Evidence map›Paper›PMID 42645772›Full record

ArticleClinical and experimental nephrology2026

Real-world long-term outcomes and safety of avacopan for antineutrophil cytoplasmic antibody-associated vasculitis with advanced renal dysfunction: a multicenter cohort study (4U-AAV Study).

Kumiko Muta, Kenta Torigoe, Emi Hasegawa, Mineaki Kitamura, Akihiro Fukuda, Masao Kikuchi, Tetsu Miyamoto, Takeshi Nakata, Naoya Fukunaga, Shoichi Fujimoto and 1 more

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Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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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.

2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Kumiko MutaAdvanced Medical Education Center, Nagasaki University School of Medicine, 1-12-4, Sakamoto, Nagasaki, 852-8523, Japan. k-io@nagasaki-u.ac.jp.ORCID http://orcid.org/0000-0003-4604-9478
Kenta TorigoeDepartment of Nephrology, School of Medicine Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Emi HasegawaKidney Center, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan.
Mineaki KitamuraDepartment of Nephrology, School of Medicine Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Akihiro FukudaDepartment of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan.
Masao KikuchiDivision of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Tetsu MiyamotoKidney Center, Hospital of the University of Occupational and Environmental Health, Kitakyushu, Japan.
Takeshi NakataDepartment of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan.
Naoya FukunagaDepartment of Nephrology, Oita Prefectural Hospital, Oita, Japan.
Shoichi FujimotoDivision of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Tomoya NishinoDepartment of Nephrology, School of Medicine Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAvacopan is a promising steroid-sparing option for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV); however, its efficacy and safety in high-risk patients, such as those with severe renal dysfunction, remain unclear.

methodsThis retrospective observational study (4U-AAV study) analyzed adult patients newly diagnosed with AAV and ANCA-associated glomerulonephritis in six medical centers in Kyushu, Japan. Patients treated with avacopan were evaluated, and those receiving conventional therapy were used as a reference. The primary outcomes were all-cause mortality or initiation of maintenance renal replacement therapy, and the secondary outcomes included complete remission, AAV- or treatment-related complications, and drug-related adverse events.

resultsSeventy-four patients were enrolled, of whom 20 received avacopan. With avacopan, the median estimated glomerular filtration rate was 15.4 (interquartile range [IQR]: 9.2-38.0) mL/min/1.73 m

conclusionIn real-world practice, long-term renal outcomes of avacopan appeared descriptively comparable to those of conventional therapy in patients with AAV and renal dysfunction; however, elevated liver enzyme levels were frequent, highlighting the need for careful monitoring and further prospective studies.

Indexed as

ANCA-associated vasculitisAvacopanC5a selective antagonist

Identifiers

PMID42645772

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