Hepatotoxicity associated with eculizumab in a patient with atypical hemolytic uremic syndrome

Oruç, Ayşegül; Ayar, Yavuz; Vuruşkan, Berna Aytaç; Yıldız, Abdülmecit; Aktaş, Nimet; Yavuz, Mahmut; Güllülü, Mustafa; Dilek, Kamıl

doi:10.1016/j.nefro.2017.10.001

Cited by 10 publications

(5 citation statements)

References 8 publications

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“…The most prominent risk is the susceptibility to infection with Neisseria meningitidis (meningococcus) [ 11 ]. Furthermore, evidence is accumulating regarding the potential (long-term) adverse effects of eculizumab, such as hepatotoxicity [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Pharmacology, Pharmacokinetics and Pharmacodynamics of Eculizumab, and Possibilities for an Individualized Approach to Eculizumab

et al. 2019

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Eculizumab is the first drug approved for the treatment of complement-mediated diseases, and current dosage schedules result in large interindividual drug concentrations. This review provides insight into the pharmacokinetic and pharmacodynamic properties of eculizumab, both for reported on-label (paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, generalized myasthenia gravis) and off-label (hematopoietic stem cell transplantation-associated thrombotic microangiopathy) indications. Furthermore, we discuss the potential of therapeutic drug monitoring to individualize treatment and reduce costs.

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Section: Introductionmentioning

confidence: 99%

Pharmacology, Pharmacokinetics and Pharmacodynamics of Eculizumab, and Possibilities for an Individualized Approach to Eculizumab

et al. 2019

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“…Other concerns include hepatotoxicity in association with eculizumab therapy as reported in children and adults. 11 Furthermore, deposition of eculizumab has been reported in individuals with C3 glomerulopathy or cTMA and its significance is currently unknown. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Successful Pregnancies During Ongoing Eculizumab Therapy in Two Patients With Complement-Mediated Thrombotic Microangiopathy

et al. 2020

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In patients with pregnancy-associated complement gene variant–mediated thrombotic microangiopathy (cTMA), terminal complement blockade is used for treatment of cTMA flares during pregnancy or following delivery. We report pregnancy and delivery outcomes of 2 genetically high-risk patients with cTMA, including 1 kidney transplant recipient, during ongoing eculizumab therapy. In both patients, the first manifestation of cTMA occurred independent from pregnancy. One patient has a history of 2 uneventful pregnancies with prophylactic plasma infusions, and the other has a history of early abortion during long-term eculizumab therapy following kidney transplantation. Overall, pregnancy and delivery outcomes under ongoing eculizumab therapy in our 2 patients with preserved kidney function were excellent as compared with other patients reported in the literature. Eculizumab plasma concentrations were maintained in the therapeutic range during pregnancy and were also detectable in cord blood. Results of cord blood analysis showed deficient complement activity, with low factor and regulator levels, most likely reflecting the age of the neonates and presence of eculizumab in cord blood. In conclusion, pregnancy during ongoing eculizumab treatment appeared to be safe in 2 women with a history of high-risk genetic cTMA and excellent kidney function, even following kidney transplantation.

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“…Unlike our patient, neither of these children had elevated liver enzyme levels prior to treatment. 8 Oruc et al 9 have observed hepatotoxicity following eculizumab treatment in an adult HUS patient with no preexisting liver disease. The mechanism of hepatotoxicity associated with biologic drugs like eculizumab is not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Infant onset severe complement‐mediated hemolytic uremic syndrome complicated by secondary sclerosing cholangitis

Yeşilbaş

Şevketoğlu

Petmezci

et al. 2018

J of Clinical Apheresis

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Hepatotoxicity associated with eculizumab in a patient with atypical hemolytic uremic syndrome

Cited by 10 publications

References 8 publications

Pharmacology, Pharmacokinetics and Pharmacodynamics of Eculizumab, and Possibilities for an Individualized Approach to Eculizumab

Pharmacology, Pharmacokinetics and Pharmacodynamics of Eculizumab, and Possibilities for an Individualized Approach to Eculizumab

Successful Pregnancies During Ongoing Eculizumab Therapy in Two Patients With Complement-Mediated Thrombotic Microangiopathy

Infant onset severe complement‐mediated hemolytic uremic syndrome complicated by secondary sclerosing cholangitis

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