New treatments for systemic vasculitis: focus on avacopan, an oral selective C5a receptor inhibitorDownload in PDF
The author reviews the available evidence showing the possible role of selective c5a complement receptor inhibition in thetreatment of ANCA-associated vasculitis (AAV). In the randomized, placebo-controlled, phase 2 study (CLEAR), theaddition of avacopan, a new oral C5a receptor inhibitor, to theremission induction treatment with cyclophosphamide or rituximab with or without glucocorticoids in patients with AAV resulted in a higher remission rate at 12 weeks (86% and81%, respectively) compared with that in patients treated with cyclophosphamide or rituximab in combination with high dose glucocorticoids and placebo (70%, р≤0.01). The safety profile of avacopan was favorable. There were no deaths, while the occurence of serious infections was 4-5%. The rate of adverse effects of glucocorticoids in the avacopan groups was lower than in the control group. Additional studies areneeded to evaluate the long-term outcomes of treatment with avacopan as a steroid-sparing agent in patients with AAV.
Аvacopan, CCX168, selective C5a receptor inhibitor, systemic vasculitis, ANCA.