Highlights from the breakout session: optimising new treatments

This session presented emerging realworld evidence on novel glucocorticoid (GC) sparing therapies for ANCA-associated vasculitis (AAV). It covered the first-in-class oral C5a receptor antagonist avacopan for severe granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA), and antiinterleukin-5 therapies in the management of eosinophilic granulomatosis with polyangiitis (EGPA). Avacopan was approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) for the treatment of AAV in 2021, following the phase 3 ADVOCAT E trial comparing oral avacopan to an oral GC taper for GPA and MPA. The 2024 KDIGO clinical practice guidelines for AAV now incorporate avacopan as an alternative to GC for remission induction. Phase 3 trials in EGPA have demonstrated superiority of mepolizumab versus placebo (MIRRA, 2017) and non-inferiority of benralizumab versus mepolizumab (MANDARA, 2024) for sustaining remission. Real-world data, as presented in this session, are essential to understand the efficacy and safety of these new therapies in broader AAV patient populations.