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Kidney Week

Abstract: SA-PO804

Real-World Effectiveness of Ravulizumab among C5 Inhibitor-Naive Patients with Atypical Hemolytic Uremic Syndrome (aHUS): A Physician Panel-Based Chart Review Study (aHUS IMPACT)

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Hanna, Ramy Magdy, University of California, Irvine, California, United States
  • Chaturvedi, Shruti, John Hopkins University, Baltimore, Maryland, United States
  • Ong, Moh-Lim, Alexion, AstraZeneca Rare Disease, Boston, Massachusetts, United States
  • Nag, Dr. Arpita, Alexion, AstraZeneca Rare Disease, Boston, Massachusetts, United States
  • Song, Rui, Analysis Group, Inc., Boston, Massachusetts, United States
  • Huynh, Lynn, Analysis Group, Inc., Boston, Massachusetts, United States
  • Burdeau, Jordan, Analysis Group, Inc., Boston, Massachusetts, United States
  • Duh, Mei Sheng, Analysis Group, Inc., Boston, Massachusetts, United States
  • Wang, Yan, Alexion, AstraZeneca Rare Disease, Boston, Massachusetts, United States
Background

aHUS is a rare disease and form of thrombotic microangiopathy (TMA) caused by complement dysregulation. Ravulizumab (RAV; a C5 inhibitor [C5i]) is approved for aHUS based on registrational clinical studies, but real-world evidence is limited.

Methods

This was a retrospective, longitudinal, physician panel-based chart review of C5i-naive patients (pts) in the USA treated with RAV. Physicians with medical and laboratory records for ≥1 pt with aHUS randomly selected 1–5 pts with aHUS who had ≥6 months of medical records after RAV initiation, unless the pt died.

Results

Overall, 79 C5i-naive pts with aHUS (enrolled by 31 physicians) initiated RAV. Median (IQR) pt age at RAV initiation was 44 (27–54) years; 3 pts (4%) had a kidney transplant before RAV initiation and 20 (25%) received dialysis 12 months before to ≤2 weeks after RAV initiation. Laboratory parameters over time are shown in the Figure. Statistically significant changes from baseline occurred as early as Day 4 (LDH and percent change in serum creatinine [SCr]; both p<0.001) and Day 8 (platelet count, p<0.001). The proportions of pts with normalization of platelets, LDH and ≥25% improvement in SCr were 19/59 (32%), 17/51 (33%) and 19/58 (33%) at Day 8 and 40/48 (83%), 35/38 (92%) and 42/48 (88%) within 12 months after RAV initiation. Complete TMA response rates were 61% and 70% within 6 and 12 months after RAV initiation, respectively, and the median (IQR) time to complete TMA response was 3 months (1–13).

Conclusion

This study supports the immediate and sustained benefits of initiating with RAV in pts with aHUS as seen by the early response and continued improvement.

Funding

  • Commercial Support – Alexion, AstraZeneca Rare Disease.