ANCA Vasculitis — SCE Rheumatology MCQ

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ModerateRheumatology PharmacologyANCA VasculitisSCE Rheumatology

A 45-year-old woman is diagnosed with ANCA-associated vasculitis. Avacopan is being considered as part of her induction regimen. What is the mechanism of action of Avacopan?

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Correct answer: B — Complement C5a receptor antagonist

Avacopan is an oral complement C5a receptor (C5aR) antagonist. It was demonstrated in the ADVOCATE trial to be non-inferior to glucocorticoids when used with Rituximab or Cyclophosphamide for induction of AAV, with improved renal outcomes at week 52. BSR 2025 AAV guidelines recommend considering Avacopan as a steroid-sparing agent. The recommended duration is 12 months as there are no data beyond this period. It is particularly useful for patients at high risk of glucocorticoid adverse effects.

Reference: BSR 2025 - Management recommendations for ANCA-associated vasculitis; Jayne DRW et al 2021 ADVOCATE trial