Intermediate results of a prospective multicenter observational study of long-term therapy with eculizumab biosimilar in patients with atypical hemolytic uremic syndrome (ECU-аHUS-N03)
- Autores: Kotenko O.N.1,2, Vinogradov V.E.1, Ivanova E.S.1, Shutov E.V.3, Dudko M.Y.3, Mayorov V.V.4, Kudlay D.A.5,6,7, Markova O.A.6, Kolobov E.P.6, Borozinets A.Y.6
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Afiliações:
- City Clinical Hospital No. 52, Moscow
- Pirogov Russian National Research Medical University
- Moscow Botkin Multidisciplinary Scientific and Clinical Center
- City Clinical Hospital named after S.S. Yudin
- Sechenov First Moscow State Medical University (Sechenov University)
- JSC GENERIUM
- NRC Institute of Immunology FMBA of Russia
- Edição: Volume 17, Nº 2 (2025)
- Páginas: 12-22
- Seção: Original Articles
- URL: https://journals.eco-vector.com/2075-3594/article/view/692652
- DOI: https://doi.org/10.18565/nephrology.2025.2.12-22
- ID: 692652
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Resumo
Background. Atypical hemolytic uremic syndrome (aHUS) is a rare systemic disease of hereditary or acquired origin, included in the group of thrombotic microangiopathies, the progressive course of which leads to life-threatening damage to organs and systems, most often accompanied by acute kidney injury. The disease is based on uncontrolled activation of the alternative complement pathway. The main drug for the pathogenetic therapy of aHUS is eculizumab, a recombinant humanized monoclonal IgG antibody to the C5 component of complement.
Objective. Prospective multicenter observational study was conducted to collect and analyze data on the efficacy and safety of the eculizumab bioanalogue Elizaria® (JSC GENERIUM) in long-term pathogenetic therapy in patients with aHUS in Moscow.
Material and methods. The intermediate results of the study included data from 30 patients who received Elizaria® in routine clinical practice. The patients were divided into two groups: dialysis-dependent and with conservative stage of renal failure, stratified by GFR and proteinuria/albuminuria level. The follow-up period of patients was at least 32 weeks and included 3 visits.
Results. Lactate dehydrogenase activity remained stable throughout the analyzed follow-up period and was 195.3±59.49 U/L at Visit 3 in all patients, 200±65.44 and 176.8±29.81 U/L in the groups of patients without hemodialysis (HD) and on HD, respectively. At Visit 3, the platelet count in patients on HD remained stable within normal limits. In the group of patients without HD, a slight decrease in the platelet count within normal values was recorded. TMA-related events were absent in 22 (96%) patients not receiving hemodialysis at Visit 3. In 5 (17%) patients with acute disease, the absence of TMA-related events by Visit 3 was recorded in 40% of cases. Hemoglobin concentration remained stable throughout the follow-up period. At Visit 3, a statistically significant decrease in the reticulocyte count was recorded in the overall group (p=0.021) and in the group without HD (p<0.001). A statistically significant decrease in the schistocyte count was noted in the overall group (p=0.015). Quality of life according to the FACIT-F scale remained stable throughout the follow-up period. During the safety assessment, 13 episodes of mild adverse reactions were recorded in 2 patients on HD.
Conclusion. Long-term pathogenetic therapy with Elizaria® in patients with aHUS was characterized by a stable effect and a favorable safety profile.
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Sobre autores
Oleg Kotenko
City Clinical Hospital No. 52, Moscow; Pirogov Russian National Research Medical University
Email: oamarkova@generium.ru
ORCID ID: 0000-0001-8264-7374
Dr.Sci. (Med.), Chief External Expert in Nephrology of the Moscow City, Head of the Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital No. 52; Professor at the Department of General Therapy, Faculty of Continuous Professional Education, Pirogov Russian National Research Medical University
Rússia, Moscow; MoscowVladimir Vinogradov
City Clinical Hospital No. 52, Moscow
Email: oamarkova@generium.ru
ORCID ID: 0000-0002-2499-4770
Head of the Consultative and Diagnostic Nephrology Department
Rússia, MoscowEkaterina Ivanova
City Clinical Hospital No. 52, Moscow
Email: oamarkova@generium.ru
ORCID ID: 0000-0001-7407-5695
Cand.Sci. (Med.), Nephrologist, Nephrology Department No. 1
Rússia, MoscowEvgeny Shutov
Moscow Botkin Multidisciplinary Scientific and Clinical Center
Email: oamarkova@generium.ru
ORCID ID: 0000-0002-1047-0378
Dr.Sci. (Med.), Professor, Senior Researcher, Head of the Interdistrict Nephrology Center
Rússia, MoscowMarina Dudko
Moscow Botkin Multidisciplinary Scientific and Clinical Center
