Eculizumab Rescue Therapy in Patients With Recurrent Atypical Hemolytic Uremic Syndrome After Kidney Transplantation

Duineveld, Caroline; Bouwmeester, Romy N.; Wijnsma, Kioa L.; Berger, Stefan P.; Heuvel, L.P.W.J. van den; Berger, Dr.SP.; Bemelman, F. J.; Heijden, J.W. van der; Wetering, J. van de; Vries, Aiko P.J. de; Wetzels, Jack F.M.; Wijk, J. A. E. van; Bouts, Antonia H.; Dorresteijn, Eiske M.; Gracchi, Valentina; Horuz-Engels, F.A.P.T.; Keijzer-Veen, Mandy G.; Rooij, R.W.G. van; Kar, Nicole C. A. J. van de; Heuvel, Lambert P. van den

doi:10.1016/j.ekir.2023.01.016

Cited by 10 publications

(5 citation statements)

References 36 publications

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“…Clinical outcomes and detailed description of the patients are described elsewhere in detail. 21,22 In short, it was shown that early eculizumab withdrawal in patients with aHUS is safe and cost-effective in patients with native kidneys. In post-transplant patients with aHUS, rescue treatment in case of recurrence is also effective, but some patients suffer from irreversible loss of kidney function.…”

Section: Data Collectionmentioning

confidence: 99%

Proteinuria and Exposure to Eculizumab in Atypical Hemolytic Uremic Syndrome

Avest¹,

Steenbreker²,

Bouwmeester

et al. 2023

CJASN

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Section: Data Collectionmentioning

confidence: 99%

Proteinuria and Exposure to Eculizumab in Atypical Hemolytic Uremic Syndrome

Avest¹,

Steenbreker²,

Bouwmeester

et al. 2023

CJASN

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“…Discontinuation of therapy was successful in three patients. At the end of the follow-up (median 29 months), three patients lost their grafts, and six had GFR less than 30 (15).…”

Section: Atypical Hemolytic Uremic Syndromementioning

confidence: 99%

Eculizumab in kidney diseases

Pour-Reza-Gholi,

Assadiasl

2023

J Nephropharmacol

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The C5 inhibitor monoclonal antibody, eculizumab, has been approved for the treatment of atypical hemolytic uremic syndrome (aHUS) and paroxysmal nocturnal hemoglobinuria (PNH); however, the efficacy and safety of this drug in treating other complement-related renal diseases has not yet been elucidated. The high cost of eculizumab therapy and the rare adverse effects have created a paradox in conducting large clinical trials. Therefore, there is a need to increase clinicians’ awareness of the available data on the efficacy/safety of this drug in treating renal diseases. Herein, we have reviewed the outcomes of the administration of eculizumab in aHUS, PNH, lupus erythematosus nephritis, C3 glomerulonephritis, IgA nephropathy, and antibody-mediated rejection (AMR) in highly sensitized patients. Initial findings suggest its efficacy in treating acute injuries but lower effectiveness in preventing chronic lesions. Besides, early diagnosis and timely initiation of eculizumab are of particular importance.

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“… 2 , 3 Because of the high costs of eculizumab, in some countries eculizumab therapy is initiated reactively, at the time of suspected posttransplant aHUS recurrence. 4 Using this strategy, early diagnosis of aHUS recurrence is important, as several studies showed that early start of eculizumab improved outcome. 5 , 6 However, management of TMA after kidney transplantation is difficult.…”

mentioning

confidence: 99%

“…First, patients with aHUS may present with recurrence without laboratory signs of TMA and only slow loss of kidney function, which may result in a diagnostic delay. 4 , 7 , 8 , 9 , 10 Second, there are many other causes of TMA after kidney transplantation, which are difficult to discern from aHUS. 11 There is currently no accurate diagnostic test for aHUS recurrence after kidney transplantation.…”

mentioning

confidence: 99%

Eculizumab Rescue Therapy in Patients With Recurrent Atypical Hemolytic Uremic Syndrome After Kidney Transplantation

Cited by 10 publications

References 36 publications

Proteinuria and Exposure to Eculizumab in Atypical Hemolytic Uremic Syndrome

Proteinuria and Exposure to Eculizumab in Atypical Hemolytic Uremic Syndrome

Eculizumab in kidney diseases

Ex Vivo Test of Complement Dysregulation in Atypical Hemolytic Uremic Syndrome Kidney Transplant patients: A Pilot Study

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