PMID- 36545762
OWN - NLM
STAT- MEDLINE
DCOM- 20230426
LR  - 20230814
IS  - 1744-8409 (Electronic)
IS  - 1744-666X (Linking)
VI  - 19
IP  - 5
DP  - 2023 May
TI  - Avacopan for the treatment of ANCA-associated vasculitis: an update.
PG  - 461-471
LID - 10.1080/1744666X.2023.2162041 [doi]
AB  - INTRODUCTION: Glucocorticoids (GC) have been part of the standard treatment of 
      anti-neutrophil cytoplasm autoantibodies (ANCA)-associated vasculitides (AAV) for 
      more than 60 years. Various therapeutic advances have occurred over the past 2 
      decades and led to a significant reduction of GC exposure, but most patients 
      still have to suffer from complications of GC, including infections, metabolic 
      abnormalities, and cardiovascular morbidity. In 2007, activation of the 
      complement pathway was demonstrated to play a role in the pathogenesis of AAV. 
      Avacopan, an oral competitive inhibitor of the C5a receptor (C5aR1, CD88), was 
      then developed, with an additional aim to decrease the use of GC. AREAS COVERED: 
      In this article, we briefly summarize the rationale for targeting the complement 
      pathway in AAV, and review relevant findings from pre-clinical, phase I, II, and 
      III studies, subsequent and more recent case reports and series on the efficacy 
      and safety of avacopan. EXPERT OPINION: Based on the results of these studies, 
      avacopan was approved in most countries since late 2021, as an adjunctive 
      induction treatment for patients with AAV. Several newer questions now are 
      pending answers, including as to how avacopan should be used in real-world 
      practice, beyond how it was given in the original clinical trials.
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 - 20221226
PL  - England
TA  - Expert Rev Clin Immunol
JT  - Expert review of clinical immunology
JID - 101271248
RN  - O880NM097T (avacopan)
RN  - 0 (Aniline Compounds)
RN  - 0 (Nipecotic Acids)
RN  - 0 (Glucocorticoids)
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
SB  - IM
EIN - Expert Rev Clin Immunol. 2024 Mar;20(3):321. PMID: 37578317
MH  - Humans
MH  - *Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
MH  - Aniline Compounds/adverse effects
MH  - Nipecotic Acids/adverse effects
MH  - Glucocorticoids/therapeutic use
MH  - Antibodies, Antineutrophil Cytoplasmic
OTO - NOTNLM
OT  - ANCA
OT  - avacopan
OT  - complement
OT  - glucocorticoids
OT  - vasculitis
EDAT- 2022/12/23 06:00
MHDA- 2023/04/26 06:41
CRDT- 2022/12/22 03:03
PHST- 2023/04/26 06:41 [medline]
PHST- 2022/12/23 06:00 [pubmed]
PHST- 2022/12/22 03:03 [entrez]
AID - 10.1080/1744666X.2023.2162041 [doi]
PST - ppublish
SO  - Expert Rev Clin Immunol. 2023 May;19(5):461-471. doi: 
      10.1080/1744666X.2023.2162041. Epub 2022 Dec 26.