{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:11:11Z","timestamp":1787670671035,"version":"build-2736575974"},"reference-count":8,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T00:00:00Z","timestamp":1730246400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Ophthalmology"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Avacopan is a novel C5a receptor inhibitor which was recently licensed for treatment of severe granulomatosis with polyangiitis (GPA) in the European Union and the United Kingdom. To the best of our knowledge, this is the first described case on initial ophthalmic outcomes in a patient with severe GPA and concurrent refractory scleritis treated with avacopan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Description<\/jats:title>\n                    <jats:p>We present a case of de novo scleritis in a 77-year-old male with a background of retinitis pigmentosa with Argus II implant in situ. Severe scleral inflammation occurred following a suture removal from the implant site. Remission was not maintained despite orbital floor injections and high dose oral prednisolone. The diagnostic work-up revealed GPA which quickly progressed to involve vital organs. In view of his systemic deterioration, he was started on avacopan alongside rituximab, cyclophosphamide and high dose oral prednisolone. Sustained remission of scleritis was noted after 7 months of treatment with avacopan and low dose oral prednisolone with no other maintenance immunosuppression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We observed a sustained benefit of avacopan in allowing for successful taper of systemic steroids. We report that avacopan used alongside other immunosuppressants may be a viable option in patients with GPA and concurrent refractory scleritis. Further studies are needed to establish the longer term impact of this agent on the control of scleral inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11206721241295298","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T04:27:25Z","timestamp":1730262445000},"page":"NP17-NP21","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Avacopan in the treatment of refractory scleritis secondary to granulomatosis with polyangiitis: A case report"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7371-3736","authenticated-orcid":false,"given":"Emilia","family":"Bober","sequence":"first","affiliation":[{"name":"Uveitis and Scleritis Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavana","family":"Sharma","sequence":"additional","affiliation":[{"name":"Uveitis and Scleritis Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK"},{"name":"Ophthalmology Department, Aneurin Bevan University Health Board, Newport, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Papasavvas","sequence":"additional","affiliation":[{"name":"Uveitis and Scleritis Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"McAdoo","sequence":"additional","affiliation":[{"name":"Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Petrushkin","sequence":"additional","affiliation":[{"name":"Uveitis and Scleritis Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK"},{"name":"Rheumatology Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"bibr1-11206721241295298","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2005.04.001"},{"key":"bibr2-11206721241295298","doi-asserted-by":"publisher","DOI":"10.5582\/irdr.2016.01014"},{"key":"bibr3-11206721241295298","doi-asserted-by":"crossref","DOI":"10.1016\/S2665-9913(22)00041-8","volume":"4","author":"Thorley J","year":"2022","journal-title":"Lancet Rheumatol"},{"key":"bibr4-11206721241295298","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac330"},{"key":"bibr5-11206721241295298","unstructured":"National Institute for Health and Care Excellence. Avacopan for treating severe active granulomatosis with polyangiitis or microscopic polyangiitis, https:\/\/www.nice.org.uk\/guidance\/ta825 (2022, accessed 19 March 2024)."},{"key":"bibr6-11206721241295298","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909905"},{"key":"bibr7-11206721241295298","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2016111179"},{"key":"bibr8-11206721241295298","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2023386"}],"container-title":["European Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11206721241295298","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11206721241295298","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11206721241295298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T19:46:56Z","timestamp":1777405616000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11206721241295298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,30]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1177\/11206721241295298"],"URL":"https:\/\/doi.org\/10.1177\/11206721241295298","relation":{},"ISSN":["1120-6721","1724-6016"],"issn-type":[{"value":"1120-6721","type":"print"},{"value":"1724-6016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,30]]}}}