Pegcetacoplan Rescue After Urinary Loss of C5 Inhibitors in a Pediatric Patient with C3 Glomerulopathy (KIDNEY WEEK 2026) - Oct 2, 2026 - Abstract #FR-PO0933; Pres time: Oct 23, 2026; 10:00 AM - 12:00 PM; Location: Exhibit Hall A, Convention Center; "After pulse methylprednisolone and cyclophosphamide, renal function recovered but nephrotic syndrome persisted. Ravulizumab was initiated; pharmacokinetic studies revealed subtherapeutic levels (5 mcg/mL; goal >175) with elevated sC5b-9, indicating urinary drug loss...Eculizumab every 2 weeks also failed (UPC 11–17 g/g, albumin 1.4–1.8 g/dL)...Pegcetacoplan's success likely reflects proximal C3 blockade and subcutaneous dosing reducing dependence on serum levels vulnerable to urinary losses. Early transition to C3 inhibition should be considered over prolonged C5 inhibitor escalation in patients with persistent nephrotic proteinuria."
Clinical • Acute Kidney Injury • Complement-mediated Rare Disorders • Glomerulonephritis • Infectious Disease • Lupus Nephritis • Nephrology • Pediatrics • Pneumococcal Infections • Pneumonia • Renal Disease • Respiratory Diseases • CD46
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Niharika Koka; Mersady Redding; Nazia Mecci
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