoints of Interest: Infections, Hepatic System Abnormalities, WBC Count Decreases, and Hypersensitivity
Description
WBC=White Blood Cell
TEAE=Treatment-Emergent Adverse Event
Time Frame
From day 1 throughout the study period (day 421/week 60)
Title
Number of Subjects Experiencing a Relapse After Previously Achieving BVAS=0 During the Study
Description
BVAS=Birmingham Vasculitis Activity Score;
A relapse was defined as occurrence of at least one major item in the BVAS, or three or more minor items in the BVAS, or one or two minor items in the BVAS recorded at two consecutive visits, after:
having achieved remission at Week 26 (BVAS=0 and no glucocorticoids for ANCA-associated vasculitis within 4 weeks) or
having achieved BVAS=0 at any time during the treatment period
The BVAS form is divided into 9 organ-based systems, with each section including symptoms/signs that are typical of that particular organ involvement in systemic vasculitis. The clinician only scores features believed to be due to active vasculitis. Completion of the form provides a numerical score, which ranges from 0 (best health) to 63 (worst health).
Time Frame
From day 1 throughout the study period (day 421/week 60)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Clinical diagnosis of granulomatosis with polyangiitis (Wegener's) or microscopic polyangiitis
Male and female subjects, aged at least 18 years, with newly-diagnosed or relapsed associated vasculitis (AAV) where treatment with cyclophosphamide or rituximab is needed; where approved by Regulatory Agencies, adolescents (12-17 year old) may be enrolled
Use of adequate contraception
Positive test for anti-proteinase 3 (PR3) or anti-myeloperoxidase (MPO)
At least 1 major item, or at least 3 non-major items, or at least the 2 renal items of proteinuria and hematuria on Birmingham Vasculitis Activity Score (BVAS)
Estimated glomerular filtration rate ≥15 mL/minute/1.73 m^2 at screening
Exclusion Criteria:
Pregnant or breast-feeding
Alveolar hemorrhage requiring pulmonary ventilation support at screening
Any other known multi-system autoimmune disease
Required dialysis or plasma exchange within 12 weeks prior to screening
Have a kidney transplant
Received cyclophosphamide within 12 weeks prior to screening; if on azathioprine, mycophenolate mofetil or methotrexate at the time of screening, these drugs must be withdrawn prior to receiving the cyclophosphamide or rituximab dose on Day 1
Received intravenous glucocorticoids, >3000 mg methylprednisolone equivalent, within 4 weeks prior to screening
Have been taking an oral daily dose of a glucocorticoid of more than 10 mg prednisone-equivalent for more than 6 weeks continuously prior to screening
Received rituximab or other B-cell antibody within 52 weeks of screening or 26 weeks provided B cell reconstitution has occurred (i.e., CD19 count > 0.01x10^9/L); received anti-tumor necrosis factor (TNF) treatment, abatacept, alemtuzumab, intravenous immunoglobulin (IVIg), belimumab, tocilizumab, or eculizumab within 12 weeks prior to screening
For patients scheduled to receive cyclophosphamide treatment, urinary outflow obstruction, active infection (especially varicella zoster infection), or platelet count <50,000/μL before start of dosing
Participated previously in a CCX168 study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
MD
Organizational Affiliation
Amgen
Official's Role
Study Director
Facility Information:
Facility Name
Clinical Trial Site
City
Huntsville
State/Province
Alabama
ZIP/Postal Code
35801
Country
United States
Facility Name
Clinical Trial Site
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85012
Country
United States
Facility Name
Clinical Trial Site
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85032
Country
United States
Facility Name
Clinical Trial Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Clinical Trial Site
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Clinical Trial Site
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Clinical Trial Site
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Clinical Trial Site
City
Daytona Beach
State/Province
Florida
ZIP/Postal Code
32117
Country
United States
Facility Name
Clinical Trial Site
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Clinical Trial Site
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Clinical Trial Site
City
Meridian
State/Province
Idaho
ZIP/Postal Code
83605
Country
United States
Facility Name
Clinical Trial Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Clinical Trial Site
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Clinical Trial Site
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
Clinical Trial Site
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536
Country
United States
Facility Name
Clinical Trial Site
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71101
Country
United States
Facility Name
Clinical Trial Site
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21224
Country
United States
Facility Name
Clinical Trial Site
