伊库利珠单抗
医学
阵发性夜间血红蛋白尿
重症监护医学
免疫学
背景(考古学)
脑膜炎奈瑟菌
化学预防
补体系统
内科学
抗体
遗传学
生物
古生物学
细菌
作者
Esther Benamu,José G. Montoya
出处
期刊:Current Opinion in Infectious Diseases
[Ovid Technologies (Wolters Kluwer)]
日期:2016-06-02
卷期号:29 (4): 319-329
被引量:121
标识
DOI:10.1097/qco.0000000000000279
摘要
Purpose of review Eculizumab inhibits complement effector functions and has significantly impacted the treatment of paroxysmal nocturnal hemoglobinuria and atypical hemolytic uremic syndrome. However, the risks of potentially life-threatening infections, notably with Neisseria spp. in addition to its cost, are major challenges in clinical practice. In this review, we characterize and summarize the infectious complications reported with the use of eculizumab in the context of its typical and expanding indications. Recent findings Use of eculizumab is rapidly extending to the fields of transplantation and neurology. Eculizumab has been primarily associated with an increased risk of meningococcal infections. Immunization against its commonest serotypes (ABCWY) is now possible with the advent of the meningococcal B vaccine. A combined ABCWY vaccine is underway. Preventive strategies against breakthrough Neisseria infections should also include chemoprophylaxis. Less is known about the association of eculizumab with other infections as recently reported. Surrogate markers of complement blockade, notably CH50, and eculizumab efficacy may help in the risk assessment of infection. Summary Eculizumab has opened new horizons in the treatment of complement-mediated disorders. Prophylactic and immunization strategies against the risk of Nesseria spp. infections are sound and feasible. The use of eculizumab is expanding beyond complement-mediated diseases to transplantation and neurological disorders. Further research is needed to better define and stratify the risk of infection and prevention strategies in patients with the latter indications.
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