ArticleBMC rheumatology2025
Avacopan is effective in inducing remission for MPA/GPA, regardless of changes in serum C5a levels: a single-center study in Japan.
Article in BMC rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Real-world efficacy and safety of avacopan in ANCA-associated vasculitis: a retrospective comparative study.RMD open · 2026Article
- Real-world outcomes of avacopan beyond the first year in antineutrophil cytoplasmic antibody-associated vasculitis: a retrospective cohort study.BMC rheumatology · 2026Article
- Avacopan-Associated Hepatotoxicity: Clinical Signal, Liver Injury Patterns, and Plausible Mechanisms.Cureus · 2026Review
- Making use of avacopan in clinical practice.Clinical kidney journal · 2026Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAvacopan, a selective oral C5a receptor antagonist, was approved for the treatment of microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) in 2021. However, there are still limited reports on its efficacy and safety in real-world settings, specifically regarding its impact on the Vasculitis Damage Index (VDI), and its effects on serum biomarkers are poorly understood. This study aimed to evaluate the efficacy and safety of avacopan in remission induction therapy for MPA/GPA in a real-world setting, as well as its effect on serum C5a levels.
methodsThis retrospective study investigated patients with MPA/GPA who received remission induction therapy with a 6-month follow-up at our institution, comparing those who received avacopan with those who did not. Efficacy and safety were evaluated by comparing the remission rate, changes in Birmingham Vasculitis Activity Score (BVAS) and VDI score after 6 months, daily glucocorticoid (GC) dose, and incidence of adverse events (AEs). Changes in serum C5a levels, measured using ELISA, were compared between both groups at baseline and 3 months.
resultsA total of 66 patients with MPA/GPA were included, with 14 and 52 patients in the avacopan and non-avacopan groups, respectively. The remission rate and decrease in BVAS was comparable between both groups. However, those who received avacopan had a significantly smaller increase in VDI score, significantly lower daily GC dose at 1, 3, and 6 months, and significantly lower incidence of GC-related AEs within 6 months. Serum C5a levels did not significantly change in the avacopan group but significantly decreased in the non-avacopan group. Remission was achieved in the avacopan group regardless of whether serum C5a decreased or increased.
conclusionsTreatment with avacopan appears to effectively suppress the increase in VDI score, enable reduced GC dosage, and lower the incidence of GC-related AEs during remission induction therapy for MPA/GPA in a real-world setting. Furthermore, avacopan may suppress disease activity regardless of serum C5a levels. CLINICAL TRIAL NUMBER: Not applicable.
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