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Clinical Trial Site
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02118
Country
United States
Facility Name
Clinical Trial Site
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Clinical Trial Site
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55414
Country
United States
Facility Name
Clinical Trial Site
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Clinical Trial Site
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Clinical Trial Site
City
Great Neck
State/Province
New York
ZIP/Postal Code
11021
Country
United States
Facility Name
Clinical Trial Site
City
Mineola
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Facility Name
Clinical Trial Site
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Clinical Trial Site
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Clinical Trial Site
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Clinical Trial Site
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Facility Name
Clinical Trial Site
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Clinical Trial Site
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Clinical Trial Site
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Clinical Trial Site
City
Duncansville
State/Province
Pennsylvania
ZIP/Postal Code
16635
Country
United States
Facility Name
Clinical Trial Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Clinical Trial Site
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15225
Country
United States
Facility Name
Clinical Trial Site
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02903
Country
United States
Facility Name
Clinical Trial Site
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29406
Country
United States
Facility Name
Clinical Trial Site
City
Dallas
State/Province
Texas
ZIP/Postal Code
75235
Country
United States
Facility Name
Clinical Trial Site
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Clinical Trial Site
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
Clinical Trial Site
City
Seattle
State/Province
Washington
ZIP/Postal Code
98101
Country
United States
Facility Name
Clinical Trial Site
City
Adelaide
Country
Australia
Facility Name
Clinical Trial Site
City
Auchenflower
Country
Australia
Facility Name
Clinical Trial Site
City
Brisbane
Country
Australia
Facility Name
Clinical Trial Site
City
Clayton
Country
Australia
Facility Name
Clinical Trial Site
City
Concord
Country
Australia
Facility Name
Clinical Trial Site
City
Heidelberg
Country
Australia
Facility Name
Clinical Trial Site
City
Liverpool
Country
Australia
Facility Name
Clinical Trial Site
City
Nambour
Country
Australia
Facility Name
Clinical Trial Site
City
Nedlands
Country
Australia
Facility Name
Clinical Trial Site
City
Randwick
Country
Australia
Facility Name
Clinical Trial Site
City
Saint Albans
Country
Australia
Facility Name
Clinical Trial Site
City
Southport
Country
Australia
Facility Name
Clinical Trial Site
City
St Leonards
Country
Australia
Facility Name
Clinical Trial Site
City
Westmead
Country
Australia
Facility Name
Clinical Trial Site
City
Woolloongabba
Country
Australia
Facility Name
Clinical Trial Site
City
Feldkirch
Country
Austria
Facility Name
Clinical Trial Site
City
Graz
Country
Austria
Facility Name
Clinical Trial Site
City
Innsbruck
Country
Austria
Facility Name
Clinical Trial Site
City
Antwerp
Country
Belgium
Facility Name
Clinical Trial Site
City
Brussels
Country
Belgium
Facility Name
Clinical Trial Site
City
Leuven
Country
Belgium
Facility Name
Clinical Trial Site
City
Liège
Country
Belgium
Facility Name
Clinical Trial Site
City
Calgary
Country
Canada
Facility Name
Clinical Trial Site
City
Greenfield Park
Country
Canada
Facility Name
Clinical Trial Site
City
Hamilton
Country
Canada
Facility Name
Clinical Trial Site
City
Montréal
Country
Canada
Facility Name
Clinical Trial Site
City
Québec
Country
Canada
Facility Name
Clinical Trial Site
City
Sherbrooke
Country
Canada
Facility Name
Clinical Trial Site
City
Toronto
Country
Canada
Facility Name
Clinical Trial Site
City
Vancouver
Country
Canada
Facility Name
Clinical Trial Site
City
Olomouc
Country
Czechia
Facility Name
Clinical Trial Site
City
Praha
Country
Czechia
Facility Name
Clinical Trial Site
City
Aalborg
Country
Denmark
Facility Name
Clinical Trial Site
City
Aarhus
Country
Denmark
Facility Name
Clinical Trial Site
City
Copenhagen
Country
Denmark
Facility Name
Clinical Trial Site
City
Odense
Country
Denmark
Facility Name
Clinical Trial Site
City
Roskilde
Country
Denmark
Facility Name
Clinical Trial Site
City
Angers
Country
France
Facility Name
Clinical Trial Site
City
Bordeaux
Country
France
Facility Name
Clinical Trial Site
City
Boulogne-sur-Mer
Country
France
Facility Name
Clinical Trial Site
City
Brest
Country
France
Facility Name
Clinical Trial Site
City
Bron
Country
France
Facility Name
Clinical Trial Site
City
Caen
Country
France
Facility Name
Clinical Trial Site
City
Colmar
Country
France
Facility Name
Clinical Trial Site
City
Grenoble
Country
France
