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

Author:

Turgeon David1ORCID,Bakowsky Volodko2,Baldwin Corisande3,Cabral David A4,Clements-Baker Marie5,Clifford Alison6,Cohen Tervaert Jan Willem6,Dehghan Natasha3,Ennis Daniel3,Famorca Leilani7,Fifi-Mah Aurore8,Girard Louis-Philippe9,Lefebvre Frédéric10,Liang Patrick11,Makhzoum Jean-Paul12ORCID,Massicotte-Azarniouch David13ORCID,Mendel Arielle14ORCID,Milman Nataliya15,Reich Heather N16,Robinson David B17,Ross Carolyn12,Rumsey Dax G18,Soowamber Medha1,Towheed Tanveer E5,Trudeau Judith19,Twilt Marinka20,Yacyshyn Elaine6,Yardimci Gozde K1ORCID,Khalidi Nader7,Barra Lillian21,Pagnoux Christian1ORCID

Affiliation:

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

Abstract

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.

Funder

Bristol Meyers Squibb

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Rheumatology

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