Kidney Week

Abstract: FR-PO0675

Glucocorticoid (GC)-Associated Conditions in Patients with Granulomatosis with Polyangiitis (GPA) and Microscopic Polyangiitis (MPA) with Prolonged Moderate-to-High (M/H) Dose GC Use

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - ANCA/FSGS
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Geetha, Duvuru, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Duvuru Geetha, MD, MBBS, FASN

• Mirkovic, Kelsey, Amgen Inc, Thousand Oaks, California, United States

Kelsey Mirkovic, PhD

• Pham, Phuong, Amgen Inc, Thousand Oaks, California, United States

Phuong Pham, PhD

• Oh, Sam S., Amgen Inc, Thousand Oaks, California, United States

Sam S. Oh, PhD, MPH

• Wallace, Zachary, Amgen Inc, Thousand Oaks, California, United States

Zachary Wallace, MD, MS, MSc

• Stone, John H., Massachusetts General Hospital, Boston, Massachusetts, United States

John H. Stone, MD, MPH

Background

GPA and MPA treatment usually involves rituximab (RTX) or cyclophosphamide (CYC) with GCs. Clinical guidelines recommend minimizing GC use due to significant toxicity, although some patients (pts) still need them for disease control. In this study, we conducted a retrospective claims-based analysis to characterize M/H GC use beyond 6 months (mo) and incidence of GC-associated toxicities in pts with GPA or MPA.

Methods

This study included adults (≥18 years old) with a new GPA/MPA diagnosis treated with RTX or CYC, who had 12 mo of available data before and after the first RTX or CYC date in MarketScan claims database (study period: 10/1/15 to 7/31/25). Incidence of GC-associated events during the 12-mo follow-up was compared between pts with M/H dose GC (≥7.5 mg prednisone-equivalent daily dose) during mo 7-9 (^M/HGC_7-9) and mo 10-12 (^M/HGC_10-12) vs those without.

Results

620 pts met eligibility criteria (mean age: 53.6 years; female: 59.5%; glomerulonephritis: 29.8%); 94 (15.2%) pts had ^M/HGC_7-9 and 45 (7.3%) had ^M/HGC_10-12. During follow-up, more pts with ^M/HGC_7-9 and ^M/HGC_10-12 vs those without had ≥3 unique events/pt (15 [16.0%] vs 48 [9.1%] and 10 [22.2%] vs 53 [9.2%], respectively; Table). Pts with ^M/HGC_7-9 and ^M/HGC_10-12 vs those without had higher rates of infections (pooled rate per 1000 at-risk opportunities [PRP1000]: 170.21 vs 89.35 [P<0.001] and 211.11 vs 93.04 [P<0.001], respectively). Pts with ^M/HGC_10-12 also had higher rates of metabolic and neuropsychiatric events (PRP1000: 67.96 vs 29.92 [P=0.003] and 40.46 vs 18.15 [P=0.04], respectively).

Conclusion

M/H GC use was associated with higher rates of GC-associated toxicities during follow-up. Strategies to minimize the need for GC exposure may improve outcomes in pts with GPA or MPA.

Acknowledgment

Amgen funded this retrospective claims-based analysis. Writing support was funded by Amgen Inc. and provided by Martha Mutomba, PhD, on behalf of Amgen Inc.