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Related Experiment Video

Updated: May 22, 2025

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Highlights from the breakout session: optimising new treatments.

Lucy Francis1,2, Amrita Dhutia3,4, Charles Pusey3,4

  • 1Vasculitis and Lupus Clinic, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

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|March 12, 2025
PubMed
Summary

Novel therapies like avacopan and anti-interleukin-5 treatments show promise in reducing glucocorticoid (GC) dependence for ANCA-associated vasculitis (AAV). Real-world evidence is crucial for understanding their effectiveness and safety in diverse patient groups.

Keywords:
AAVEGPAGPAMPAanti-IL-5avacopanbenralizumabcomplement inhibitormepolizumabsteroid sparing

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Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • ANCA-associated vasculitis (AAV) management traditionally relies on glucocorticoids (GCs), which have significant side effects.
  • Emerging therapies aim to spare patients from long-term GC use.
  • Novel treatments target specific inflammatory pathways implicated in AAV pathogenesis.

Purpose of the Study:

  • To present emerging real-world evidence on novel GC-sparing therapies for AAV.
  • To discuss the role of avacopan and anti-interleukin-5 therapies in AAV management.
  • To highlight the importance of real-world data for evaluating new AAV treatments.

Main Methods:

  • Review of emerging real-world evidence on avacopan and anti-interleukin-5 therapies.
  • Discussion of clinical trial data (ADVOCATE, MIRRA, MANDARA) informing treatment guidelines.
  • Analysis of the integration of new therapies into clinical practice and guidelines (KDIGO 2024).

Main Results:

  • Avacopan, a C5a receptor antagonist, is approved for severe granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), offering an alternative to GCs for remission induction.
  • Anti-interleukin-5 therapies (mepolizumab, benralizumab) are effective in sustaining remission for eosinophilic granulomatosis with polyangiitis (EGPA).
  • Real-world data are vital for assessing the efficacy and safety of these novel agents in broader patient populations.

Conclusions:

  • Novel GC-sparing therapies, including avacopan and anti-interleukin-5 agents, represent significant advancements in AAV treatment.
  • Clinical guidelines increasingly incorporate these new options, reflecting their therapeutic potential.
  • Continued evaluation through real-world evidence is essential to optimize AAV patient care and outcomes.