Avacopan improves patient outcomes in AAV by reducing glucocorticoid use, indicating a shift in management strategies.
A BSTRACT Antineutrophil cytoplasmic antibody-associated vasculitis (AAV), including granulomatosis with polyangiitis and microscopic polyangiitis, is a rare autoimmune disease characterized by small-vessel inflammation. Traditional treatment involves high-dose corticosteroids with immunosuppressants, but long-term steroid use carries significant toxicity. Avacopan, an oral C5a receptor antagonist, offers a targeted, steroid-sparing option by blocking C5a-mediated neutrophil activation, a key driver in AAV pathogenesis. It also offers a favorable pharmacokinetics and a manageable safety profile, representing a paradigm shift in AAV management by improving patient outcomes when reducing glucocorticoid burden. With further exploration, this activity of avacopan is being studied in IgA nephropathy, lupus nephritis, hidradenitis suppurativa, and complement component 3 glomerulopathy.
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Sharma et al. (2025) studied this question.
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