Undisclosed changes to primary end point assessments following database lock and trial unblinding
Target Population
Patients with newly diagnosed or relapsing granulomatosis with polyangiitis or microscopic polyangiitis
Care Setting
Clinical trial setting
Key Highlights
The NEJM retracted the article evaluating avacopan due to undisclosed changes in primary end point assessments.
The FDA proposed withdrawing approval of Tavneos (avacopan) based on new information from an investigation.
The original analysis of the pivotal clinical study allegedly did not support the drug's effectiveness.
The ADVOCATE trial involved 331 patients and compared avacopan to a tapering regimen of prednisone.
The retraction follows a correction regarding glucocorticoid dose conversions published in January 2024.
Guideline-Based Recommendations
Diagnosis
Management
Health care professionals should discuss available treatment options with patients regarding Tavneos.
Monitoring & Follow-up
Risks
Potential manipulation of study results by unblinded personnel.
Patient & Prescribing Data
Patients with granulomatosis with polyangiitis or microscopic polyangiitis.
Avacopan was reported as noninferior to prednisone for remission at week 26 and superior for sustained remission at week 52, but these findings are now retracted.
Clinical Best Practices
Ensure transparency in clinical trial reporting and endpoint assessments.
Monitor ongoing FDA evaluations regarding drug approvals.
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