International Journal of Urology and Nephrology ISSN 2756-3855 Vol. 10 (4), pp. 001-012, April, 2022. © International Scholars Journals
Full Length Research Paper
Eculizumab as a therapeutic option for refractory lupus nephritis and lupus associated thrombotic microangiopathy: A review of current evidence
Patrick Goorkiz (MD)1, John Wing Li (MMed (clin epi), FRACP) 2, Bhadran Bose MBBS, FRACP1,2
1University of Sydney, Royal Prince Alfred Hospital, Camperdown, NSW Australia.
2Department of Renal Medicine, Nepean Hospital, Kingswood, NSW, Australia.
Accepted 02 September, 2021
Lupus nephritis is a severe complication of systemic lupus erythematosus, leading to significant morbidity and mortality. The optimal choice and duration of therapy for lupus nephritis, especially in refractory disease and those associated with thrombotic microangiopathy, remains elucidated. The importance of complement activation in the disease process is gaining recognition; thus, complement blockade by eculizumab (terminal complement inhibitor) is advocated as a possible treatment option. This review summarises the latest evidence of eculizumabin treating refractorylupus nephritis with or without associated thrombotic microangiopathy. Eculizumab was successful in 19/22 cases of lupus nephritis, regarding dialysis cessation and improvement in clinical and biochemical parameters. However, there were significant complications such as nausea, vomiting, fungaemia and Streptococcus pneumonia infection. In conclusion, eculizumab might be an effective treatment for refractory lupus nephritis with or without thrombotic microangiopathy, but further clinical trials are warranted.
Key words: Eculizumab, complement, lupus nephritis, refractory, thrombotic microangiopathy.