Recent decades have witnessed significant advances in the treatment of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis which has led to a reduction in disease-related morbidity and mortality. The treatment regimen for inducing remission in patients with severe ANCA-associated vasculitis consists of a tapering course of glucocorticoids in combination with cyclophosphamide or rituximab. However, glucocorticoids have remained an anchoring medication in updated regimens and they contribute to treatment-related toxicity. 

Clinical trial on patients with ANCA-associated vasculitis has shown that avacopan was non inferior but not superior to prednisone taper with regard to remissionat week 26 and was superior to prednisone taper with regard to sustained remission at week 52. The primary outcome was remission at week 26 and no glucocorticoid use in the previous 4 weeks. .

Reference: 

1. Warrington KJ. Avacopan-Time to replace glucocorticoids. The New England Journal of Medicine. 2021; 384:664-665.
2. Jayne DRW, Merkel PA, Schall TJ, Bekker P, et al. Avacopan for the treatment of ANCA-associated vasculitis. The New England Journal of Medicine. 2021; 384:599-609.