CanVasc consensus recommendations for the use of avacopan in antineutrophil cytoplasm antibody-associated vasculitis: 2022 addendum

David Turgeon¹, Volodko Bakowsky², Corisande Baldwin³, David A Cabral⁴, Marie Clements-Baker⁵, Alison Clifford⁶, Jan Willem Cohen Tervaert⁶, Natasha Dehghan³, Daniel Ennis³, Leilani Famorca⁷, Aurore Fifi-Mah⁸, Louis-Philippe Girard⁹, Frédéric Lefebvre¹⁰, Patrick Liang¹¹, Jean-Paul Makhzoum¹², David Massicotte-Azarniouch¹³, Arielle Mendel¹⁴, Nataliya Milman¹⁵, Heather N Reich¹⁶, David B Robinson¹⁷, Carolyn Ross¹², Dax G Rumsey¹⁸, Medha Soowamber¹, Tanveer E Towheed⁵, Judith Trudeau¹⁹, Marinka Twilt²⁰, Elaine Yacyshyn⁶, Gozde K Yardimci¹, Nader Khalidi⁷, Lillian Barra²¹, Christian Pagnoux¹

Affiliations

¹ Vasculitis Clinic, Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
² Division of Rheumatology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
³ Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁵ Division of Rheumatology, Queen's University, Kingston, Ontario, Canada.
⁶ Division of Rheumatology, University of Alberta, Edmonton, Alberta, Canada.
⁷ Division of Rheumatology, McMaster University, Hamilton, Ontario, Canada.
⁸ Division of Rheumatology, University of Calgary, Calgary, Alberta, Canada.
⁹ Division of Nephrology, University of Calgary, Calgary, Alberta, Canada.
¹⁰ Division of Rheumatology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada.
¹¹ Division of Rheumatology, Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada.
¹² Division of Internal Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Québec, Canada.
¹³ Division of Nephrology, The Ottawa Hospital, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
¹⁴ Division of Rheumatology, McGill University Health Centre, Montréal, Québec, Canada.
¹⁵ Division of Rheumatology, The Ottawa Hospital, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
¹⁶ Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
¹⁷ Division of Rheumatology, University of Manitoba, Winnipeg, Manitoba, Canada.
¹⁸ Division of Pediatric Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
¹⁹ Division of Rheumatology, CISSS Chaudière-Appalaches, Université Laval, Quebec City, Québec, Canada.
²⁰ Division of Pediatric Rheumatology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
²¹ Division of Rheumatology, Department of Medicine, Western University, London, Ontario, Canada.

PMID: 36805625
DOI: 10.1093/rheumatology/kead087

CanVasc consensus recommendations for the use of avacopan in antineutrophil cytoplasm antibody-associated vasculitis: 2022 addendum

David Turgeon et al. Rheumatology (Oxford). 2023.

. 2023 Aug 1;62(8):2646-2651.

doi: 10.1093/rheumatology/kead087.

Authors

Affiliations

¹ Vasculitis Clinic, Division of Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
² Division of Rheumatology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
³ Division of Rheumatology, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
⁵ Division of Rheumatology, Queen's University, Kingston, Ontario, Canada.
⁶ Division of Rheumatology, University of Alberta, Edmonton, Alberta, Canada.
⁷ Division of Rheumatology, McMaster University, Hamilton, Ontario, Canada.
⁸ Division of Rheumatology, University of Calgary, Calgary, Alberta, Canada.
⁹ Division of Nephrology, University of Calgary, Calgary, Alberta, Canada.
¹⁰ Division of Rheumatology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada.
¹¹ Division of Rheumatology, Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada.
¹² Division of Internal Medicine, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Québec, Canada.
¹³ Division of Nephrology, The Ottawa Hospital, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
¹⁴ Division of Rheumatology, McGill University Health Centre, Montréal, Québec, Canada.
¹⁵ Division of Rheumatology, The Ottawa Hospital, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
¹⁶ Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
¹⁷ Division of Rheumatology, University of Manitoba, Winnipeg, Manitoba, Canada.
¹⁸ Division of Pediatric Rheumatology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
¹⁹ Division of Rheumatology, CISSS Chaudière-Appalaches, Université Laval, Quebec City, Québec, Canada.
²⁰ Division of Pediatric Rheumatology, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
²¹ Division of Rheumatology, Department of Medicine, Western University, London, Ontario, Canada.

PMID: 36805625
DOI: 10.1093/rheumatology/kead087

Abstract

Objective: In 2020, the Canadian Vasculitis Research Network (CanVasc) published their updated recommendations for the management of ANCA-associated vasculitides (AAV). The current addendum provides further recommendations regarding the use of avacopan in AAV based on a review of newly available evidence.

Methods: An updated systematic literature review on avacopan (formerly, CCX168) using Medline, Embase, and the Cochrane Library was performed for publications up to September 2022. New recommendations were developed and categorized according to the EULAR grading levels, as done for previous CanVasc recommendations. A modified Delphi procedure and videoconferences were used to reach ≥80% consensus on the inclusion, wording and grading of each recommendation.

Results: Three new recommendations were developed. They focus on avacopan therapy indication and duration, as well as timely glucocorticoid tapering.

Conclusion: These 2022 addended recommendations provide rheumatologists, nephrologists and other specialists caring for patients with AAV with guidance for the use of avacopan, based on current evidence and consensus from Canadian experts.

Keywords: ANCA; anti-neutrophil cytoplasm antibody-associated vasculitis; avacopan; glomerulonephritis; granulomatosis with polyangiitis; microscopic polyangiitis.

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Comment in

The paradigm shift in ANCA-associated vasculitis: prime time for the complement targeting.
Quartuccio L, Treppo E, Alberici F. Quartuccio L, et al. Rheumatology (Oxford). 2023 Aug 1;62(8):2633-2634. doi: 10.1093/rheumatology/kead188. Rheumatology (Oxford). 2023. PMID: 37084252 No abstract available.

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CanVasc consensus recommendations for the use of avacopan in antineutrophil cytoplasm antibody-associated vasculitis: 2022 addendum

Affiliations

CanVasc consensus recommendations for the use of avacopan in antineutrophil cytoplasm antibody-associated vasculitis: 2022 addendum

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Abstract

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Medical