a phase 3 clinical trial of ccx168 (avacopan) in patients with anca-associated vasculitis

Conditions: ANCA-Associated Vasculitis

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.

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. study acquired by amgen and all disclosures were done by previous sponsor chemocentryx.

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to screening; if on azathioprine, mycophenolate mofetil or methotrexate at the time of screening, these drugs must be withdrawn prior to receiving the cyclophosphamide or rituximab dose on day 1 * received intravenous glucocorticoids, \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

Keywords: anca-associated vasculitis complement vasculitis c5ar avacopan ccx168 mpa gpa