Ravulizumab demonstrates long-term efficacy, safety and favorable patient survival in patients with paroxysmal nocturnal hemoglobinuria
- Author(s)
- Kulasekararaj, A; Brodsky, R; Schrezenmeier, H; Griffin, M; Röth, A; Piatek, C; Ogawa, M; Yu, J; Patel, AS; Patel, Y; Notaro, R; Usuki, K; Kulagin, A; Gualandro, S; Füreder, W; Peffault de Latour, R; Szer, J; Lee, JW;
- Journal Title
- Annals of Hematology
- Publication Type
- Online publication before print
- Abstract
- Ravulizumab is a second-generation complement component 5 (C5) inhibitor (C5i) approved for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) following positive results from two pivotal trials in patients with PNH originally naive to C5i treatment and eculizumab-experienced patients with PNH. In both trials, after the 26week primary evaluation period, all patients received ravulizumab for up to 6 years. To report ravulizumab treatment outcomes in patients with PNH originally naive to C5i treatment and eculizumab-experienced patients with PNH treated for up to 6 years. Originally C5i-naive (N = 244) and eculizumab-experienced (N = 191) patients with PNH continued ravulizumab treatment for up to 6 years. Major adverse vascular events (MAVEs; including thrombotic events [TEs]) and survival are reported, including a comparison of survival with untreated patients from the International PNH Registry. Laboratory parameters for intravascular hemolysis (IVH) are also described. For up to 6 years (1468.0 patient-years of exposure), ravulizumab provided durable control of terminal complement activity and IVH, resulting in a low incidence of MAVEs (including TEs) reported (MAVE rate: 0.7-1.4 per 100 patient-years) and, compared with untreated patients from the International PNH Registry, reduced the risk of mortality by five-fold. The few breakthrough IVH events reported (N = 122) were commonly associated with complement-amplifying conditions, and only two events (1.8%) were associated with suboptimal inhibition of C5 (i.e. serum free C5 ≥ 0.5 µg/mL). These results support the long-term use of ravulizumab as the first-line treatment of choice for patients with PNH. Trial registration details: NCT01374360; registered: October 29, 2004; NCT02946463; registered: October 27, 2016; NCT03056040; registered: June 05, 2017.
- Keywords
- Complement inhibitor; Intravascular hemolysis; Lactate dehydrogenase; Paroxysmal nocturnal hemoglobinuria; Ravulizumab; Survival
- Department(s)
- Haematology
- Publisher's Version
- https://doi.org/10.1007/s00277-025-06193-5
- Open Access at Publisher's Site
https://doi.org/10.1007/s00277-025-06193-5- Terms of Use/Rights Notice
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Creation Date: 2025-01-28 02:47:07
Last Modified: 2025-01-28 02:54:38