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Avacopan in the treatment of ANCA-associated vasculitis.
- Source :
-
Expert opinion on investigational drugs [Expert Opin Investig Drugs] 2018 May; Vol. 27 (5), pp. 491-496. Date of Electronic Publication: 2018 May 08. - Publication Year :
- 2018
-
Abstract
- Introduction: ANCA-associated vasculitis (AAV) is a rare but potentially life-threatening disease. Currently used induction treatment (cyclophosphamide or rituximab with high-dose corticosteroids) has significantly improved outcome of AAV, but is associated with high toxicity. Alternative complement pathway activation was shown to play a role in the pathogenesis of AAV, thus providing rationale for the use of avacopan, a selective inhibitor of C5a receptor, in the treatment of AAV. Areas covered: Pharmacokinetic and pharmocodynamic properties of avacopan, clinical efficacy and safety and tolerability of avacopan in so far performed clinical trials in patients with AAV are reviewed and discussed. Expert opinion: Avacopan was shown to have at least similar efficacy compared to high dose corticosteroids in patients with active AAV with renal involvement, while there were no major safety issues reported. Replacement of corticosteroids should decrease the corticosteroid-related toxicity and improve long-term outcome of patients with AAV even though this still needs to be confirmed in a larger trial. Data on long-term outcome of avacopan-treated patients are currently lacking and will be eagerly awaited. In the future, avacopan could replace corticosteroids not only in the induction phase, but also in the maintenance treatment of AAV.
- Subjects :
- Aniline Compounds adverse effects
Aniline Compounds pharmacology
Animals
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis physiopathology
Glucocorticoids administration & dosage
Glucocorticoids adverse effects
Glucocorticoids therapeutic use
Humans
Immunologic Factors administration & dosage
Immunologic Factors therapeutic use
Nipecotic Acids adverse effects
Nipecotic Acids pharmacology
Aniline Compounds therapeutic use
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis drug therapy
Nipecotic Acids therapeutic use
Receptor, Anaphylatoxin C5a antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1744-7658
- Volume :
- 27
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Expert opinion on investigational drugs
- Publication Type :
- Academic Journal
- Accession number :
- 29718732
- Full Text :
- https://doi.org/10.1080/13543784.2018.1472234