Fatemeh Pour-Reza-Gholi
1 
, Sara Assadiasl
2* 1 Department of Nephrology, Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract
The C5 inhibitor monoclonal antibody, eculizumab, has been approved for the treatment of atypical hemolytic uremic syndrome (aHUS) and paroxysmal nocturnal hemoglobinuria (PNH); however, the efficacy and safety of this drug in treating other complement-related renal diseases has not yet been elucidated. The high cost of eculizumab therapy and the rare adverse effects have created a paradox in conducting large clinical trials. Therefore, there is a need to increase clinicians’ awareness of the available data on the efficacy/safety of this drug in treating renal diseases. Herein, we have reviewed the outcomes of the administration of eculizumab in aHUS, PNH, lupus erythematosus nephritis, C3 glomerulonephritis, IgA nephropathy, and antibody-mediated rejection (AMR) in highly sensitized patients. Initial findings suggest its efficacy in treating acute injuries but lower effectiveness in preventing chronic lesions. Besides, early diagnosis and timely initiation of eculizumab are of particular importance.
Implication for health policy/practice/research/medical education:
Apart from the approved indications, eculizumab may help to treat complement-related kidney diseases. Eculizumab appears to be effective in treating acute injuries; however, it shows low efficacy in preventing chronic lesions. The high cost and low adverse effects of eculizumab are the main disadvantage and advantage of eculizumab therapy, respectively.
Please cite this paper as: Pour-Reza-Gholi F, Assadiasl S. Eculizumab in kidney diseases. J Nephropharmacol. 2024;13(1):e10630. DOI: 10.34172/npj.2023.10630.