Infections associated with the use of eculizumab: recommendations for prevention and prophylaxis

Benamu, Esther; Montoya, José G.

doi:10.1097/qco.0000000000000279

Cited by 120 publications

(59 citation statements)

References 95 publications

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“…Therefore, patients who have not been vaccinated against N. meningitidis should receive a quadrivalent meningococcal vaccine at least 2 weeks prior to the first dose of eculizumab [22, 23]. In patients like ours where we need to give the therapy immediately, prophylactic antibiotics can be administered till then.…”

Section: Discussionmentioning

confidence: 99%

Atypical hemolytic uremic syndrome in first trimester pregnancy successfully treated with eculizumab

et al. 2017

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Background Atypical hemolytic uremic syndrome is a rare disorder which is known to cause acute thrombotic microangiopathy during pregnancy with poor maternal and fetal outcomes. Atypical hemolytic uremic syndrome is caused mostly by dysregulation of alternative complement pathway secondary to genetic mutations. Most of the cases reported have been in the post-partum period. We report a rare case of a patient who presents with thrombotic microangiopathy in the first trimester of her eleventh pregnancy and was successfully treated with eculizumab.Case presentationA 30-year-old woman presented at 10 weeks of gestation with hypertension, hemolytic anemia, thrombocytopenia, and acute kidney injury, consistent with thrombotic microangiopathy. She was managed initially with daily plasmapheresis. However, her kidney function did not recover, requiring hemodialysis. ADAMTS13 activity was later found to be within normal limit, hence diagnosis of atypical hemolytic uremic syndrome was strongly considered at that time and she was immediately treated with anti-C5 humanized monoclonal antibody (eculizumab). The patient responded well (resolution of thrombotic microangiopathy and recovery of renal function) to eculizumab, with continued remission after discharge and successfully delivered a healthy baby at term without any peripartum complications.ConclusionEarly recognition of atypical hemolytic uremic syndrome is often difficult as several other conditions also manifest as thrombotic microangiopathy during pregnancy, causing delay in initiating appropriate treatment. Our case suggests that treatment of atypical hemolytic uremic syndrome in early trimester of pregnancy with eculizumab results in good outcome to mother and fetus.

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Section: Discussionmentioning

confidence: 99%

Atypical hemolytic uremic syndrome in first trimester pregnancy successfully treated with eculizumab

et al. 2017

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“…Eculizumab (Soliris®) is a humanized monoclonal antibody (mAb) which function as a terminal complement inhibitor [57]. It was the first therapeutic agent approved by the FDA for atypical hemolytic uremic syndrome (aHUS) and paroxysmal nocturnal hemoglobinuria (PNH)-associated with thrombotic microangiopathy (TMA) in 2007 and 2011 respectively [58]. Soliris® (Alexion Pharmaceuticals, New Haven, Connecticut, USA) is in the form of sterile solution for i.v.…”

Section: Virus-like Particlementioning

confidence: 99%

New Generation Peptide-Based Vaccine Prototype

Özcan¹,

Karahan²,

Kumar³

et al. 2020

Current and Future Aspects of Nanomedicine

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Synthetic peptide-based vaccine prototypes are the future potential vaccination. Antigens, which belong to minimal microbial component and produce antibodies such as peptides and polysaccharides, can promote long-term protection against pathogens that can cause infectious diseases. Production of peptides becomes simple with solid phase peptide synthesis and microwave-assisted solid phase peptide synthesis using automatic synthesizers. The use of synthetic peptides was approved by the health authorities for vaccine design. Peptides are themselves very weak immunogens and need adjuvants to provide an effective autoimmune response. For this reason, peptide antigens are conjugated with biopolymers and loaded with nanoparticles. The toxicity of vaccine prototypes is evaluated in cell culture, and non-toxic prototypes are selected for vaccinating experimental animals. The most effective peptide-based vaccine prototype is determined as the one with the highest antibody level. The goal of this book chapter is to illustrate the use of peptides vaccine systems and present their opportunities with their future development.

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“…54 During the interval until protective titers are achieved, penicillin V potassium at 250 mg q12 hours or ciprofloxacin 500 mg daily have been recommended. 55 In non-immune individuals, consideration could also be given to vaccination against Haemophilus influenzae type b and Pneumococcus pneumoniae. 56 …”

Section: Therapeuticsmentioning

confidence: 99%

Atypical Hemolytic Uremic Syndrome: A Brief Review

Zhang

Harley

et al. 2017

Hematology Reports

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Atypical hemolytic uremic syndrome (aHUS) is a disease characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury. The histopathologic lesions of aHUS include thrombotic microangiopathy involving the glomerular capillaries and thrombosis involving arterioles or interlobar arteries. Extra-renal manifestations occur in up to 20% of patients. The majority of aHUS is caused by complement system defects impairing ordinary regulatory mechanisms. Activating events therefore lead to unbridled, ongoing complement activity producing widespread endothelial injury. Pathologic mutations include those resulting in loss-of-function in a complement regulatory gene (CFH, CFI, CD46 or THBD) or gain-of-function in an effector gene (CFB or C3). Treatment with the late complement inhibitor, eculizumab – a monoclonal antibody directed against C5 – is effective.

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Infections associated with the use of eculizumab: recommendations for prevention and prophylaxis

Cited by 120 publications

References 95 publications

Atypical hemolytic uremic syndrome in first trimester pregnancy successfully treated with eculizumab

Atypical hemolytic uremic syndrome in first trimester pregnancy successfully treated with eculizumab

New Generation Peptide-Based Vaccine Prototype

Atypical Hemolytic Uremic Syndrome: A Brief Review

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