Reduced Dose Maintenance Eculizumab in Atypical Hemolytic Uremic Syndrome (aHUS): an Update on a Previous Case Report

Overview

Journal Clin Pharmacol

Publisher Dove Medical Press

Specialty Pharmacology

Date 2012 Jan 31

PMID 22287856

Citations 11

Authors

Maro Ohanian

Christian Cable

Kathleen Halka

Affiliations

Soon will be listed here.

Abstract

Objective: To describe how maintenance eculizumab sustains improved renal function in severe atypical hemolytic uremic syndrome (aHUS).

Case Report: A previously described 50-year-old woman with aHUS had a remarkable recovery with eculizumab, which safely reversed profound neurologic damage and eliminated the need for dialysis. Her recovery has been sustained on long-term eculizumab treatment. She initially received eculizumab 900 mg weekly for four doses. On week 5 she commenced maintenance therapy starting at 1200 mg every 2 weeks. Due to nausea and vomiting at that dose, the maintenance dosing was reduced to 600 mg weekly, beginning on dose seven. After receiving 600 mg weekly for nine doses, eculizumab was then reduced to 600 mg every 2 weeks, with continued improvement in renal function. This dosing is lower than the usual 1200 mg every 2 weeks described in the adult literature and used in current clinical trials of aHUS.

Conclusion: Six months after the initial diagnosis, our patient continues to have improved renal function on maintenance doses of eculizumab as low as 600 mg every 2 weeks.

Citing Articles

Epidemiology, Management, and Outcome of Atypical Hemolytic Uremic Syndrome in an Omani Cohort.

Riyami D, Mohammed S, Al Salmi I, Metry A, Al Kalbani N, Almurshadi F Oman Med J. 2024; 38(6):e569.

PMID: 38317858 PMC: 10839635. DOI: 10.5001/omj.2023.117.

Complement gene variant effect on relapse of complement-mediated thrombotic microangiopathy after eculizumab cessation.

Acosta-Medina A, Moyer A, Go R, Willrich M, Fervenza F, Leung N Blood Adv. 2022; 7(3):340-350.

PMID: 35533258 PMC: 9881046. DOI: 10.1182/bloodadvances.2021006416.

Effect of eculizumab and recombinant human soluble thrombomodulin combination therapy in a 7-year-old girl with atypical hemolytic uremic syndrome due to anti-factor H autoantibodies.

Udagawa T, Motoyoshi Y, Matsumura Y, Takei A, Ariji S, Ito E CEN Case Rep. 2017; 3(1):110-117.

PMID: 28509254 PMC: 5411543. DOI: 10.1007/s13730-013-0097-7.

Clinical Practice Guidelines for the Management of Atypical Hemolytic Uremic Syndrome in Korea.

Cheong H, Jo S, Yoon S, Cho H, Kim J, Kim Y J Korean Med Sci. 2016; 31(10):1516-28.

PMID: 27550478 PMC: 4999392. DOI: 10.3346/jkms.2016.31.10.1516.

Current treatment of atypical hemolytic uremic syndrome.

Kaplan B, Ruebner R, Spinale J, Copelovitch L Intractable Rare Dis Res. 2014; 3(2):34-45.

PMID: 25343125 PMC: 4204535. DOI: 10.5582/irdr.2014.01001.

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