ArticleInternal medicine (Tokyo, Japan)2026
Vanishing Bile Duct Syndrome Caused by a Treatment Regimen Including Avacopan for Microscopic Polyangiitis.
Article in Internal medicine (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Real-world long-term outcomes and safety of avacopan for antineutrophil cytoplasmic antibody-associated vasculitis with advanced renal dysfunction: a multicenter cohort study (4U-AAV Study).Clinical and experimental nephrology · 2026Article
- Article
- Avacopan-Associated Hepatotoxicity: Clinical Signal, Liver Injury Patterns, and Plausible Mechanisms.Cureus · 2026Review
- Avacopan-associated Liver Injury in Japanese Patients with ANCA-associated Vasculitis: Clinical, Genetic, and Mechanistic Perspectives.Internal medicine (Tokyo, Japan) · 2026Article
- Systematic Review of Efficacy and Safety of Avacopan in Real-World Clinical Practice.Kidney international reports · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
An 81-year-old man was treated with prednisolone, avacopan, and rituximab for microscopic polyangiitis and sulfamethoxazole/trimethoprim (SMX/TMP) and vonoprazan for prophylaxis. The liver enzyme levels were elevated 42 days after avacopan administration. Avacopan, SMX/TMP, and vonoprazan treatment were discontinued. A liver biopsy revealed vanishing bile duct syndrome. The patient was subsequently treated with ursodeoxycholic acid and glucocorticoid. Although vasculitis remained in remission, the patient ultimately died. Autopsy revealed persistent bile ductopenia and progressive liver cell injury confirmed by cytokeratin 7 positivity, severe cholestasis, and portal fibrosis. Further studies are required to elucidate associated mechanisms and risk factors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.