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Abstract: SA-PO0829

Addition of Avacopan to the Standard Care of Patients with Pauci-Immune Glomerulonephritis Is Associated with Higher Remission Rates During the First Year Following Diagnosis

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Lionaki, Sophia, Department of Nephrology, 2nd of Internal Medicine, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • Tsoumpou, Ioanna, Department of Nephrology, 2nd of Internal Medicine, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • Gkalitsiou, Dimitra, Department of Nephrology General Hospital "G. Gennimatas", Athens, Greece
  • Skalioti, Chrysanthi, Department of Nephrology and Transplantation National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
  • Koukoulaki, Maria, Nephrology Department, General Hospital of Nikaia-Piraeus, Athens, Greece
  • Papasotiriou, Marios, Department of Nephrology and Kidney Transplantation, University Hospital of Patras, Patra, Greece
  • Papachristou, Evangelos, Department of Nephrology and Kidney Transplantation, University Hospital of Patras, Patra, Greece
  • Gkika, Louiza, Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece
  • Ntounousi, Evaggelia, Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece
  • Zermpala, Synodi, Nephrology Department, General Hospital of Nikaia-Piraeus, Athens, Greece
  • Moustakas, Georgios, Department of Nephrology General Hospital "G. Gennimatas", Athens, Greece
  • Petrakis, Ioannis, Department of Nephrology, University Hospital of Heraklion, Crete, Greece
  • Stylianou, Konstantinos, Department of Nephrology, University Hospital of Heraklion, Crete, Greece
  • Spanos, Georgios, Department of Nephrology, General Hospital Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
  • Bamichas, Gerasimos Ioannis, Department of Nephrology, General Hospital Thessaloniki "G. Papanikolaou", Thessaloniki, Greece
  • Stefanidis, Ioannis, Department of Nephrology, University Hospital of Thessaly, Thessaly, Greece
  • Marinaki, Smaragdi, Department of Nephrology and Transplantation National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
Background

The addition of avacopan to the standard of care,cyclophosphamide or rituximab with glucocorticoids,of pauci-immune glomerulonephritis and vasculitis aims to improve disease outcomes and reduce side effects of therapy by minimizing the cumulative exposure to glucocorticoids.The goal of this study was to compare the clinical characteristics and outcomes of patients who received avacopan in addition to standard therapy to those who did not.

Methods

A retrospective, multicenter study of patients with biopsy-confirmed PIGN, who were categorized based on the addition of avacopan or not to standard treatment. Demographics, histopathological findings,clinical characteristics,labs and outcomes were recorded.The standard of care for induction therapy included the combination of glucocorticoids with cyclophosphamide or rituximab.
Outcomes of interest included treatment resistance, relapse, ESKD and death.

Results

225 patients were studied with an average age of 58.2 years,113(50.2%) men,209(92.9%) ANCA-positive,156 (74.6%) had P/MPO-ANCA,with a BVAS of 14.7 (±5.7),36(14.2%) required acute dialysis. 28(12.4%) received avacopan. Within of 12.7 months from the KBx, 92.85% in the avacopan group achieved remission compared to 75.85% of those who received only the standard treatment

Conclusion

The addition of avacopan to the standard of care of patients with PIGN seems to be associated with higher remission rates during the 1st year, compared to the rates of patients who did not receive avacopan.

Digital Object Identifier (DOI)