On May 6, the U.S. Food & Drug Administration’s (FDA’s) Arthritis Advisory Committee narrowly voted in support of avacopan, a C5a receptor inhibitor, for the treatment of adult patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. Although the panelists were excited about the possibility of a steroid-sparing therapy, some raised questions about whether results from…
A phase 3 trial described in The New England Journal of Medicine (NEJM) highlights the potential of a C5a receptor inhibitor, avacopan, for anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis.1 Avacopan may potentially offer a steroid-sparing option for the treatment of this serious disease. Current Treatment of ANCA-Associated Vasculitis Morbidity and mortality from ANCA-associated vasculitis have…
Drug-induced lupus erythematosus and ANCA-associated vasculitis (AAV) are both autoimmune conditions associated with the use of hydralazine, a commonly prescribed drug for hypertension and congestive heart failure. Although the pathogenesis is unknown, it is believed that hydralazine alters neutrophil and lymphocyte function and promotes exposure of antigens, leading to the development of anti-neutrophil antibodies (ANCA)…
Hydralazine has been in use as a treatment for hypertension, most notably in heart failure patients, since 1951.1 The drug is a known cause of autoimmune disease, most specifically hydralazine-induced lupus. Hydralazine-induced lupus occurs in 7–13% of those taking the medication.2-4 It often presents with constitutional symptoms, arthritis/arthralgias, cutaneous lesions, serositis, myalgias and/or hepatomegaly. Features…
NEW YORK (Reuters Health)—Long-term rituximab use lowers the chance of relapse of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV), compared with standard maintenance therapy, according to a report from the MAINRITSAN3 randomized trial. “Physicians should consider AAV to be a long-lasting, chronic disease which requires maintenance therapy,” says Dr. Pierre Charles of Cochin Hospital, Paris…
SNOWMASS VILLAGE, COLO.—The study of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is ongoing, and research results should help improve treatment for this patient population. Key trials and therapeutic options were discussed at the 2020 ACR Winter Symposium during the session, Update on the Treatment of ANCA-Associated Vasculitis, by Peter A. Merkel, MD, MPH, chief of…
In an international clinical trial, adding the drug belimumab to standard maintenance therapy for patients in remission with vasculitis did not lower the relapse rate. The double-blind, placebo-controlled study evaluated the safety and efficacy of belimumab as adjunctive therapy to maintain remission in anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Results of the multi-center, industry-sponsored…
I would like to tell you a story. Two, actually. I am just returning from the 19th International Vasculitis and ANCA Workshop, which is always a fascinating meeting. In its inception, it was a workshop, in the true sense of the word. Now, we discuss anti-neutrophil cytoplasmic antibody (ANCA) testing as casually as we discuss…
CHICAGO—Ken Smith, MD, PhD, professor of medicine at the University of Cambridge, England, gave an update on anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) at the 2018 ACR/ARHP Annual Meeting. Although vasculitis tends to be defined first by vessel size, the clinical differentiation between the forms is not reliable, explained Dr. Smith. For example, granulomatosis with…
Researchers sought to identify predictors of patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) who took rituximab for maintenance had a better sustained remission rate through 60 months than those taking azathioprine, according to the latest results from the maintenance of remission using rituximab in systemic ANCA-associated vasculitis (MAINRITSAN) trial, a prospective, randomized trial…