Soliris (eculizumab) / AstraZeneca - LARVOL DELTA

Acute Management of Guillain-Barré Syndrome: A Narrative Review. (PubMed, Arch Intern Med Res) - "Although the C5 inhibitor eculizumab failed to improve outcomes in a phase 3 trial, early results with the upstream C1q inhibitor ANX005 suggest that earlier complement inhibition may reduce nerve injury and improve functional outcomes. Other investigational approaches include IgG-degrading enzymes such as imlifidase, FcRn inhibitors such as efgartigimod, regulatory T-cell therapies, and regenerative strategies...Important gaps also remain in subtype-specific treatment, nerve regeneration, long-term rehabilitation, treatment-related fluctuations, and access to care. Future research should focus on more targeted and individualized therapies that address both immune-mediated injury and subsequent nerve damage."

Clinical • Journal • Pain • Respiratory Diseases

Meningococcal infection in patients receiving eculizumab or ravulizumab for generalized myasthenia gravis or neuromyelitis optica spectrum disorder: A real-world study of US clinical practice. (PubMed, J Neurol Sci) - "This real-world study demonstrates that Nm infection and associated mortality rates in the United States among patients receiving eculizumab or ravulizumab have remained stably low despite increasing patient-years of exposure to each treatment. These results suggest Nm-related risk mitigation strategies are effective in patients receiving eculizumab or ravulizumab."

Journal • Real-world evidence • CNS Disorders • Immunology • Infectious Disease • Meningococcal Infections • Myasthenia Gravis • Neuromyelitis Optica Spectrum Disorder • Rare Diseases

Comparative Efficacy of Zilucoplan Versus Intravenous Immunoglobulin, Eculizumab, and Ravulizumab Using Matching-Adjusted Indirect Comparisons. (PubMed, Neurol Ther) - "In this analysis, zilucoplan was associated with a significantly higher magnitude of clinically meaningful improvement in QMG and MG-ADL scores compared to IVIg and two C5 inhibitors, eculizumab and ravulizumab. In the absence of head-to-head clinical data, these findings provide additional evidence to assist with treatment decisions in this setting."

Journal • CNS Disorders • Immunology • Myasthenia Gravis

When Tests Mislead: Presumed Shiga ToxinâAssociated Hemolytic Uremic Syndrome Despite Negative Stool Studies (ACG 2026) - "Differentiating between these entities is critical, as aHUS may require complement inhibition therapy such as eculizumab, whereas typical HUS is managed with supportive care...Distinguishing typical from atypical HUS is critical because management differs substantially; aHUS may require complement inhibition therapy, whereas typical HUS is treated with supportive care. Clinical context, including diarrheal prodrome, exposure history, complement evaluation, and treatment response, remains essential for accurate diagnosis."

Acute Kidney Injury • Atypical Hemolytic Uremic Syndrome • Complement-mediated Rare Disorders • Gastrointestinal Disorder • Hematological Disorders • Nephrology • Renal Disease • Thrombocytopenia • HP

Navigating coexisting autoimmunity and immunodeficiency in thymoma: a case report of TAMA, Good's syndrome, and myasthenic crisis. (PubMed, Front Immunol) - "Because conventional rapid immunomodulatory options were limited, efgartigimod and eculizumab were administered sequentially. The pulmonary infection continued to progress, and the patient ultimately died. This case highlights the importance of immune and infection risk assessment before potent immunomodulatory therapy."

Journal • CNS Disorders • Dermatitis • Dermatology • Dermatopathology • Graft versus Host Disease • Immunology • Infectious Disease • Myasthenia Gravis • Respiratory Diseases • Solid Tumor • Thymoma • Thymus Cancer • CD4 • CD8

Atypical hemolytic uremic syndrome: pathophysiology, clinical presentation, and treatment strategies. (PubMed, Child Kidney Dis) - "The introduction of complement inhibitors, such as eculizumab and ravulizumab, has significantly improved clinical outcomes by reducing recurrence and preserving renal function. This review aimed to examine the pathophysiology, clinical manifestations, and treatment strategies of aHUS. Early and targeted complement inhibition is essential for preventing irreversible kidney damage and optimizing outcomes, particularly in children and transplant recipients."

