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Avacopan: An Oral Complement 5a Inhibitor for ANCA-associated Vasculitis
Journal article   Open access

Avacopan: An Oral Complement 5a Inhibitor for ANCA-associated Vasculitis

Matthew J Mandell, Gatr-Alnada Gheriani, Aleksander Lenert and Petar S Lenert
Rheumatology, Vol.1(1), p.23
2022
DOI: 10.17925/RMD.2022.1.1.23
url
https://doi.org/10.17925/rmd.2022.1.1.23View
Published (Version of record) Open Access

Abstract

The oral complement 5a receptor antagonist, avacopan, was recently studied in phase II and III clinical trials in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This article summarizes the study findings and considers the implications for future care of patients with AAV. Avacopan was proven to be safe and noninferior to glucocorticoids for AAV in a study where patients with severe newly diagnosed or relapsing AAV were initially treated with either rituximab or cyclophosphamide. Greater improvement in the glomerular filtration rate, reduced numbers of relapses and better health-related quality of life were observed in the avacopan group compared with the prednisone group. Patients in the avacopan group also had fewer glucocorticoid-associated adverse events and, despite complement inhibition, there were no cases of Neisseria meningitidis infection reported in either group. Future studies should address the long-term safety of avacopan and whether it can completely replace glucocorticoids in AAV-induction protocols and for the management of minor disease relapses.

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