Study: Tavneos controls AAV, fewer side effects than glucocorticoids
Patients on approved oral therapy may also enjoy better quality of life
Tavneos (avacopan) can control ANCA-associated vasculitis (AAV) just about as well as standard glucocorticoids but causes fewer side effects — and as such, use of the approved therapy may help people with AAV enjoy a better quality of life.
Those are the findings of a review study by a research team in Saudi Arabia, who conducted a “systematic search” of four databases spanning from 2000 to 2025.
“The included studies showed that [Tavneos] was associated with remission rates comparable to conventional glucocorticoid regimens at 26 weeks [or about six months,] and improved sustained remission at 52 weeks [or one year],” the researchers wrote. “These outcomes were achieved with significantly reduced cumulative glucocorticoid exposure and were accompanied by fewer steroid-associated toxicities, including infections … and psychiatric complications.”
Glucocorticoids, a class of steroid medications, are a standard treatment in AAV, but their long-term use is linked to serious side effects.
The study, “Efficacy and safety of avacopan in the treatment of ANCA-associated vasculitis: a systematic review and meta-analysis,” was published in the journal BMC Rheumatology by two researchers from the King Fahad Military Medical Complex in Dhahran.
In AAV, self-reactive antibodies trigger neutrophils, a type of immune cell, to launch an inflammatory response that damages small blood vessels. This damage is partly driven by activation of the complement system, a group of proteins that plays a key role in the body’s immune response.
Tavneos used as add-on treatment in GPA, MPA
Tavneos is widely approved as an add-on to standard treatments in adults with severe active granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) — the two most common types of AAV. Standard treatment typically involves rituximab or cyclophosphamide, two immunosuppressive medications, plus glucocorticoids.
The therapy works by blocking a specific step in complement signaling, which is expected to reduce AAV-related damage and symptoms without the broad side effects of glucocorticoids.
The researchers noted that Tavneos “has been evaluated as a glucocorticoid-sparing agent in the treatment of AAV, including in both [appropriately-controlled] trials and early real-world studies.”
Treatment guidelines recommend the use of immunosuppressants combined with glucocorticoids or Tavneos to bring active GPA or MPA into remission, defined as periods in which the disease is under control.
To get a clearer picture of how well Tavneos works compared with glucocorticoids, the researchers reviewed studies published over more than two decades, from January 2000 to March 2025, that reported comparative results between the two treatments.
A total of nine studies, covering 2,080 patients, were used in the final analysis. Patients in the individual studies had GPA, MPA, newly diagnosed or relapsing AAV, or isolated ear, nose, and throat involvement.
In the different studies — mostly randomized and controlled clinical trials — Tavneos was evaluated alone or in combination with standard treatment and compared with standard of care, most commonly involving a tapering regimen of the glucocorticoid prednisone.
The main goal was to examine remission rates after six months and one year. Secondary goals included relapse rates, kidney outcomes, adverse events, and glucocorticoid-associated toxicity. The researchers also assessed health-related quality of life.
All studies reported comparable or better remission rates
All of the studies reported comparable or superior remission rates with Tavneos-based regimens, especially after one year of treatment. However, the meta-analysis of pooled data from all nine studies showed “no statistically significant difference between the two treatment strategies in terms of the likelihood of achieving remission or disease control,” the researchers wrote.
The therapy was also associated with “substantial benefits in terms of reduced glucocorticoid-associated toxicity, improved kidney function … and improved health-related quality of life,” the researchers wrote.
These findings are consistent with the quantitative reductions in glucocorticoid toxicity index (GTI) scores reported in various studies, supporting the conclusion that [Tavneos] substantially decreases the burden of treatment-related [side effects].
Specifically, people treated with Tavneos experienced fewer and less severe glucocorticoid-related side effects — including psychiatric problems, high blood sugar, weight gain, and serious infections — compared with those on prednisone.
“These findings are consistent with the quantitative reductions in glucocorticoid toxicity index (GTI) scores reported in various studies, supporting the conclusion that [Tavneos] substantially decreases the burden of treatment-related [side effects],” the scientists wrote.
Data across studies also showed major improvements in terms of disease activity and kidney function with treatment. At least two of the studies reported greater gains on patient-reported quality of life with Tavneos than with standard prednisone-based regimens.
“These findings highlight the potential of complement [suppressors] as alternative therapies with a comparable efficacy profile and the added benefit of reduced glucocorticoid-related toxicity,” the scientists wrote.
The team noted, however, that there is still a small number of available studies reporting on Tavneos, and that one-year outcomes may not be enough to fully evaluate the therapy’s long-term safety and efficacy.
“Further research is needed to address these gaps through longer-term follow-up and real-world data,” the researchers concluded.
About the Author