Journal • Review • Acute Kidney Injury • Atypical Hemolytic Uremic Syndrome • Chronic Kidney Disease • Complement-mediated Rare Disorders • Hematological Disorders • Nephrology • Pediatrics • Renal Disease • Thrombocytopenia • Transplantation

BEST-NMOSD: Rituximab Versus Ravulizumab, Inebilizumab, Satralizumab, and Eculizumab in NMOSD (clinicaltrials.gov) - P4 | N=540 | Recruiting | Sponsor: Massachusetts General Hospital | Not yet recruiting ➔ Recruiting

Enrollment open • CNS Disorders • Neuromyelitis Optica Spectrum Disorder • Rare Diseases

Perioperative Complement Inhibition with Eculizumab in High-Risk Antiphospholipid Syndrome: A Case Series (ACR Convergence 2026) - No abstract available

Clinical • Genetic Disorders • Hematological Disorders

Combination of anti-CD20 antibody and anti-C5 eculizumab for the treatment of Complement-Mediated TMA Secondary to SLE: A retrospective cohort study (ACR Convergence 2026) - "Our study provides a clinical proof of concept that targeting both B cells and the terminal complement cascade can effectively improve the outcome of SLE cm-TMA, with an acceptable safety profile. Larger-scale studies are warranted for further validation."

Retrospective data • Acute Kidney Injury • Complement-mediated Rare Disorders • Hematological Disorders • Inflammatory Arthritis • Lupus • Nephrology • Renal Disease • Systemic Lupus Erythematosus • Thrombocytopenia

Thrombotic Microangiopathy post Simultaneous Pancreas-Kidney (SPK) transplant: a challenging scenario (TTS 2026) - "Management strategies vary and may include withdrawal of CNI therapy, plasma exchange or complement inhibition with drugs like eculizumab...She received induction immunosuppression with anti-thymocyte globulin, followed by standard maintenance therapy: prednisolone, tacrolimus, and mycophenolate mofetil (MMF)...Tacrolimus was subsequently replaced with Belatacept. However, CMV reactivated, necessitating a switch to an mTOR inhibitor (everolimus). Due to concerns for maribavir resistance, valganciclovir was restarted... Delayed post-transplant TMA may be multi-factorial, with contributions from CNI toxicity, viral infections, and genetic mutations. This case highlights the importance of dynamic immunosuppression adjustment and infection management. Ongoing management requires careful balancing of rejection risk and infectious complications, with complement inhibition considered for recurrent or refractory TMA."

Antibody-mediated Rejection • Beta-Thalassemia • Diabetes • Diabetic Nephropathy • Genetic Disorders • Gynecology • Hematological Disorders • Infectious Disease • Metabolic Disorders • Neutropenia • Transplantation • Type 1 Diabetes Mellitus

A CASE OF CARFILZOMIB-INDUCED THROMBOTIC MICROANGIOPATHY WITH RENAL RECOVERY AFTER EARLY INITIATION OF ECULIZUMAB (CHEST 2026) - No abstract available

Clinical • Critical care • Hematological Disorders • Oncology

An Approach to Antibody-Mediated Rejection in Pediatric Liver Transplantation. (PubMed, Pediatr Transplant) - "In severe or refractory cases, targeted therapies such as rituximab, bortezomib, and eculizumab may be considered. A stepwise diagnostic and management algorithm is presented. This resource outlines a practical approach to the diagnosis and management of AMR in pediatric liver transplantation, serving as a reference for busy clinicians who may encounter this serious but underrecognized cause of graft dysfunction and loss."

Journal • Review • Antibody-mediated Rejection • Pediatrics • Transplantation

Autoimmune inflammatory diseases of the central nervous system: advances in clinical trials and immunotherapeutic strategies. (PubMed, Reumatologia) - "In AE, first-line immunotherapies (high-dose glucocorticoids, intravenous immunoglobulin, and plasma exchange) remain based mainly on observational data, while second-line therapies such as rituximab and cyclophosphamide are increasingly used despite limited comparative trial data. Recent systematic reviews and individual patient data meta-analyses have highlighted both the potential and the limitations of existing observational evidence, and several randomized phase II-III trials are now underway evaluating agents including bortezomib, satralizumab, and inebilizumab. In NMOSD, the therapeutic landscape has advanced more rapidly, with multiple pivotal randomized controlled trials of targeted biologics (e.g. complement inhibition with eculizumab, B-cell depletion with inebilizumab, interleukin-6 [IL-6] receptor blockade with satralizumab) demonstrating large reductions in relapse risk and leading to regulatory approvals...Emerging strategies include use of adaptive and..."

