Outcomes of patients with atypical haemolytic uraemic syndrome with native and transplanted kidneys treated with eculizumab: a pooled post hoc analysis

Christophe M. Legendre, Josep M. Campistol, Thorsten Feldkamp, Giuseppe Remuzzi, John F. Kincaid, Åsa Lommelé, Jimmy Wang, Laurent E. Weekers, Neil S. Sheerin

Research output: Contribution to journalArticlepeer-review

Abstract

Atypical haemolytic uraemic syndrome (aHUS) often leads to end-stage renal disease (ESRD) and kidney transplantation; graft loss rates are high due to disease recurrence. A post hoc analysis of four prospective clinical trials in aHUS was performed to evaluate eculizumab, a terminal complement inhibitor, in patients with native or transplanted kidneys. The trials included 26-week treatment and extension periods. Dialysis, transplant and graft loss were evaluated. Study endpoints included complete thrombotic microangiopathy (TMA) response, TMA event-free status, haematologic and renal parameters and adverse events. Of 100 patients, 74 had native kidneys and 26 in the transplant subgroup had a collective history of 38 grafts. No patients lost grafts and only one with pre-existing ESRD received a transplant on treatment. Efficacy endpoints were achieved similarly in both subgroups. After 26 weeks, mean absolute estimated glomerular filtration rate increased from baseline to 61 and 37 ml/min/1.73 m2 in native (n = 71; P < 0.0001) and transplanted kidney (n = 25; P = 0.0092) subgroups. Two patients (one/subgroup) developed meningococcal infections; both recovered, one continued therapy. Eculizumab was well tolerated. Eculizumab improved haematologic and renal outcomes in both subgroups. In patients with histories of multiple graft losses, eculizumab protected kidney function.

Original languageEnglish
Pages (from-to)1275-1283
Number of pages9
JournalTransplant International
Volume30
Issue number12
DOIs
Publication statusPublished - Dec 1 2017

Keywords

  • atypical haemolytic uraemic syndrome
  • eculizumab
  • kidney transplantation

ASJC Scopus subject areas

  • Transplantation

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