ClinicalTrials.gg
RecruitingNCT07176546Updated Sep 2, 2026

TAVNEOS for Otolaryngologic Manifestations of Granulomatosis With Polyangiitis

A Phase 2/3 interventional study of Avacopan and Placebo in Granulomatosis With Polyangiitis, Wegener's and GPA, sponsored by Robert Spiera, MD. Recruiting at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-02.

Sponsored by Robert Spiera, MD · Phase 2/3, Interventional, and Treatment

From the registry’s dates

  • Started May 2026; still recruiting 5 months later.
Phase
Phase 2/3
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a single center double-blind placebo-controlled study. Patients with GPA and active ears, nose, and throat (ENT) disease in at least two ENT domains, as defined after endoscopic visualization of the upper airway and audiometric evaluation, if applicable, by a single otolaryngologist using a validated GPA ENT disease activity score, will be eligible for inclusion. Patients will be treated with standard of care (SOC) treatment as determined by their treating rheumatologist. In addition to SOC, patients will be randomized to receive TAVNEOS 30mg BID or placebo. Patients will be followed for 52 weeks with standardized ENT assessment along with rheumatologic evaluation of overall disease activity with BVAS.

02

Conditions studied

  • Granulomatosis With Polyangiitis
  • Wegener's
  • GPA

Keywords

  • Tavneos
  • avacopan
  • GPA
  • ENT
03

In context

Granulomatosis with Polyangiitis

104 studies on the registry are indexed under Granulomatosis with Polyangiitis; 16 are open to participants now.

This study's planned enrollment of 30 is below the median of 70 across 69 interventional studies indexed under Granulomatosis with Polyangiitis.

Browse Granulomatosis with Polyangiitis studies →

Lead sponsor

This is the only study on the registry with Robert Spiera, MD as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • GPA diagnosis defined by score of ≥5 on 2022 ACR/EULAR Classification Criteria for GPA
  • Active GPA (both newly diagnosed and relapsing disease) in the ENT domain within 1 month prior to screening, where the active disease is defined as a score of ≥2 on a GPA ENT disease activity score (7 items scored as 1= present 0= absent) performed by direct endoscopic visualization of the upper airway and audiometric evaluation, if applicable, by a single expert otolaryngologist. Items included in the GPA ENT disease activity score are:

    • Bloody rhinorrhea (Daily blood stained nasal discharge)
    • Objective stridor (Stridor assessed by doctor)
    • Inflammation on nasal examination (Ulcers, granulation, friable mucosa on rigid nasal endoscopy. Excluding crusting)
    • Inflammation on flexible laryngoscopy (Ulcers, granulation, friable mucosa in the larynx)
    • Inflamed TM*/middle ear (Persistent inflammation or granulation tissue in tympanic membrane/middle ear)
    • Sudden sensorineural hearing loss (30db drop in 3 frequencies within 72 hours)
  • Other ENT/upper airway manifestations of active GPA observed during structured ENT exam including but not limited to lacrimal gland dacryocystitis and endobronchial disease
  • Age 18 and older
  • Willing and able to comply with treatment and follow-up procedures
  • Men and women of must agree to use an acceptable method of during treatment and for twelve months after completion of treatment.
  • Willing and able to provide written
  • Adequate liver function as defined by or ALT \<2x

Exclusion criteria

Exclusion Criteria:

  • Creatinine >4.0mg/dl or \<15 at baseline or dependence on dialysis
  • Respiratory failure requiring mechanical ventilatory support or had experienced alveolar hemorrhage requiring invasive pulmonary ventilation support anticipated to last beyond the screening period of the study
  • Previous treatment with TAVNEOS within 6 months of screening
  • Inability to comply with study and/or follow-up procedures at investigator discretion.
  • Intravenous in the 4 weeks prior to screening except as premedication prior to infusion of rituximab
  • Pregnant or breast-feeding
  • Any other known multi-system disease including eosinophilic granulomatosis with polyangiitis (Churg-Strauss), systemic lupus erythematosus, IgA vasculitis (Henoch-Schonlein), rheumatoid vasculitis, Sjogren's syndrome, anti-glomerular basement membrane disease, or cryoglobulinemic vasculitis
  • Required dialysis or plasma exchange within 12 weeks prior to screening
  • Have had a kidney transplant
  • Any of the following within 12 weeks prior to screening: symptomatic congestive heart failure requiring prescription medication, unstable angina (unless successfully treated with stent or bypass surgery), cardiac arrhythmia, myocardial infarction or stroke
  • History or presence of any form of cancer within the 5 years prior to screening, with the exception of excised basal cell or squamous cell carcinoma of the skin, or carcinoma in situ such as cervical or breast carcinoma in situ that has been excised or resected completely and is without evidence of local recurrence or
  • Evidence of tuberculosis based on interferon gamma release assay (IGRA), tuberculin purified protein derivative (PPD) skin test, or chest radiography (X rays or CT scan) done at screening or within 6 weeks prior to screening
  • , , or viral screening test showing evidence of active or chronic viral infection done at screening or within 6 weeks prior to screening
  • Received a within 4 weeks prior to screening
  • WBC count less than 3500/uL, or less than 1500/uL, or lymphocyte count less than 500/uL before start of dosing
  • Evidence of hepatic disease: , ALT, alkaline phosphatase, or >3 times the before start of dosing
  • Known to avacopan or inactive ingredients of the TAVNEOS capsules
  • Participated in any clinical study of an product within 30 days prior to screening or within 5 half-lives after taking the last dose
  • Participated previously in an TAVNEOS study
  • Concurrent use of strong inducers of the CYP450 ie. carbamazepine, phenobarbital, phenytoin, rifampin, or St. John's wort
  • Known hypersensitivity to avacopan or inactive ingredients of the avacopan capsules (including gelatin, polyethylene glycol, or Cremophor)
  • History or presence of any medical condition or disease which, in the opinion of the Investigator, may place the patient at unacceptable risk for study participation
Terms in these criteria, in plain language(18)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
30 participants (estimated)

