From the New York Medical College, Valhalla, NY.
Departments of Medicine and Cardiology, New York Medical College/Westchester Medical Center, Valhalla, NY.
Cardiol Rev. 2023;31(1):3-6. doi: 10.1097/CRD.0000000000000496. Epub 2022 Dec 2.
Avacopan is a small-molecule complement 5a receptor (CD88) antagonist recently approved by the United States Food and Drug Administration as an adjunct therapy in combination with immunosuppressants and corticosteroids for treatment of ANCA-vasculitis. The selective ability of avacopan to inhibit the C5a receptor blocks neutrophil chemoattraction, activation, and adhesion while maintaining other beneficial complement pathways. Therefore, avacopan's unique selective property provides a breakthrough treatment for ANCA- vasculitis given that current therapies of corticosteroid treatment often lead to a decreased quality of life and a possible relapse. Clinical trials prove that avacopan is an excellent adjunctive treatment option, although it is not approved for the primary treatment of ANCA-vasculitis at this time. Initial clinical trials show substantial promise for avacopan, but additional studies with a longer duration will be needed to test for its durability and safety.
阿伐考帕尼是一种小分子补体 5a 受体(CD88)拮抗剂,最近获得美国食品和药物管理局批准,与免疫抑制剂和皮质类固醇联合使用,作为治疗抗中性粒细胞胞质抗体相关性血管炎的辅助疗法。阿伐考帕尼选择性抑制 C5a 受体,阻止中性粒细胞趋化、激活和黏附,同时维持其他有益的补体途径。因此,阿伐考帕尼独特的选择性为抗中性粒细胞胞质抗体相关性血管炎提供了一种突破性的治疗方法,因为目前的皮质类固醇治疗往往导致生活质量下降和可能的复发。临床试验证明阿伐考帕尼是一种很好的辅助治疗选择,尽管目前它尚未被批准用于抗中性粒细胞胞质抗体相关性血管炎的主要治疗。初步临床试验显示阿伐考帕尼有很大的希望,但需要进行更长时间的研究来测试其耐久性和安全性。