Effectiveness and Safety of Switching to Ravulizumab From Eculizumab in Kidney Transplant Recipients With Atypical Hemolytic Uremic Syndrome: A Global aHUS Registry Analysis
Anja Gaeckler, Imad Al-Dakkak, Nuria Saval, Hans Herman Dieperink, Margriet Eygenraam, Larry A. Greenbaum, Nicole Isbel, Johan Vande Walle
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Abstract
Introduction
Atypical hemolytic uremic syndrome (aHUS) is a disease of complement dysregulation that may lead to kidney failure. Ravulizumab and eculizumab are complement C5 inhibitors approved for the treatment of aHUS. This study assessed the real-world effectiveness and safety of switching to ravulizumab from eculizumab in kidney transplant recipients with aHUS.
Methods
The Global aHUS Registry is a multicenter study enrolling patients with aHUS since 2012. Effectiveness and safety outcomes were assessed in kidney transplant recipients with aHUS who switched to ravulizumab from eculizumab up to September 2, 2024.
Results
Overall, 38 patients received a kidney transplant before ravulizumab initiation; 27 patients with ≥3 months of ravulizumab treatment were included in the patient characteristics and effectiveness analyses. Median (range) time on eculizumab and ravulizumab treatment was 66.1 (3.7, 158.3) and 24.1 (4.2, 49.3) months, respectively (n = 27); time from last kidney transplantation to ravulizumab initiation was 65.9 (3.7, 184.0) months. Following ravulizumab initiation, laboratory parameters remained stable, and no kidney transplant rejections/graft failures were reported. In the safety analysis (n = 38), 23 adverse events were reported in 19 patients (50.0%) at or after ravulizumab initiation, and none were considered treatment-related. No new events of thrombotic microangiopathy or kidney impairment and no meningococcal infections or deaths were reported.
Conclusion
This analysis from the Global aHUS Registry provides real-world evidence to demonstrate that the transition to ravulizumab from eculizumab in kidney transplant recipients with aHUS is successful, with stable graft function with no treatment-related safety concerns.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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