Update on antineutrophil cytoplasmic antibody vasculitis: Erratum

In the article “Update on antineutrophil cytoplasmic antibody vasculitis” [1] published in Current Opinion in Nephrology and Hypertension, Volume 35, Issue 2, several textual inaccuracies were identified in the published version. The corrected statements are mentioned below. Page 272 “With the use of avacopan, initially, as part of the induction regimen, prednisone dose can be reduced to 20 mg daily and tapered over a period of at least 4 weeks with the continuation of avacopan.” Should read: “With the use of avacopan, initially, as part of the induction regimen, prednisone generally can be tapered more quickly with a reduced cumulative steroid dose while continuing avacopan.” Page 274 “Nevertheless, it is still advised to add prednisone at a dose of 20 mg daily along with avacopan and taper over a period of at least 4 weeks.” Should read: “Nevertheless, it is still advised to add a steroid taper along with avacopan. The steroid taper dose and duration may need to be adjusted based on the disease severity and patient specific factors with continued disease activity monitoring over time. As a reference, in the first 26 weeks of the ADVOCATE clinical trial, patients who received rituximab induction had received a mean total cumulative steroid dose in prednisone equivalents of 3265 mg and 1417 mg in the Placebo and Avacopan groups, respectively. The median prednisone equivalents were 3026 mg and 625 mg, respectively, and difference between mean and median values may be related to initial use of pulse dose steroids in some of the patients [1]” Page 275 Change: “Avacopan can be used at the start of treatment as part of an induction regimen at 30 mg BID along with a reduced steroid dose (equivalent to prednisone 20 mg daily) and steroids can be tapered over a period of at least 4 weeks, with the continuation of avacopan (avacopan was continued for 52 weeks in the ADVOCATE trial). To: Avacopan can be used at the start of treatment as part of an induction regimen at 30 mg BID along with a steroid taper with a reduced dose and duration, while continuing avacopan (avacopan was continued for 52 weeks in the ADVOCATE trial), leading to a reduced cumulative steroid exposure. While the ADVOCATE trial did not include maintenance rituximab doses for those who were started on rituximab induction, many do continue rituximab maintenance treatment, as described in a multicentre real world study by Charlotte Gabilan, et al.[2] As mentioned above, due to the potential for hepatotoxicity with avacopan, laboratory monitoring is advised. The manufacturer of avacopan recommends laboratory tests every 4 weeks for the first 6 months to monitor liver function tests, and as clinically indicated thereafter. The manufacturer also has guidelines for discontinuation of avacopan based on values of elevated AST, ALT and bilirubin tests. As with many medications, avacopan has multiple potential drug interactions. The manufacturer recommends decreasing the dose of avacopan to 30 mg once a day when coadministered with strong CYP3A4 enzyme inhibitors and to avoid coadministration of strong and moderate CYP3A4 enzyme inducers with avacopan.[3] 1. Geetha D, Dua A, Yue H, et al. Efficacy and safety of avacopan in patients with ANCA-associated vasculitis receiving rituximab in a randomized trial. Ann Rheum Dis 2024;83:223-232. 2. Gabilan C, Belliere J, Moranne O, et al. Avacopan for anti-neutrophil cytoplasm antibodies-associated vasculitis: a multicentre real-world study. Rheumatology 2025;64:2214-2219. 3. Tavneos (avacopan) [prescribing information]. Thousand Oaks, CA: ChemoCentryx Inc; June 2024. (https://www.pi.amgen.com/-/media/Project/Amgen/Repository/pi-amgen-com/Tavneos/tavneos_fpi_english.pdf