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Risk for Neisseria Infections in Patient Treated with Eculizumab

Purpose: To reduce the risk of Neisseria infections in a patient being treated with eculizumab.

Description

Eculizumab is a humanized monoclonal antibody that targets C5. Therapy with eculizumab prevents activation of the subsequent elements of the terminal complement cascade (C6, C7, C8, C9). This blockage places the patient at risk for infections with Neisseria species, similar to the risk seen in a patient with a hereditary deficiency affecting one of these components of the terminal complement cascade.


 

Eculizumab is used to treat patients with paroxysmal nocturnal hemoglobinuria (PNH).

 

Implications:

(1) The patient should be vaccinated against Neisseria meningitidis prior to starting eculizumab therapy. Since therapy is lifelong in PNH, booster shots may be required over time.

(2) The patient should take special precautions during an outbreak of Neisseria meningitidis or if exposed to a patient with Neisseria meningitidis. This may include prophylactic antibiotic therapy.

(3) The patient should practice safe sex and avoid sexual exposures associated with Neisseria gonorrhoeae.

(4) The patient may be at increased risk for infection caused by other Neisseria species.

(5) The patient should be evaluated at the first sign of a fever or an infection.

(6) The patient should carefully consider potential exposures when traveling.

 


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Specialty

Objective

ICD-10