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.
- 74studies open or running
- 5phase 3 trials
- 933papers published this year
- 15NIH-funded projects
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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%.
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6 months
by May 2027
A complement factor B pillPossible
Novartis' iptacopan phase 2 (84 people) finishes December 2026.
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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.
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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.
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5 years
by late 2031
CAR T cells for refractory diseaseLong shot
Novartis' rapcabtagene autoleucel phase 2 (126 people) is due June 2029.
The research paths
Complement blockers
71.0% sustained remissionDetails and 4 trialsHide
Avacopan approved; factor B and other complement blockers in trials.
WatchIptacopan; tarperprumig.
- Iptacopan (complement factor B pill)Novartis · 84 people · fully enrolled Dec 2026
- TarperprumigAlexion · 78 people · fully enrolled Oct 2027
- Avacopan for severe kidney involvement (REVERSE)University Hospital, Toulouse · 130 people · not yet open Mar 2030
- BDB-001 (anti-C5a) vs cyclophosphamideStaidson Biopharmaceuticals · 300 people · enrolling Apr 2027
Eosinophil-targeted drugs for EGPA
59% remissionDetailsHide
Anti-IL-5 antibodies replace much of the steroid burden.
WatchLong-term outcomes.
Less treatment and cell therapy
Details and 5 trialsHide
Lower steroid doses, stopping maintenance safely, and CAR T cells for refractory disease.
WatchMASTER-ANCA; SAFE-LOW.
- Maintaining vs stopping immunosuppression (MASTER-ANCA)Centre Hospitalier Départemental Vendée · 136 people · fully enrolled Mar 2028
- Low-dose steroids (SAFE-LOW)Ottawa Hospital Research Institute · 36 people · enrolling Feb 2028
- Pioglitazone to protect the kidneys (RENATO)Assistance Publique - Hôpitaux de Paris · 126 people · enrolling Apr 2028
- Rapcabtagene autoleucel CAR T cellsNovartis · 126 people · fully enrolled Jun 2029
- Obinutuzumab for relapsing PR3-ANCA vasculitisAssistance Publique - Hôpitaux de Paris · 33 people · enrolling Dec 2027
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
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ANCA vasculitis with kidney disease
Pioglitazone
Locations and eligibility → -
ANCA vasculitis
Low-dose steroids
Locations and eligibility → -
Relapsing PR3-ANCA vasculitis
Obinutuzumab
Locations and eligibility →
See every recruiting ANCA vasculitis trial →
When the trials finish
Completion dates the trials registered. Results usually follow 3 to 12 months later.
- Heating up
- Maturing
- Early
- Cooling
- Fully enrolled, waiting on results
- Still enrolling
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
- New GPA or MPARituximab (or cyclophosphamide) with steroids or avacopan.
- MaintenanceRituximab every 6 months for about 2 years or longer.
- EGPASteroids; mepolizumab or benralizumab; cyclophosphamide for severe organ involvement.
- Severe kidney involvementInduction therapy; plasma exchange in selected cases; dialysis if needed.
How to read this page, and sourcesHow to read this page, and sources
- GPA, MPA and EGPA are related but treated differently; check which type a result applies to.
- Forecasts are editorial judgments by Find a Trial, not predictions from sponsors or regulators.
See ANCA vasculitis trials recruiting now →