Facility Name
Clinical Trial Site
City
Marseille
Country
France
Facility Name
Clinical Trial Site
City
Metz
Country
France
Facility Name
Clinical Trial Site
City
Nantes
Country
France
Facility Name
Clinical Trial Site
City
Nîmes
Country
France
Facility Name
Clinical Trial Site
City
Paris
Country
France
Facility Name
Clinical Trial Site
City
Toulouse
Country
France
Facility Name
Clinical Trial Site
City
Valenciennes
Country
France
Facility Name
Clinical Trial Site
City
Aachen
Country
Germany
Facility Name
Clinical Trial Site
City
Bad Bramstedt
Country
Germany
Facility Name
Clinical Trial Site
City
Berlin
Country
Germany
Facility Name
Clinical Trial Site
City
Cologne
Country
Germany
Facility Name
Clinical Trial Site
City
Dresden
Country
Germany
Facility Name
Clinical Trial Site
City
Essen
Country
Germany
Facility Name
Clinical Trial Site
City
Freiburg
Country
Germany
Facility Name
Clinical Trial Site
City
Fulda
Country
Germany
Facility Name
Clinical Trial Site
City
Hamburg
Country
Germany
Facility Name
Clinical Trial Site
City
Hannover
Country
Germany
Facility Name
Clinical Trial Site
City
Heidelberg
Country
Germany
Facility Name
Clinical Trial Site
City
Jena
Country
Germany
Facility Name
Clinical Trial Site
City
Kirchheim unter Teck
Country
Germany
Facility Name
Clinical Trial Site
City
Leipzig
Country
Germany
Facility Name
Clinical Trial Site
City
Ludwigshafen
Country
Germany
Facility Name
Clinical Trial Site
City
Lübeck
Country
Germany
Facility Name
Clinical Trial Site
City
Mannheim
Country
Germany
Facility Name
Clinical Trial Site
City
Munich
Country
Germany
Facility Name
Clinical Trial Site
City
Tuebingen
Country
Germany
Facility Name
Clinical Trial Site
City
Villingen-Schwenningen
Country
Germany
Facility Name
Clinical Trial Site
City
Budapest
Country
Hungary
Facility Name
Clinical Trial Site
City
Debrecen
Country
Hungary
Facility Name
Clinical Trial Site
City
Cork
Country
Ireland
Facility Name
Clinical Trial Site
City
Dublin
Country
Ireland
Facility Name
Clinical Trial Site
City
Ancona
Country
Italy
Facility Name
Clinical Trial Site
City
Firenze
Country
Italy
Facility Name
Clinical Trial Site
City
Genova
Country
Italy
Facility Name
Clinical Trial Site
City
Milano
Country
Italy
Facility Name
Clinical Trial Site
City
Monza
Country
Italy
Facility Name
Clinical Trial Site
City
Parma
Country
Italy
Facility Name
Clinical Trial Site
City
Reggio Emilia
Country
Italy
Facility Name
Clinical Trial Site
City
Torino
Country
Italy
Facility Name
Clinical Trial Site
City
Udine
Country
Italy
Facility Name
Clinical Trial Site
City
Aichi
Country
Japan
Facility Name
Clinical Trial Site
City
Akita
Country
Japan
Facility Name
Clinical Trial Site
City
Chiba
Country
Japan
Facility Name
Clinical Trial Site
City
Hiroshima
Country
Japan
Facility Name
Clinical Trial Site
City
Hokkaido
Country
Japan
Facility Name
Clinical Trial Site
City
Ishikawa
Country
Japan
Facility Name
Clinical Trial Site
City
Kagawa
Country
Japan
Facility Name
Clinical Trial Site
City
Kanagawa
Country
Japan
Facility Name
Clinical Trial Site
City
Kobe
Country
Japan
Facility Name
Clinical Trial Site
City
Miyazaki
Country
Japan
Facility Name
Clinical Trial Site
City
Nagoya
Country
Japan
Facility Name
Clinical Trial Site
City
Okayama
Country
Japan
Facility Name
Clinical Trial Site
City
Osaka
Country
Japan
Facility Name
Clinical Trial Site
City
Saitama
Country
Japan
Facility Name
Clinical Trial Site
City
Shimane
Country
Japan
Facility Name
Clinical Trial Site
City
Shizuoka
Country
Japan
Facility Name
Clinical Trial Site
City
Tokyo
Country
Japan
Facility Name
Clinical Trial Site
City
Toyama
Country
Japan
Facility Name
Clinical Trial Site
City
Yokohama
Country
Japan
Facility Name
Clinical Trial Site
City
Groningen
Country
Netherlands
Facility Name
Clinical Trial Site
City
Leiden
Country
Netherlands
Facility Name
Clinical Trial Site
City
Rotterdam
Country
Netherlands
Facility Name
Clinical Trial Site
City
Christchurch
Country
New Zealand
Facility Name
Clinical Trial Site
City
Dunedin
Country
New Zealand
Facility Name
Clinical Trial Site
City
Grafton
Country
New Zealand
Facility Name
Clinical Trial Site
City
Hamilton
Country
New Zealand
Facility Name
Clinical Trial Site
City
Takapuna
Country
New Zealand
Facility Name
Clinical Trial Site
City
Nordbyhagen
Country
Norway
Facility Name
Clinical Trial Site
City
Oslo
Country
Norway
Facility Name
Clinical Trial Site
City
Tromsø
Country
Norway
Facility Name
Clinical Trial Site
City
Badalona
Country
Spain
Facility Name
Clinical Trial Site
City
Barcelona
Country
Spain
Facility Name
Clinical Trial Site
City
Burela
Country
Spain
Facility Name
Clinical Trial Site
City
Lleida
Country
Spain
Facility Name
Clinical Trial Site
City
Madrid
Country
Spain
Facility Name
Clinical Trial Site
City
San Sebastián
Country
Spain
Facility Name
Clinical Trial Site
City
Linköping
Country
Sweden
Facility Name
Clinical Trial Site
City
Lund
Country
Sweden
Facility Name
Clinical Trial Site
City
Stockholm
Country
Sweden
Facility Name
Clinical Trial Site
City
Uppsala
Country
Sweden
Facility Name
