ÌÇÐÄÔ­´´

ANCA-associated vasculitis (AAV) is a group of autoimmune disorders that involve inflammation of the blood vessels. It is characterized by the presence of antibodies called antineutrophil cytoplasmic antibodies (ANCA). AAV can affect small, medium, and large blood vessels throughout the body, and it can cause a range of symptoms depending on which organs are affected.

Background

ANCA-associated vasculitis (AAV) is a rare autoimmune disease characterised by severe inflammation of blood vessels and often requires intensive treatment. Corticosteroids have traditionally played a central role in the management of AAV, but prolonged exposure can cause substantial morbidity.

In 2022, NICE recommended avacopan (TA825), alongside a cyclophosphamide- or rituximab-based regimen, as an option for treating severe active granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA). Despite its availability within the NHS, there is limited understanding of how avacopan has been used across England and whether access is equitable among patients who may be eligible for treatment.

Led by the RECORDER team at the ÌÇÐÄÔ­´´, in collaboration with the NHS England GIRFT Adult Rheumatology Workstream, this project will evaluate the uptake and equity of access to avacopan in England between 2022 and 2026.

Using retrospective cohort methods, we will analyse national Drug Patient-level Contract Monitoring (DPLCM) data to describe avacopan use, link this with demographic information from NHS England systems, and use population-level data from the Office for National Statistics to provide geographical and socioeconomic context.

Aims

1)  To describe the use of avacopan among people with AAV according to age, sex, ethnicity, socioeconomic status and geographical region.

2) To assess disparities in access to avacopan among patients eligible for treatment, using prior approval for rituximab as a marker of eligibility.