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Abstract: SA-OR086

Sibeprenlimab for the Treatment of IgAN: VISIONARY Phase 3 Interim and Prespecified Subgroup Analyses

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Perkovic, Vlado, University of New South Wales, Sydney, New South Wales, Australia
  • Barratt, Jonathan, University of Leicester, Leicester, England, United Kingdom
  • Lafayette, Richard A., Stanford Medicine, Stanford, California, United States
  • Liew, Adrian, The Kidney and Transplant Practice, Singapore, Singapore
  • Suzuki, Yusuke, Juntendo University Faculty of Medicine, Tokyo, Japan
  • Carroll, Kevin, KJC Statistics, Ltd, Cheadle, United Kingdom
  • Cheung, Chee Kay, University of Leicester, Leicester, England, United Kingdom
  • Tesar, Vladimir, Univerzita Karlova, Prague, Czechia
  • Trimarchi, Hernan, Hospital Britanico de Buenos Aires, Buenos Aires, Argentina
  • Wong, Muh Geot, Concord Repatriation General Hospital, Concord, New South Wales, Australia
  • Zhang, Hong, Peking University First Hospital Department of Nephrology, Beijing, China
  • Xia, Jing, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey, United States
  • Fajardo, Cecile, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey, United States
  • Shah, Lokesh N., Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey, United States
  • Hafkin, Jeffrey, Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, New Jersey, United States
  • Rizk, Dana V., The University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
Background

In a prespecified interim analysis of VISIONARY, sibeprenlimab led to a 51.2% (P<0.0001) placebo (PBO)-adjusted reduction in uPCR-24h at 9 mos. We report on uPCR-24h, disease activity, and biomarkers through 12 mos of treatment and across prespecified subgroups.

Methods

VISIONARY, a phase 3 double-blind, PBO-controlled trial (NCT05248646), randomized adults with IgAN on supportive therapy 1:1 to SC sibeprenlimab 400 mg or PBO Q4W. uPCR-24h reduction and remission, hematuria, serum immunoglobulins, APRIL, Gd-IgA1, and safety were assessed for up to 12 mos. uPCR-24h responses were assessed across subgroups (demographics, screening uPCR-24h, eGFR, SGLT2i use, and prior immunosuppression).

Results

Greater reductions in uPCR-24h (54.3% PBO-adjusted) and spot uPCR were observed at 12 mos with sibeprenlimab vs PBO. Sibeprenlimab substantially reduced serum immunoglobulins, Gd-IgA1, APRIL, and rates of hematuria, and achieved higher rates of proteinuric remission (34.3%) vs PBO (12.7%). At 9 mos, uPCR-24h reduction was consistent across subgroups, including SGLT2i use. No deaths occurred; safety was comparable between groups.

Conclusion

Sibeprenlimab reduced proteinuria and biomarkers and led to higher rates of hematuric/proteinuric remission up to 12 mos, with favorable safety; benefits were consistent across subgroups. VISIONARY is ongoing, evaluating sibeprenlimab’s safety and efficacy (eGFR) over 24 mos.

Funding

  • Commercial Support – Otsuka Pharmaceutical Development & Commercialization, Inc. (Princeton, NJ, USA)

Digital Object Identifier (DOI)