대한신장학회

논문분류	춘계학술대회 초록집
제목	Efficacy and Safety of Avacopan in Antineutrophil Cytoplasmic Autoantibody-Associated Glomerulonephritis: Multicenter Cohort Study in Korea
저자	Sungmi Kim
출판정보	2026; 2026(1):
키워드	Antineutrophil cytoplasmic autoantibody-associated glomerulonephritis, avacopan, efficacy, safety, glucocorticoid
초록	Objectives: Antineutrophil cytoplasmic autoantibody (ANCA)-associated glomerulonephritis (GN) responds rapidly to conventional immunosuppressive therapy but is frequently accompanied by treatment-related morbidities. Avacopan, a selective C5a receptor inhibitor, has emerged as a treatment option for immune-mediated GN involving the alternative complement pathway. This study aims to evaluate the efficacy and safety of avacopan in the Korean cohort with ACNA-GN. Methods: This multicenter cohort study included 12 patients with biopsy-proven ACNA-GN who received avacopan between 2024 and 2025. Primary outcomes were temporal changes in estimated glomerular filtration rate (eGFR) and proteinuria during the first year, and dialysis dependency. Results: The median duration of avacopan use was 334 days (interquartile range (IQR) 224–475). The mean eGFR level was 18.6 ± 10.8 ml/min/1.73m2 and the mean urine protein-to-creatinine ratio (UPCR) was 2.9 ± 3.1 g/g. The mean percentage of global glomerulosclerosis was 20.9%. Three and two patients belonged to the sclerotic and focal classes of the Berden classification, respectively. The changes in eGFR from baseline to 26 and 52 weeks were 9.7 ± 10.2 and 12.4 ± 9.4 ml/min/1.73m2, respectively. The changes in UPCR from baseline at 26 and 52 weeks were -1.9 ± 3.0 and -2.5 ± 3.2 g/g, respectively. A total of 5 patients initiated kidney replacement therapy (KRT), but 2 discontinued it within 3 months of initiation. The median duration of glucocorticoid use was 103 days (IQR 68–394), and 7 patients discontinued glucocorticoid within 3 months of initiation. Two patients experienced adverse effects of elevated liver enzyme levels related to avacopan, but these did not lead to the discontinuation of avacopan. Conclusion: This study highlights that favorable kidney outcomes were achieved with avacopan in the treatment of ANCA-GN, without the development of fatal adverse effects. Kidney function improved consistently throughout the treatment despite the early glucocorticoid withdrawal.
원문(PDF)	PDF 원문보기

간행물 검색

대한신장학회 회원관리 규정