Eculizumab in atypical hemolytic uremic syndrome: strategies toward restrictive use.
With the introduction of the complement C5-inhibitor eculizumab, a new era was entered for patients with atypical hemolytic uremic syndrome (aHUS). Eculizumab therapy very effectively reversed thrombotic microangiopathy and reduced mortality and morbidity. Initial guidelines suggested lifelong treat...
| Published in: | Pediatric Nephrology Vol. 34; no. 11; pp. 2261 - 2278 |
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| Main Authors: | , , , |
| Format: | protocol questions and answers review tables/charts Journal Article |
| Published: |
Springer Nature
Nov2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139138132&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139138132 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Nov2019 vid: 34 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 139138132 139138132 144052046 139138132 10.1007/s00467-018-4091-3 139138132 ppf: 2261 ppct: 17 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Eculizumab in atypical hemolytic uremic syndrome: strategies toward restrictive use. aug: au: Wijnsma, Kioa L. Duineveld, Caroline Wetzels, Jack F. M. van de Kar, Nicole C. A. J. affil: Radboud Institute for Molecular Life Sciences, Amalia Children's Hospital, Department of Pediatric Nephrology, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands sug: subj: Atypical Hemolytic Uremic Syndrome Drug Therapy Antibodies, Monoclonal Therapeutic Use Treatment Outcomes Thrombocytopenia Drug Therapy Thrombocytopenia Mortality Mortality Prevention and Control Kidney Transplantation Transplant Recipients Treatment Duration Individualized Medicine Protocols Economics, Pharmaceutical Antibodies, Monoclonal Adverse Effects ab: With the introduction of the complement C5-inhibitor eculizumab, a new era was entered for patients with atypical hemolytic uremic syndrome (aHUS). Eculizumab therapy very effectively reversed thrombotic microangiopathy and reduced mortality and morbidity. Initial guidelines suggested lifelong treatment and recommended prophylactic use of eculizumab in aHUS patients receiving a kidney transplant. However, there is little evidence to support lifelong therapy or prophylactic treatment in kidney transplant recipients. Worldwide, there is an ongoing debate regarding the optimal dose and duration of treatment, particularly in view of the high costs and potential side effects of eculizumab. An increasing but still limited number of case reports and small cohort studies suggest that a restrictive treatment regimen is feasible. We review the current literature and focus on the safety and efficacy of restrictive use of eculizumab. Our current treatment protocol is based on restrictive use of eculizumab. Prospective monitoring will provide more definite proof of the feasibility of such restrictive treatment. pubtype: Academic Journal doctype: protocol questions and answers review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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