+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Timing of eculizumab therapy for C3 glomerulonephritis



Timing of eculizumab therapy for C3 glomerulonephritis



Clinical Kidney Journal 8(4): 449-452



Eculizumab is an anti-C5 antibody that inhibits C5 cleavage and prevents the generation of the terminal complement complex C5b-9. Eculizumab is licensed to treat paroxysmal nocturnal haemoglobinuria or atypical haemolytic uraemic syndrome (aHUS). Clinical trials are ongoing for C3 glomerulopathy. Given the unfamiliarity of physicians with these rare diseases and the variability of clinical presentation, a delayed initiation of eculizumab therapy is common. Thus, the question arises as to what extent improvement of kidney function may be expected when patients have been dialysis dependent for weeks or months already when eculizumab is initiated. Furthermore, given the high cost and potential adverse effects of eculizumab, the question arises of when to stop therapy because of futility when patients with kidney-only manifestations remain dialysis dependent. In literature reports, eculizumab was stopped as early as after 3 weeks because the patient remained dialysis dependent. In this issue of CKJ, Inman et al. report on eculizumab-induced reversal of dialysis-dependent kidney failure from C3 glomerulonephritis, illustrating both the potential benefit of eculizumab for this complement-mediated disease and the need for lengthy therapy-dialysis independency was reached after 5 months of eculizumab. Indeed, there are reports of renal function recovery when eculizumab was initiated after 4 months on dialysis and of recovery of renal function 2.0-3.5 months after initiation of eculizumab in dialysis-dependent patients with C3 glomerulopathy or aHUS.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059136046

Download citation: RISBibTeXText

PMID: 26251715

DOI: 10.1093/ckj/sfv065


Related references

Severe active C3 glomerulonephritis triggered by immune complexes and inactivated after eculizumab therapy. Diagnostic Pathology 11(1): 94-94, 2016

Eculizumab and recurrent C3 glomerulonephritis. Pediatric Nephrology 28(10): 1975-1981, 2014

Eculizumab and refractory membranoproliferative glomerulonephritis. New England Journal of Medicine 366(12): 1165-1166, 2012

Eculizumab in the treatment of membranoproliferative glomerulonephritis. Nephron. Clinical Practice 128(3-4): 270-276, 2015

Eculizumab: a shift for the treatment of glomerulonephritis with C3 deposits?. Giornale Italiano di Nefrologia 29(4): 377-377, 2012

A case of C3 glomerulonephritis successfully treated with eculizumab. Pediatric Nephrology 30(6): 1033-1037, 2016

Eculizumab for dense deposit disease and C3 glomerulonephritis. Clinical Journal of the American Society of Nephrology 7(5): 748-756, 2012

Eculizumab-induced reversal of dialysis-dependent kidney failure from C3 glomerulonephritis. Clinical Kidney Journal 8(4): 445-448, 2015

Post-streptococcal glomerulonephritis associated with atypical hemolytic uremic syndrome: to treat or not to treat with eculizumab?. Clinical Kidney Journal 9(1): 90-96, 2016

A Prospective, Multicenter, Randomized Phase II Study to Evaluate the Efficacy and Safety of Eculizumab in Patients with Guillain-Barré Syndrome (GBS): Protocol of Japanese Eculizumab Trial for GBS (JET-GBS). Jmir Research Protocols 5(4): E210-E210, 2016

Eculizumab therapy. Biology of Blood and Marrow Transplantation 20(4): 438-439, 2014

The immunohistological findings in various forms of glomerulonephritis: a comparative investigation based on 335 renal biopsies. Part I: Endocapillary glomerulonephritis, mesangioproliferative glomerulonephritis, mesangioproliferative glomerulonephritis with focal crescents, minimal proliferating intercapillary glomerulonephritis (without nephrotic syndrome). Pathology, Research and Practice 162(2): 178-197, 1978

Eculizumab: A novel therapy for paroxysmal nocturnal hemoglobinuria. Drugs of Today 43(8): 539-546, 2007

Extracapillary proliferative glomerulonephritis after therapy with co trimoxazole a drug induced glomerulonephritis?. Kidney International: 594, 1985

Clinical effects of pulse therapy in membranoproliferative glomerulonephritis type 1 and rapidly progressive glomerulonephritis. Pediatric Nephrology 4(5): C48, 1990