eculizumab (Soliris)

Indications

• paroxysmal nocturnal hemoglobinuria
• hemolytic uremic syndrome (HUS)
• membranoproliferative glomerulonephritis
• Degos-Touraine syndrome
• AChR-Ab + myasthenia gravis

Dosage

• meningococcal vaccination must be administered to all patients at least 2 weeks prior to the 1st dose of eculizumab*
• infusion 600-900 mg diluted to 5 mg/mL over 35 minutes
  • every 7 days during induction phase
  • every 14 +/- 2 days during maintenance
  • 600 mg weekly for 1st 4 weeks
  • 900 mg week 5
  • 900 mg every 2 weeks thereafter

300 mg single use vials, 30 ml of 10 mg/mL of sterile solution

* ref case of HUS seemed to have much shorter interval between meningococcal vaccination & first dose of eculizumab

Adverse effects

• > 10-20%%
  • headache
  • pyrexia
  • nasopharyngitis, upper respiratory infection, cough
  • abdominal pain
  • nausea/vomiting
  • diarrhea
  • hypertension
  • anemia
  • peripheral edema
  • urinary tract infections
• increased risk of invasive meningococcal disease

• drug adverse effects of pharmaceutical monoclonal antibodies

Mechanism of action

• reduces hemolysis by inhibiting terminal complement activation
• targets complement C5

More general terms

• pharmaceutical monoclonal antibody