Clinical Trial Site
City
Örebro
Country
Sweden
Facility Name
Clinical Trial Site
City
Basel
Country
Switzerland
Facility Name
Clinical Trial Site
City
Bern
Country
Switzerland
Facility Name
Clinical Trial Site
City
Fribourg
Country
Switzerland
Facility Name
Clinical Trial Site
City
Lausanne
Country
Switzerland
Facility Name
Clinical Trial Site
City
St. Gallen
Country
Switzerland
Facility Name
Clinical Trial Site
City
Zürich
Country
Switzerland
Facility Name
Clinical Trial Site
City
Aberdeen
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Basildon
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Birmingham
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Bristol
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Cambridge
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Canterbury
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Cardiff
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Carshalton
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Dorchester
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Dudley
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Exeter
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Glasgow
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Inverness
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Kirkcaldy
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Leeds
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Leicester
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Liverpool
Country
United Kingdom
Facility Name
Clinical Trial Site
City
London
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Manchester
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Newcastle
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Nottingham
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Oxford
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Reading
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Salford
Country
United Kingdom
Facility Name
Clinical Trial Site
City
Westcliff-on-Sea
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request
IPD Sharing Time Frame
Data sharing requests relating to this study will be considered beginning 18 months after the study has ended and either 1) the product and indication (or other new use) have been granted marketing authorization in both the US and Europe or 2) clinical development for the product and/or indication discontinues and the data will not be submitted to regulatory authorities. There is no end date for eligibility to submit a data sharing request for this study.
IPD Sharing Access Criteria
Qualified researchers may submit a request containing the research objectives, the Amgen product(s) and Amgen study/studies in scope, endpoints/outcomes of interest statistical analysis plan, data requirements, publication plan, and qualifications of the researcher(s). In general, Amgen does not grant external requests for individual patient data for the purpose of re-evaluating safety and efficacy issues already addressed in the product labelling. Requests are reviewed by a committee of internal advisors, and if not approved, may be further arbitrated by a Data Sharing Independent Review Panel. Upon approval, information necessary to address the research question will be provided under the terms of a data sharing agreement. This may include anonymized individual patient data and/or available supporting documents, containing fragments of analysis code where provided in analysis specifications. Further details are available at the URL below.
IPD Sharing URL
http://www.amgen.com/datasharing
Citations:
PubMed Identifier
35482532
Citation
Harigai M, Kaname S, Tamura N, Dobashi H, Kubono S, Yoshida T. Efficacy and safety of avacopan in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis: A subanalysis of a randomized Phase 3 study. Mod Rheumatol. 2023 Mar 2;33(2):338-345. doi: 10.1093/mr/roac037.
Results Reference
derived
PubMed Identifier
35167187
Citation
Soulsby WD. Journal Club Review of "Avacopan for the Treatment of ANCA-Associated Vasculitis". ACR Open Rheumatol. 2022 Jul;4(7):558-561. doi: 10.1002/acr2.11412. Epub 2022 Feb 15.
Results Reference
derived
PubMed Identifier
33596356
Citation
Jayne DRW, Merkel PA, Schall TJ, Bekker P; ADVOCATE Study Group. Avacopan for the Treatment of ANCA-Associated Vasculitis. N Engl J Med. 2021 Feb 18;384(7):599-609. doi: 10.1056/NEJMoa2023386.
Results Reference
derived
PubMed Identifier
32088663
Citation
Merkel PA, Jayne DR, Wang C, Hillson J, Bekker P. Evaluation of the Safety and Efficacy of Avacopan, a C5a Receptor Inhibitor, in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Treated Concomitantly With Rituximab or Cyclophosphamide/Azathioprine: Protocol for a Randomized, Double-Blind, Active-Controlled, Phase 3 Trial. JMIR Res Protoc. 2020 Apr 7;9(4):e16664. doi: 10.2196/16664.
Results Reference
derived
Learn more about this trial
A Phase 3 Clinical Trial of CCX168 (Avacopan) in Patients With ANCA-Associated Vasculitis
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