Email: oamarkova@generium.ru
ORCID ID: 0000-0001-7868-1334
Cand.Sci. (Med.), Head of the Consultative and Diagnostic Nephrology Department
Rússia, MoscowVasily Mayorov
City Clinical Hospital named after S.S. Yudin
Email: oamarkova@generium.ru
ORCID ID: 0000-0001-5094-1261
Head of the Nephrology Department
Rússia, MoscowDmitry Kudlay
Sechenov First Moscow State Medical University (Sechenov University); JSC GENERIUM; NRC Institute of Immunology FMBA of Russia
Email: oamarkova@generium.ru
ORCID ID: 0000-0003-1878-4467
Dr.Sci. (Med.), Corresponding Member of the Russian Academy of Sciences, Professor, Department of Pharmacology, Institute of Pharmacy, Sechenov First Moscow State Medical University (Sechenov University); Vice President for the Implementation of New Medical Technologies, JSC GENERIUM
Rússia, Moscow; Moscow; MoscowOksana Markova
JSC GENERIUM
Autor responsável pela correspondência
Email: oamarkova@generium.ru
ORCID ID: 0000-0002-1179-3881
Head of the Scientific Expertise and Pharmacovigilance Department
Rússia, MoscowEvgeny Kolobov
JSC GENERIUM
Email: oamarkova@generium.ru
ORCID ID: 0009-0000-9798-5640
Director of the Marketing and Promotion Department of Onco-Hematology Drugs
Rússia, MoscowAnton Borozinets
JSC GENERIUM
Email: a.borozinets@generium.ru
ORCID ID: 0000-0002-4863-8471
Cand.Sci. (Med.), Senior Researcher, Department of Marketing and Promotion of Onco-Hematological Drugs
Rússia, MoscowBibliografia
- Yerigeri K., Kadatane S., Mongan K. et al. Atypical Hemolytic-Uremic Syndrome: Genetic Basis, Clinical Manifestations, and a Multidisciplinary Approach to Management. J. Multidiscip. Healthc. 2023;16:2233–49.
- Noris M., Bresin E., Mele C., Remuzzi G. Genetic Atypical Hemolytic-Uremic Syndrome. В: GeneReviews® [Internet]. University of Washington, Seattle; 2021 [cited 2025 Feb 11]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1367.
- Java A. Atypical hemolytic uremic syndrome: diagnosis, management, and discontinuation of therapy. Hematol. Am. Soc. Hematol. Educ. Program. 2024;(1):200–5.
- Козловская Н.Л., Добронравов В.А., Боброва Л.А. и др. Клинические рекомендации по ведению взрослых пациентов с атипичным гемолитико-уремическим синдромом. Нефрология и диализ. 2023;25(4):465–92. [Kozlovskaya N.L., Dobronravov V.A., Bobrova L.A. et al. Clinical guidelines for the management of adult patients with atypical hemolytic uremic syndrome. Nephrology and Dialysis. 2023;25(4):465–92 (In Russ.)].
- Козловская Н.Л. Атипичный гемолитико-уремический синдром: современные представления о патогенезе, клинике, подходах к диагностике и лечению: тромбоз гемостаз и реология. Тромбоз, гемостаз и реология. 2019;4:12–20. [Kozlovskaya N.L. Atypical hemolytic uremic syndrome: modern concepts of pathogenesis, clinical picture, approaches to diagnosis and treatment: thrombosis, hemostasis and rheology. Thrombosis, hemostasis and rheology. 2019;4:12–20 (In Russ.)].
- Yan K., Desai K., Gullapalli L. et al. Epidemiology of Atypical Hemolytic Uremic Syndrome: A Systematic Literature Review. Clin. Epidemiol. 2020;12:295–305.
- Pugh D., O’Sullivan E.D., Duthie F.A. et al. Interventions for atypical haemolytic uraemic syndrome. Cochrane Database Syst. Rev. 2021;3(3):CD012862.
- Poppelaars F., Thurman J.M. Complement-mediated kidney diseases. Mol. Immunol. 2020;128:175–87.
- Noris M., Galbusera M., Gastoldi S. et al. Dynamics of complement activation in aHUS and how to monitor eculizumab therapy. Blood. 2014;124(11): 1715–26.
- Lee H., Kang E., Kang H.G. et al. Consensus regarding diagnosis and management of atypical hemolytic uremic syndrome. Korean J. Intern. Med. 2020;35(1):25–40.
- Halimi J.M., Al-Dakkak I., Anokhina K. et al. Clinical characteristics and outcomes of a patient population with atypical hemolytic uremic syndrome and malignant hypertension: analysis from the Global aHUS registry. J. Nephrol. 2023;36(3):817–28.
- European Medicines Agency (EMA). Soliris: EPAR – product information. 2012. [Сited 2025 May 28]. Available from: https://www.ema.europa.eu/en/documents/product-information/soliris-epar-product-information_en.pdf.
- FDA. SOLIRIS® (eculizumab) – approval package, prescribing information. 2019. [Сited 2025 May 28]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2019/125166Orig1s431.pdf.
- Государственный реестр лекарственных средств. Инструкция по применению лекарственного препарата Элизария. 2024. [Дата обращения 28 мая 2025]. URL: https://grls.rosminzdrav.ru/ Grls_View_v2.aspx?routingGuid=fbe35e43-92d4-4201-9458-8d6ed79c054a. [State Register of Medicines. Instructions for use of the medicinal product Elizaria. 2024. [Accessed May 28, 2025]. URL: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=fbe35e43-92d4-4201-9458-8d6ed79c054a. (In Russ.)].
