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Getting the latest healthcare news for you
A new real-world study flags serious liver risks with avacopan, a drug used to treat ANCA-associated vasculitis. While liver enzyme elevations were uncommon overall, two patients developed severe drug-induced liver injury — both resolving after stopping the drug. Researchers are urging close monitoring, especially in the first three months of treatment.
A new real-world study published in Arthritis & Rheumatology raises a cautionary flag for clinicians prescribing avacopan, an approved treatment for ANCA-associated vasculitis (AAV). Researchers analyzed data from 238 patients in a US registry and found that while liver enzyme elevations were relatively rare, two patients developed confirmed cases of drug-induced liver injury (DILI) — both rated "highly probable" on a standardized causality assessment tool.
The more severe case saw peak ALT levels reach 978 U/L, with a liver biopsy revealing mixed portal inflammation with eosinophils. Fortunately, both patients recovered fully — one within 6 weeks and the other within 7 weeks of discontinuing avacopan — and neither progressed to the more serious vanishing bile duct syndrome.
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Why it matters: Avacopan remains a valuable tool for managing AAV, but these findings highlight the importance of routine liver monitoring — particularly in the first three months of therapy. Clinicians should proactively discuss these risks with patients and adhere closely to recommended monitoring timelines.