Journal • Review • CNS Disorders • Immunology • Inflammation • Multiple Sclerosis • Neuromyelitis Optica Spectrum Disorder • Pediatrics • Psychiatry • Rare Diseases • Solid Tumor • IL6

Complement C5 inhibition after kidney transplantation – A national single-center experience from Slovenia (TTS 2026) - " We retrospectively reviewed medical records of kidney transplant recipients treated with eculizumab/ravulizumab at the University Medical Centre Ljubljana, including their clinical, laboratory, and histopathological characteristics, as well as treatment outcomes...One patient, eight years after transplantation, received eculizumab for one month for chronic active AMR without TMA, in addition to intensified immunosuppression including daratumumab... C5 inhibition may be effective in kidney transplant recipients with primary aHUS, de novo TMA (with or without AMR), and in selected cases of C3 nephropathy."

Clinical • Antibody-mediated Rejection • Atypical Hemolytic Uremic Syndrome • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Complement-mediated Rare Disorders • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Infectious Disease • Nephrology • Transplantation

Therapeutics Beyond Delivery: Repurposed Drugs and Biologic Pathways. (PubMed, Curr Hypertens Rep) - "Metformin has demonstrated a trend towards prolongation of pregnancy in a randomized controlled trial, with larger trials ongoing. Proton pump inhibitors and sulfasalazine show compelling preclinical efficacy, though neither has yet translated to clinical benefit, possibly reflecting inadequate drug exposure in vivo. Novel biologic approaches, including sFlt-1-targeting siRNA, complement inhibition with eculizumab, and placenta-tropic lipid nanoparticle delivery systems, represent promising emerging strategies. Advancing molecular classification of pre-eclampsia is essential to identifying targetable pathways and selecting patients most likely to benefit from specific interventions. Improved pharmacokinetic evaluation in pregnancy, earlier identification of at-risk women using circulating biomarkers, and regulatory frameworks supportive of obstetric research will be critical to translating promising candidates into effective therapies."

Journal • Review • Gynecology • Obstetrics

Evaluation of eculizumab for the prevention of delayed graft function after kidney transplantation in adults: A randomized, double-blind, placebo-controlled trial. (PubMed, Am J Transplant) - P2/3 | "Although eculizumab did not significantly reduce the incidence of DGF in adult deceased donor kidney transplants, post hoc analyses suggested a treatment benefit in recipients of an ECD kidney managed with cold storage. CLINICAL TRIAL NUMBER: NCT02145182."

Clinical • Journal • Transplantation

Encore presentation: The ConfIdeS study: Imlifidase desensitization results in timelier transplant with superior 1-year eGFR among highly sensitized patients compared to control (TTS 2026) - "Participants were randomized 1:1 to imlifidase desensitization or control (any combination of PLEX, IVIG, anti-CD20, eculizumab, or waiting a more compatible organ). The imlifidase arm received rabbit anti-thymocyte globulin induction and triple maintenance immunosuppression with corticosteroids, mycophenolic acid, and tacrolimus... Imlifidase significantly increased immediate transplant rates and met the primary endpoint by improving 1-year kidney function compared with heterogeneous, institution-specific desensitization strategies. The variability of control treatments highlighted the absence of a standardized alternative approach. Imlifidase was generally well tolerated with no unexpected safety concerns."

Clinical • Chronic Kidney Disease • Transplantation

Kidney transplant outcomes in patients with complement dysregulation. (PubMed, World J Transplant) - "In this Indian transplant cohort with complement dysregulation, CFHR1-CFHR3 structural variants and AFH antibody positivity defined the predominant biologic substrate, post-transplant recurrence clustered within the early weeks after transplantation, and disease-directed therapy with plasma exchange, rituximab, and selective eculizumab achieved durable graft preservation despite limited access to long-term complement inhibition. Comprehensive pre-transplant complement evaluation and biologic risk stratification are essential for safe transplantation in complement-mediated kidney disease, particularly in resource-limited settings."

Journal • Atypical Hemolytic Uremic Syndrome • Cardiovascular • Complement-mediated Rare Disorders • Hematological Disorders • Hypertension • Immunology • Infectious Disease • Nephrology • Transplantation • CD46 • CFHR3

Prospective, Multicenter, Single-Arm Clinical Study on Eculizumab in the Treatment of Active ANCA-Associated Rapidly Progressive Glomerulonephritis (ChiCTR) - P4 | N=20 | Not yet recruiting | Sponsor: The First Affiliated Hospital, Zhejiang University School of Medicine; The First Affiliated Hospital, Zhejiang University School of Medicine

New P4 trial • Glomerulonephritis • Lupus Nephritis • Nephrology

The efficacy and safety of single-dose eculizumab combined with conventional preconditioning in ABO-incompatible renal transplantation with high baseline isoagglutinin titers (TTS 2026) - "All patients underwent preconditioning consisting of plasma exchange, rituximab, and oral immunosuppressive agents, with preoperative target titers achieved: IgG ≤1:32 and IgM ≤1:16...Two patients were suspected of having acute T cell-mediated rejection secondary to low tacrolimus concentrations, with no significant between-group difference (p=0.582); all rejection episodes resolved after glucocorticoid and/or cyclophosphamide therapy... Single-dose eculizumab combined with conventional preconditioning may safely reduce the risk of antibody-mediated rejection in ABOi renal transplant recipients with high baseline isoagglutinin titers. Given the small sample size, further studies with larger cohorts are required."

