When to Stop Eculizumab in Complement-Mediated Thrombotic Microangiopathies

Sven R. Olson, Eric Lu, Emilio Sulpizio, Joseph J. Shatzel, Jose Rueda, Thomas Deloughery

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

The terminal complement-inhibitor eculizumab has dramatically changed the management of patients with atypical hemolytic uremic syndrome (aHUS), and has also shown promise for treating certain forms of secondary HUS (sHUS), including that caused by drugs and solid-organ/hematopoietic stem cell transplant. While effective, eculizumab is costly and inconvenient. In this review, we evaluate the literature on eculizumab cessation in these diseases to better inform clinicians who consider stopping therapy. Reported relapse rates in aHUS after stopping eculizumab are as high as 30%, suggesting indefinite therapy is reasonable and that patients who choose to stop should be closely monitored. In sHUS, relapse is rare, justifying short courses of eculizumab.

Original languageEnglish (US)
Pages (from-to)96-107
Number of pages12
JournalAmerican Journal of Nephrology
Volume48
Issue number2
DOIs
StatePublished - Aug 1 2018

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Thrombotic Microangiopathies
Complement Inactivating Agents
Recurrence
Hematopoietic Stem Cells
eculizumab
Transplants
Therapeutics
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Nephrology

Cite this

When to Stop Eculizumab in Complement-Mediated Thrombotic Microangiopathies. / Olson, Sven R.; Lu, Eric; Sulpizio, Emilio; Shatzel, Joseph J.; Rueda, Jose; Deloughery, Thomas.

In: American Journal of Nephrology, Vol. 48, No. 2, 01.08.2018, p. 96-107.

Research output: Contribution to journalReview article

Olson, Sven R. ; Lu, Eric ; Sulpizio, Emilio ; Shatzel, Joseph J. ; Rueda, Jose ; Deloughery, Thomas. / When to Stop Eculizumab in Complement-Mediated Thrombotic Microangiopathies. In: American Journal of Nephrology. 2018 ; Vol. 48, No. 2. pp. 96-107.
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