Post-marketing safety profile and clinical prioritization of adverse events with avacopan in ANCA-associated vasculitis: a FAERS pharmacovigilance analysis

Ren Fail. 2025 Dec;47(1):2568971. doi: 10.1080/0886022X.2025.2568971. Epub 2025 Oct 23.

Abstract

Avacopan, a novel C5a receptor inhibitor, offers therapeutic potential for ANCA-associated vasculitis. This study assessed its post-marketing safety using the FDA Adverse Event Reporting System (FAERS) from Q4 2021 to Q4 2024. Disproportionality analyses identified 75 adverse events (AEs) potentially linked to avacopan, with hepatobiliary disorders and infections being most prominent. A total of 62 AEs were classified as having moderate clinical priority, including drug-induced liver injury, renal failure, and deafness. Subgroup analysis revealed age- and sex-based differences in AE patterns. Logistic regression indicated that older age and concomitant use of rituximab or proton-pump inhibitors increased the risk of hepatobiliary AEs. These findings highlight the need for close monitoring of hepatic function and infection risk during avacopan therapy. Further research is warranted to explore the underlying mechanisms and potential drug interactions.

Keywords: ANCA-associated vasculitis; Avacopan; FAERS; drug-induced liver injury; pharmacovigilance; post-marketing safety.

MeSH terms

  • Adult
  • Adverse Drug Reaction Reporting Systems / statistics & numerical data
  • Aged
  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis* / drug therapy
  • Chemical and Drug Induced Liver Injury / epidemiology
  • Chemical and Drug Induced Liver Injury / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pharmacovigilance
  • Product Surveillance, Postmarketing
  • United States / epidemiology
  • United States Food and Drug Administration