Eculizumab prevents thrombotic microangiopathy in patients with atypical haemolytic uraemic syndrome in a long-term observational study

Details

Serval ID
serval:BIB_F12D4F15201E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Eculizumab prevents thrombotic microangiopathy in patients with atypical haemolytic uraemic syndrome in a long-term observational study
Journal
Clin Kidney J
Author(s)
Menne J., Delmas Y., Fakhouri F., Kincaid J. F., Licht C., Minetti E. E., Mix C., Provot F., Rondeau E., Sheerin N. S., Wang J., Weekers L. E., Greenbaum L. A.
ISSN
2048-8505 (Print)
ISSN-L
2048-8505
Publication state
Published
Issued date
04/2019
Volume
12
Number
2
Pages
196-205
Language
english
Notes
Menne, Jan
Delmas, Yahsou
Fakhouri, Fadi
Kincaid, John F
Licht, Christoph
Minetti, Enrico E
Mix, Chris
Provot, Francois
Rondeau, Eric
Sheerin, Neil S
Wang, Jimmy
Weekers, Laurent E
Greenbaum, Larry A
eng
England
Clin Kidney J. 2018 May 16;12(2):196-205. doi: 10.1093/ckj/sfy035. eCollection 2019 Apr.
Abstract
Background: Eculizumab, a terminal complement inhibitor, is approved for atypical haemolytic uraemic syndrome (aHUS) to inhibit complement-mediated thrombotic microangiopathy (TMA). Methods: In five parent studies, eculizumab effectively prevented TMA and improved renal and haematologic outcomes in patients with aHUS; therefore, these patients could enrol in this long-term, prospective, observational and multicentre study. The primary endpoint was the TMA manifestation rate off and on eculizumab post-parent study. Post hoc analyses evaluated rates during labelled versus non-labelled dosing regimens, and in those with versus without identified complement abnormalities. Serious targeted treatment-emergent adverse events (TEAEs) were evaluated. Results: Of 87 patients in the current study, 39 and 76 had off- and on-treatment periods, respectively; 17 (44%) with off periods reinitiated eculizumab. TMA manifestation rate per 100 patient-years was 19.9 off and 7.3 on treatment [hazard ratio (HR), 4.7; P = 0.0008]; rates were highest off treatment and lowest during labelled regimens. TMA manifestations with hospitalizations/serious AEs occurred more frequently off versus on treatment. TMA rates were higher among patients with identified complement abnormalities (HR, 4.5; P = 0.0082). Serious targeted TEAEs occurred at similar rates off and on treatment. Conclusions: As expected, patients with aHUS have increased risk of TMA manifestations after discontinuation of eculizumab or in the setting of non-labelled eculizumab dosing. Collectively, results show that maintaining eculizumab treatment minimizes risk of TMA, particularly in patients with identified complement abnormalities. Future studies are needed to further characterize TMA and longer term outcomes on labelled or non-labelled eculizumab regimens and after discontinuation of treatment.
Keywords
atypical haemolytic uraemic syndrome, complement, discontinuation, eculizumab, observational study, thrombotic microangiopathy
Pubmed
Create date
01/03/2022 11:17
Last modification date
02/03/2022 7:36
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