Study arms

  • Active comparator
    TAVNEOS

    BID dose of 30 mg TAVNEOS

    Drug: Avacopan

  • Placebo comparator
    Placebo

    BID dose of 30 mg TAVNEOS-matching placebo

    Drug: Placebo

Interventions

  • BID dose of 30 mg TAVNEOS (3-10mg capsules)

    Also known as: TAVNEOS

  • DrugPlacebo

    BID dose of 30mg TAVNEOS-matching placebo (3-10mg capsules)

06

What researchers measure

Primary outcomes

  1. Proportion of patients in ENT remission without relapse

    The proportion of patients in ENT remission without relapse in each treatment group at week 52 with no glucocorticoid (GC) exposure 4 weeks prior to week 52, where ENT remission is defined as a score of 0 on GPA ENT disease activity score

    Time frame: Week 52

Secondary outcomes

  1. Mean ENT disease activity score

    Comparison of mean ENT disease activity scores between treatment groups at week 52

    Time frame: Week 52

  2. Change in ENT disease activity score

    Change in ENT GPA disease activity score between week 26 and week 52

    Time frame: Between week 26 and week 52

  3. Proportion of patients in ENT remission with BVAS 0 at week 52 and sustained remission

    Proportion of patients in remission with BVAS 0 at week 52 and sustained remission from week 26 to week 52 with BVAS 0 and no glucocorticoids for 4 weeks prior to assessment

    Time frame: Week 52

  4. Cumulative steroid dose

    Time frame: Through study completion, an average of 60 weeks

  5. Duration of steroid-free remission

    Time frame: Through study completion, an average of 60 weeks

  6. Change in Vasculitis Damage Index (VDI)

    Change in VDI in the ENT domain at week 52

    Time frame: Week 52

  7. Sino-nasal Outcome Test (SNOT-22)

    Scale 0-110 (Higher score equals worse outcome)

    Time frame: Through study completion, an average of 60 weeks

  8. ANCA-Associated Vasculitis Patient-Reported Outcome (AAV-PRO)

    Scale 0-119 (Higher score equals worse outcome)

    Time frame: Through study completion, an average of 60 weeks

  9. Number of surgical procedures in the ENT domain required

    Number of surgical procedures in the ENT domain required during the study period

    Time frame: Through study completion, an average of 60 weeks

  10. Number of ENT flares

    Number of ENT flares as measured by the rise in GPA ENT DAS (defined by an increase of ≥1 point on the GPA ENT DAS)

    Time frame: Through study completion, an average of 60 weeks

  11. Time to ENT relapse

    Time frame: Through study completion, an average of 60 weeks

  12. Number of GPA flares

    Number of GPA flares as measured by Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS-WG)

    Time frame: Through study completion, an average of 60 weeks

07

Study locations

2 of 2 sites recruiting
  • Hackensack Meridian School of Medicine - Advanced Lung and Airway Center
    Edison, New Jersey 08820, United States
    Recruiting
    • Robert Lebovics, MD · Contactrobert.lebovics@hmhn.org · 732-321-7000
    • Robert Lebovics, MD · Sub investigator
    • Jeffrey Luo · Sub investigator
  • Hospital for Special Surgery
    New York, New York 10021, United States
    Recruiting
    • Liza M Morales, MPH · Contactmoralesli@hss.edu · 212-774-2048
    • Robert F Spiera, MD · Principal investigator
    • Lindsay Lally, MD · Principal investigator
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started May 2026 (actual). Primary completion is estimated for Jul 2030, 50 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 18, 2025
First posted
Sep 16, 2025
StartActual
May 22, 2026
Primary completionEst.
Jul 2030
CompletionEst.
Oct 2030
Last update
Sep 2, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 2, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07176546
Lead sponsor
Robert Spiera, MD
Collaborators
Amgen
Responsible party
Robert Spiera, MD (Principal Investigator, Hospital for Special Surgery, New York) — Sponsor-investigator
First posted
Sep 16, 2025
Start date
May 22, 2026
Primary completion
Jul 2030 (estimated)
Completion
Oct 2030 (estimated)
Last update
Sep 2, 2026

Study contacts

Liza M Morales, MPH
Contact
moralesli@hss.edu
212-774-2048
Robert F Spiera, MD
principal investigator · Hospital for Special Surgery, New York
Lindsay Lally, MD
principal investigator · Hospital for Special Surgery, New York

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Avacopan

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