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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Nephrol
2017 ; 30
(1
): 127-134
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Improved renal recovery in patients with atypical hemolytic uremic syndrome
following rapid initiation of eculizumab treatment
#MMPMID26995002
Walle JV
; Delmas Y
; Ardissino G
; Wang J
; Kincaid JF
; Haller H
J Nephrol
2017[Feb]; 30
(1
): 127-134
PMID26995002
show ga
BACKGROUND: Eculizumab is approved for atypical hemolytic uremic syndrome (aHUS).
Guidelines discuss the importance of prompt treatment. We report a post hoc
analysis investigating the effect of baseline factors, including patient
characteristics and time from the latest aHUS manifestation to eculizumab
initiation, on change from baseline in estimated glomerular filtration rate
(eGFR) and other outcomes. METHODS: Data were pooled from four phase 2,
open-label, single-arm, prospective clinical studies of eculizumab for patients
with aHUS. Multivariate regressions identified predictors of eGFR change from
baseline. The proportion of patients achieving sustained eGFR increase (defined:
?15 ml/min/1.73 m(2) for ?28 days) and platelet count normalization were
evaluated 1 year post-treatment. Baseline characteristics and eGFR outcomes were
summarized by time to treatment from last aHUS manifestation [?7 days (n = 21)
versus >7 days (n = 76)]. RESULTS: Baseline eGFR were similar between groups.
Multivariate regression analysis demonstrated time from aHUS manifestation to
eculizumab treatment, age, baseline lactate dehydrogenase (LDH) and baseline
hemoglobin were independently predictive of eGFR change from baseline. Mean eGFR
change from baseline at 1 year was significantly higher in patients treated in
?7 days than >7 days (57 vs. 23 ml/min/1.73 m(2), p = 0.0098). After 1 year,
17/21 and 36/76 patients in the ?7 and >7 day groups, respectively, achieved a
sustained increase in eGFR. Mean time to platelet count normalization was similar
between groups. CONCLUSIONS: Younger age, higher baseline LDH and lower baseline
hemoglobin were associated with greater eGFR improvements. Early eculizumab
initiation led to improved renal recovery, demonstrating the importance of rapid
diagnosis and treatment of patients with aHUS.
|*Glomerular Filtration Rate
[MESH]
|Adolescent
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Antibodies, Monoclonal, Humanized/*therapeutic use
[MESH]