- Иванов Р., Секарева Г., Кравцова О. и др. Правила проведения исследований биоаналоговых лекарственных средств (биоаналогов). Фармакокинетика и фармакодинамика. 2014;1:21–36. [Ivanov R., Sekareva G., Kravtsova O. et al. Rules for conducting studies of biosimilar drugs (bioanalogues). Pharmacokinetics and pharmacodynamics. 2014; 1: 21–36 (In Russ.)].
- Gusarova V., Degterev M., Lyagoskin I. et al. Analytical and functional similarity of biosimilar Elizaria® with eculizumab reference product. J. Pharmaceut. Biomed. Analysis. 2022;220(1):115004. Doi: 10.1016/ j.jpba.2022.115004.
- Kulagin A.D., Ptushkin V.V., Lukina E.A. et al. Randomized multicenter noninferiority phase III clinical trial of the first biosimilar of eculizumab. Ann. Hematol. 2021;100(11):2689–98.
- Fakhouri F., Hourmant M., Campistol J.M. et al. Terminal Complement Inhibitor Eculizumab in Adult Patients With Atypical Hemolytic Uremic Syndrome: A Single-Arm, Open-Label Trial. Am. J. Kidney Dis. Off J. Natl. Kidney Found. 2016;68(1):84–93.
- Stevens P.E., Levin A., Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann. Intern. Med. 2013;158(11):825–30.
- Kulasekararaj A., Brodsky R., Kulagin A., Jang J.H. Biosimilars in rare diseases: a focus on paroxysmal nocturnal hemoglobinuria. Haematologica. 2023;108(5):1232–43.
- Птушкин В.В., Кулагин А.Д., Лукина Е.А. и др. Результаты многоцентрового клинического исследования Ib фазы по оценке безопасности, фармакокинетики и фармакодинамики первого биоаналога экулизумаба у нелеченых пациентов с пароксизмальной ночной гемоглобинурией в фазе индукции терапии. Терапевтический архив. 2020;92(7):77–84. [Ptushkin V.V., Kulagin A.D., Lukina E.A. et al. Results of a multicenter phase Ib clinical trial to assess the safety, pharmacokinetics, and pharmacodynamics of the first bioanalogue of eculizumab in untreated patients with paroxysmal nocturnal hemoglobinuria in the induction phase of therapy. Therapeutic archive. 2020; 92(7): 77–84 (In Russ.)].
- Kulagin A., Ptushkin V., Lukina E. et al. Phase III Clinical Trial of Elizaria® and Soliris® in Adult Patients with Paroxysmal Nocturnal Hemoglobinuria: Results of Comparative Analysis of Efficacy, Safety, and Pharmacological Data. Blood. 2019;134(Suppl._1):3748.
- Коротчаева Ю.В., Козловская Н.Л., Шифман Е.М. Сравнительный анализ эффективности препаратов экулизумаба в лечении акушерского атипичного гемолитико-уремического синдрома. Клин. фармакология и терапия. 2021;30(3):25–30. [Korotchaeva Yu.V., Kozlovskaya N.L., Shifman E.M. Comparative analysis of the effectiveness of eculizumab drugs in the treatment of obstetric atypical hemolytic uremic syndrome. Clin. pharmacology and therapy. 2021;30(3):25–30 (In Russ.)].
- Лаврищева Ю.В., Яковенко А.А., Кудлай Д.А. Опыт применения российского биоаналога оригинального препарата экулизумаба для лечения больных атипичным гемолитико-уремическим синдромом. Тер. архив. 2020; 92 (6):76–80. doi: 10.26442/00403660.2020.06.000649. [Lavrishcheva Yu.V., Yakovenko A.A., Kudlai D.A. Experience in using a Russian bioanalogue of the original drug eculizumab for the treatment of patients with atypical hemolytic uremic syndrome. Therapeutic archive. 2020; 92 (6):76–80. doi: 10.26442/00403660.2020.06.000649 (In Russ.)].
- Эмирова Х.М., Орлова О.М., Музуров А.Л. и др. Опыт применения Элизарии® при атипичном гемолитико-уремическом синдроме. Педиатрия. Журнал им. Г.Н. Сперанского. 2019;98(5):225–9. [Emirova H.M., Orlova O.M., Muzurov A.L. et al. Experience of using Elizaria® in atypical hemolytic uremic syndrome. Pediatrics. Speransky Journal. 2019;98(5):225–9 (In Russ.)].
- Brocklebank V., Walsh P.R., Smith-Jackson K. et al. Atypical hemolytic uremic syndrome in the era of terminal complement inhibition: an observational cohort study. Blood. 2023;142(16):1371–86.
- Licht C., Greenbaum L.A., Muus P. et al. Efficacy and safety of eculizumab in atypical hemolytic uremic syndrome from 2-year extensions of phase 2 studies. Kidney Int. 2015.;87(5):1061–73.
- Franchini M. Atypical hemolytic uremic syndrome: from diagnosis to treatment. Clin. Chem. Lab. Med. 2015;53(11):1679–88.
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