TY - JOUR
T1 - Outcomes of patients with atypical haemolytic uraemic syndrome with native and transplanted kidneys treated with eculizumab
T2 - a pooled post hoc analysis
AU - Legendre, Christophe M.
AU - Campistol, Josep M.
AU - Feldkamp, Thorsten
AU - Remuzzi, Giuseppe
AU - Kincaid, John F.
AU - Lommelé, Åsa
AU - Wang, Jimmy
AU - Weekers, Laurent E.
AU - Sheerin, Neil S.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - 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.
AB - 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.
KW - atypical haemolytic uraemic syndrome
KW - eculizumab
KW - kidney transplantation
UR - http://www.scopus.com/inward/record.url?scp=85034242950&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85034242950&partnerID=8YFLogxK
U2 - 10.1111/tri.13022
DO - 10.1111/tri.13022
M3 - Article
AN - SCOPUS:85034242950
VL - 30
SP - 1275
EP - 1283
JO - Transplant International
JF - Transplant International
SN - 0934-0874
IS - 12
ER -