Research outlook

Where ANCA vasculitis treatment is heading

ANCA vasculitis · Updated Nov 14, 2026

ANCA-associated vasculitis is a group of autoimmune diseases (GPA, MPA and EGPA) in which antibodies inflame small blood vessels, often damaging the kidneys, lungs and sinuses; a few thousand Americans are diagnosed each year. Rituximab and cyclophosphamide put most into remission, but relapses are common and long-term steroids cause much of the harm. Avacopan and anti-IL-5 drugs have reduced steroid use; complement blockers and CAR T cells are next.

  1. Now

    Nov 2026

    Fewer steroids, better kidneysHappened 71.0% sustained remission

    Avacopan with rituximab: 71.0% in sustained remission at 1 year vs 56.1% with a prednisone taper.

    71.0%: in sustained remission at week 52, vs 56.1% with prednisone.

    Two targeted options for EGPAHappened 59% remission

    Benralizumab matched mepolizumab (59% vs 56% remission) and let more people stop steroids.

    59%: in remission with benralizumab, vs 56% with mepolizumab.

    Rituximab not better for EGPAHappened 63.5% remission

    In REOVAS, rituximab gave 63.5% remission vs 60.4% with conventional treatment.

    63.5%: in remission at day 180 with rituximab, vs 60.4%.

  2. 6 months

    by May 2027

    A complement factor B pillPossible

    Novartis' iptacopan phase 2 (84 people) finishes December 2026.

  3. 12 months

    by Nov 2027

    Another complement blockerPossible

    Alexion's tarperprumig phase 2 (78 people) is due October 2027.

    Obinutuzumab for relapsing GPALong shot

    A French trial tests a stronger B-cell-depleting antibody for relapsing PR3-ANCA disease; due December 2027.

  4. 3 years

    by late 2029

    When to stop maintenance treatmentPossible

    MASTER-ANCA (136 people) tests stopping immunosuppression in people in stable remission; due March 2028.

    Protecting the kidneysPossible 71.0% remission (avacopan)

    RENATO tests pioglitazone (due April 2028) and REVERSE tests avacopan for severe kidney disease (due March 2030).

    71.0%: in sustained remission at week 52, vs 56.1% with prednisone.

  5. 5 years

    by late 2031

    CAR T cells for refractory diseaseLong shot

    Novartis' rapcabtagene autoleucel phase 2 (126 people) is due June 2029.

Happened Likely Possible Long shot

The research paths

Rising

Complement blockers

71.0% sustained remission
Details and 4 trialsHide
Established

Eosinophil-targeted drugs for EGPA

59% remission
DetailsHide

Anti-IL-5 antibodies replace much of the steroid burden.

WatchLong-term outcomes.

Active

Less treatment and cell therapy

Details and 5 trialsHide

Borrowed from other conditions

From Severe asthma

Mepolizumab and benralizumab

Approved

Eosinophil-targeting antibodies first approved for asthma.

From PNH and IgA nephropathy

Iptacopan

Phase 2

A complement factor B pill.

From CLL and lupus nephritis

Obinutuzumab

Phase 2

A stronger B-cell-depleting antibody.

Open to join now

See every recruiting ANCA vasculitis trial →

When the trials finish

Completion dates the trials registered. Results usually follow 3 to 12 months later.

2026202720282029203020312032Today
Dec 2026
Apr 2027
TarperprumigComplement blockers
Oct 2027
Obinutuzumab for relapsing PR3-ANCA vasculitisLess treatment and cell therapy
Dec 2027
Low-dose steroids (SAFE-LOW)Less treatment and cell therapy
Feb 2028
Mar 2028
Pioglitazone to protect the kidneys (RENATO)Less treatment and cell therapy
Apr 2028
Rapcabtagene autoleucel CAR T cellsLess treatment and cell therapy
Jun 2029

What just happened

Rituximab no better than standard care for EGPA

REOVAS, Ann Intern Med.

FDA approves benralizumab for EGPA

MANDARA, NEJM.

Standard treatment today

How to read this page, and sourcesHow to read this page, and sources

See ANCA vasculitis trials recruiting now →

Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.