Clinical • Antibody-mediated Rejection • Hematological Disorders • Infectious Disease • Nephrology • Transplantation

Different Induction Strategies in Kidney Transplantation: A Comparative Analysis of Alemtuzumab, Alemtuzumab plus Eculizumab, and Basiliximab (TTS 2026) - "The initial baseline immunosuppressive regimen in all groups consisted of tacrolimus, mycophenolate mofetil, and prednisone. This analysis demonstrates that combination induction therapy with ALEM + ECU provides a good balance between immune response control and infectious safety. This strategy achieves maximal graft survival by significantly reducing the risk of severe infections compared to ALEM, while demonstrating superior efficacy to standard BAS therapy."

Infectious Disease • Transplant Rejection • Transplantation

Clinical Practice of Complement C5 Monoclonal Antibody in ABO-Incompatible Living Related Donor Kidney Transplantation (TTS 2026) - "The experimental group received perioperative Eculizumab (600–900 mg/dose, 1–3 doses) in addition to standard desensitization (rituximab, plasmapheresis/immunoadsorption, IVIG, and baseline immunosuppression). As an adjunctive protocol for desensitization in ABOi kidney transplantation, Eculizumab effectively blocks the complement cascade. It provides excellent clinical outcomes for recipients with high preoperative blood group antibody titers while significantly reducing the frequency of plasmapheresis and associated medical costs. Postoperative monitoring for opportunistic infections, particularly Parvovirus B19, should be intensified."

Clinical • Infectious Disease • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases • Transplantation • CD4 • CD8

Discontinuation of Eculizumab after kidney transplantation in pediatric aHUS: Is it safe? A multicenter cohort study (TTS 2026) - "Prophylactic anti-C5 therapy is associated with favorable long-term patient and graft outcomes in pediatric kidney transplant recipients with aHUS. In contrast, initiation of therapy only after clinical manifestation of post-transplant TMA—even in patients without identifiable complement gene mutations—was associated with rapid progression to fatal outcomes. Anti-C5 withdrawal appears feasible in carefully selected patients under close monitoring."

Clinical • Atypical Hemolytic Uremic Syndrome • Complement-mediated Rare Disorders • Nephrology • Pediatrics • Transplantation • CFHR3

Donor APOL1 high-risk genotypes and early graft failure: Two cases of De Novo collapsing FSGS with second hits (TTS 2026) - "Her post-transplant course was complicated by antibody-mediated rejection (ABMR) at 1 month requiring plasmapheresis/IVIG/eculizumab, followed by mixed AMR/ACR at 4 months...Despite treatment with losartan and resolution of DSAs, she experienced progressive graft dysfunction with creatinine rising to 4.09 mg/dL by 11 months post-transplant, with ongoing nephrotic range proteinuria...Despite plasmapheresis, RAAS inhibition, SGLT2 inhibition, and sparsentan, his creatinine rose to 5.74 mg/dL with protein/creatinine ratio of 12.44 g/g by 10 months, necessitating dialysis initiation... Both cases illustrate the "two-hit" hypothesis of APOL1-mediated kidney disease, where donor high-risk genotypes combined with immunologic injury (rejection) and/or viral infections (BK, CMV) precipitate rapid cFSGS development and graft failure within the first year. These cases underscore the importance of donor APOL1 genotyping and heightened surveillance for rejection and viral..."

Clinical • Antibody-mediated Rejection • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Focal Segmental Glomerulosclerosis • Glomerulonephritis • IgA Nephropathy • Infectious Disease • Inflammation • Metabolic Disorders • Nephrology • Transplant Rejection • Type 2 Diabetes Mellitus

Eculizumab Monotherapy as First-Line Treatment for Early-Onset De Novo Thrombotic Microangiopathy Following ABO-Incompatible Kidney Transplantation: A Case Series (TTS 2026) - "Conclusions. Short-course eculizumab monotherapy is a safe, rapid, and highly effective first-line treatment for early-onset de novo TMA following ABOi kidney transplantation, successfully preserving allograft function without interfering with the accommodation mechanism."

Clinical • Monotherapy • Hematological Disorders • Infectious Disease • Thrombocytopenia • Transplantation