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Ikezoe T, Noji H, Ueda Y, Kanda Y, Okamoto S, Usuki K, Matsuda T, Akiyama H, Shimono A, Yonemura Y, Kawaguchi T, Chiba S, Kanakura Y, Nishimura JI, Ninomiya H, Obara N. Long-term follow-up of patients with paroxysmal nocturnal hemoglobinuria treated with eculizumab: post-marketing surveillance in Japan. Int J Hematol 2022; 115:470-480. [PMID: 35146630 DOI: 10.1007/s12185-022-03287-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 11/29/2022]
Abstract
All Japanese patients with paroxysmal nocturnal hemoglobinuria (PNH) treated with eculizumab were enrolled in post-marketing surveillance (PMS) between June 2010 and August 2019 to assess the long-term effectiveness and safety of eculizumab. The reduction in intravascular hemolysis, the change in hemoglobin (Hb) level, and the change in renal function were assessed to determine the effectiveness of eculizumab. The types and frequencies of adverse events (AEs) were assessed to determine its safety. A total of 632 patients were enrolled and the median treatment duration was 3.6 years. Treatment with eculizumab significantly reduced lactate dehydrogenase (LDH) levels and significantly increased Hb levels. These changes were maintained for up to 5 years of treatment. An estimated glomerular filtration rate ≥ 60 ml/min/1.73 m2 and higher LDH level at baseline were associated with increases in Hb levels during eculizumab treatment. The overall incidence of any AE was 69.92/100 patient-years. Hemolysis was the most common AE (6.43/100 patient-years). The incidence of infection-related AEs was 20.57/100 patient-years, and included meningococcal infection in three patients (0.12/100 patient-years). This long-term follow-up of patients with PNH demonstrated the sustained effectiveness of eculizumab and supports its well-established safety profile.
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Affiliation(s)
- Takayuki Ikezoe
- Department of Hematology, Fukushima Medical University, Hikarigaoka-1, Fukushima, Fukushima, 960-1295, Japan.
| | - Hideyoshi Noji
- Department of Hematology, Fukushima Medical University, Hikarigaoka-1, Fukushima, Fukushima, 960-1295, Japan.,Minami Fukushima Cardiovascular Hospital, Fukushima, Japan
| | - Yasutaka Ueda
- Osaka University Graduate School of Medicine, Suita, Japan
| | | | | | | | | | | | | | | | - Tatsuya Kawaguchi
- Kumamoto University Hospital, Kumamoto, Japan.,Kumamoto Health Science University, Kumamoto, Japan
| | | | - Yuzuru Kanakura
- Osaka University Graduate School of Medicine, Suita, Japan.,Sumitomo Hospital, Osaka, Japan
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