دورية أكاديمية
A systematic review of the role of eculizumab in systemic lupus erythematosus-associated thrombotic microangiopathy
| العنوان: | A systematic review of the role of eculizumab in systemic lupus erythematosus-associated thrombotic microangiopathy |
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| المؤلفون: | Rachael D. Wright, Fariba Bannerman, Michael W. Beresford, Louise Oni |
| المصدر: | BMC Nephrology, Vol 21, Iss 1, Pp 1-8 (2020) |
| بيانات النشر: | BMC |
| سنة النشر: | 2020 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | Lupus nephritis, Eculizumab, Complement, Thrombotic microangiopathy, Systematic review, Diseases of the genitourinary system. Urology, RC870-923 |
| الوصف: | Background Lupus nephritis (LN) is a severe consequence of systemic lupus erythematosus (SLE) that affects approximately 40% of patients. Pathogenic immune complexes that are characteristic of LN deposit in the kidney and activate immune mediated pathways including the complement system. Complete remission rates in LN are approximately 44% highlighting the need for new treatment strategies in these patients. Eculizumab is a fully humanised IgG2/IgG4 monoclonal antibody directed at C5 and thus prevents the formation of the terminal complement complex. Eculizumab is successfully used in atypical haemolytic uraemic syndrome (aHUS) and paroxysomal nocturnal haemoglobinuria (PNH) but it is not standardly used in LN. The aim of this project was to determine whether there is any role for eculizumab as adjunctive therapy in LN. Methods Using a predefined search strategy on Ovid MEDLINE and EMBASE the literature was reviewed systematically to identify studies in which eculizumab had been used to treat patients with SLE. All patients were included that were treated with complement inhibitors. Favourable outcome in this study was defined as resolution of symptoms that led to treatment, discharge from hospital or recovery of renal function. Patients were excluded if there was no outcome data or if complement inhibition was unrelated to their SLE. Results From 192 abstracts screened, 14 articles were identified, involving 30 patients. All SLE patients administered eculizumab were treated for thrombotic microangiopathy (TMA) secondary to LN diagnosed either histologically (66%) or as part of a diagnosis of aHUS (73%). 93% of patients had a favourable outcome in response to eculizumab treatment, of which 46% had a favourable outcome and successfully stopped treatment without relapse in symptoms during a median follow up of 7 months. Three patients (10%) reported adverse outcomes related to eculizumab therapy. Conclusions Scientific evidence supports the involvement of complement in the pathogenesis of LN however the ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1471-2369 |
| العلاقة: | http://link.springer.com/article/10.1186/s12882-020-01888-5Test; https://doaj.org/toc/1471-2369Test; https://doaj.org/article/ad359d98895046c4995b43e3141dca70Test |
| DOI: | 10.1186/s12882-020-01888-5 |
| الإتاحة: | https://doi.org/10.1186/s12882-020-01888-5Test https://doaj.org/article/ad359d98895046c4995b43e3141dca70Test |
| رقم الانضمام: | edsbas.B90FEDE3 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 14712369 |
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| DOI: | 10.1186/s12882-020-01888-5 |