title: Eculizumab in the treatment of atypical haemolytic uraemic syndrome and other complement-mediated renal diseases.
abstract: OBJECTIVE
  This review considers the use of eculizumab in the treatment of atypical haemolytic uraemic syndrome (aHUS) as well as the other complement-mediated renal diseases, including dense deposit disease (DDD) and C3 glomerulonephritis (C3GN). In addition, a brief discussion of the effectiveness of eculizumab for the prevention of antibody-mediated rejection (AMR) in the setting of renal transplant and the treatment of shiga toxin associated haemolytic uraemic syndrome (STEC HUS) is also provided.
  
  
  RESULTS
  No randomized controlled trials exist to support the use of eculizumab in renal disease. The results of two unpublished, prospective adult and adolescent trials support its utility in aHUS, whereas retrospective data support the effectiveness in paediatric aHUS. These two data sets form the basis of the sole renal indication for eculizumab. One small, single-centre trial and a growing number of case reports support the use of eculizumab in C3 glomerulopathy (C3G). There are limited trial data in AMR and renal transplant. Finally, there are conflicting data for the use of eculizumab in STEC HUS.
  
  
  CONCLUSIONS
  The cumulative published data establish the effectiveness of eculizumab in a select group of renal diseases that have at the centre of their disease either abnormal complement control or maladaptive complement activation.
authors.affiliation: Department of Internal Medicine, University of Iowa, Iowa City, Iowa 52242, USA. carla-nester@uiowa.edu
authors.forename: Carla M
authors.initials: CM
authors.lastname: Nester
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Brophy
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D065766:Atypical Hemolytic Uremic Syndrome; D003167:Complement Activation / Q000276:immunology; D003176:Complement C3 / Q000276:immunology; D051056:Complement Inactivating Agents / Q000627:therapeutic use*; D005921:Glomerulonephritis / Q000188:drug therapy / Q000276:immunology; D006084:Graft Rejection / Q000517:prevention & control; D006463:Hemolytic-Uremic Syndrome / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery; D006801:Humans; D016030:Kidney Transplantation
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D003176:Complement C3; D051056:Complement Inactivating Agents; C481642:eculizumab