PMID- 34006155
OWN - NLM
STAT- MEDLINE
DCOM- 20220301
LR  - 20220301
IS  - 1744-8409 (Electronic)
IS  - 1744-666X (Linking)
VI  - 17
IP  - 7
DP  - 2021 Jul
TI  - Avacopan for the treatment of ANCA-associated vasculitis.
PG  - 717-726
LID - 10.1080/1744666X.2021.1932466 [doi]
AB  - Introduction: Anti-neutrophil cytoplasm autoantibodies (ANCA)-associated 
      vasculitides (AAVs) are a group of rare heterogeneous diseases characterized by 
      blood vessel inflammation resulting in organ destruction and death. Although 
      various treatment strategies have resulted in marked improvement in 
      vasculitis-specific outcomes, many patients with AAV continue to suffer from 
      complications related to the prolonged use of glucocorticoids (GC) such as 
      infections, metabolic abnormalities, and increased cardiovascular morbidity. 
      Recently, activation of the alternative complement pathway has been implicated in 
      the augmentation of the damage caused by AAV via the complement C5a receptor 
      (C5aR1, CD88). Specifically targeting this pathway may lead to improved outcomes 
      in patients with AAV.Areas covered: In this article, we have summarized the 
      rationale for targeting the complement pathway in AAV. The relevant pre-clinical, 
      phase I, II and III findings with emphasis on the efficacy, and safety of 
      avacopan, a new oral competitive inhibitor that interferes with the binding of 
      C5a to C5aR1 (CD88), are reviewed.Expert opinion: These results are encouraging, 
      may led to major changes in the treatment approach for AAV, and give rise to 
      future studies utilizing complement inhibitors in AAV patients, and potentially 
      in other immune mediated diseases.
FAU - Osman, Mohammed
AU  - Osman M
AD  - Division of Rheumatology, University of Alberta, Edmonton, Alberta, Canada.
FAU - Cohen Tervaert, Jan Willem
AU  - Cohen Tervaert JW
AD  - Division of Rheumatology, University of Alberta, Edmonton, Alberta, Canada.
FAU - Pagnoux, Christian
AU  - Pagnoux C
AD  - Vasculitis Clinic, Division of Rheumatology, Department of Medicine, Mount Sinai 
      Hospital, University of Toronto, Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20210528
PL  - England
TA  - Expert Rev Clin Immunol
JT  - Expert review of clinical immunology
JID - 101271248
RN  - 0 (Aniline Compounds)
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Nipecotic Acids)
RN  - O880NM097T (avacopan)
SB  - IM
MH  - Aniline Compounds/adverse effects
MH  - *Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy
MH  - Antibodies, Antineutrophil Cytoplasmic
MH  - Complement Pathway, Alternative
MH  - Humans
MH  - *Nipecotic Acids/adverse effects
OTO - NOTNLM
OT  - ANCA
OT  - avacopan
OT  - complement
OT  - glucocorticoids
OT  - vasculitis
EDAT- 2021/05/20 06:00
MHDA- 2022/03/03 06:00
CRDT- 2021/05/19 05:34
PHST- 2021/05/20 06:00 [pubmed]
PHST- 2022/03/03 06:00 [medline]
PHST- 2021/05/19 05:34 [entrez]
AID - 10.1080/1744666X.2021.1932466 [doi]
PST - ppublish
SO  - Expert Rev Clin Immunol. 2021 Jul;17(7):717-726. doi: 
      10.1080/1744666X.2021.1932466. Epub 2021 May 28.