YUE Cai, DU Yali, HUANG Yangyu, CHEN Limeng, GUAN Yuzhou, HAN Bing. Complement Inhibitors in Rare Diseases[J]. Journal of Rare Diseases, 2022, 1(4): 391-399. DOI: 10.12376/j.issn.2097-0501.2022.04.006
Citation: YUE Cai, DU Yali, HUANG Yangyu, CHEN Limeng, GUAN Yuzhou, HAN Bing. Complement Inhibitors in Rare Diseases[J]. Journal of Rare Diseases, 2022, 1(4): 391-399. DOI: 10.12376/j.issn.2097-0501.2022.04.006

Complement Inhibitors in Rare Diseases

Funds: 

CAMS Innovation Fund for Medical Sciences 2021-I2M-1-003

More Information
  • Corresponding author:

    HAN Bing, E-mail: hanbing_li@sina.com.cn

  • Received Date: May 12, 2022
  • Accepted Date: July 04, 2022
  • Available Online: December 22, 2022
2097-0501/©2022 Editorial Office of Journal of Rare Diseases This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/)
  • The complement system is a self-protection mechanism of the human body. The abnormal activation of the complement system is involved in the occurrence and development of various diseases. The application of complement inhibitors in many rare diseases was a milestone in leading to the progress of such disease as paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), and others. Recently, the application of complement inhibitors has gradually expanded to other complement-related diseases. This review summarizes the literature on the current application of complement inhibitors in rare diseases and looks into the prospects of the application in the rare diseases.

  • [1]
    Brodsky RA. Paroxysmal nocturnal hemoglobinuria[J]. Blood, 2014, 124: 2804-2811.
    [2]
    Thompson CA. FDA approves drug to treat rare hemoglobinuria[J]. Am J Health Syst Pharm, 2007, 64: 906.
    [3]
    Parker C, Omine M, Richards S, et al. Diagnosis and management of paroxysmal nocturnal hemoglobinuria[J]. Blood, 2005, 106: 3699-3709.
    [4]
    Parker CJ. Update on the diagnosis and management of paroxysmal nocturnal hemoglobinuria[J]. Hematology Am Soc Hematol Educ Program, 2016: 208-216.
    [5]
    Brodsky RA, Peffault de Latour R, Rottinghaus ST, et al. Characterization of breakthrough hemolysis events observed in the phase 3 randomized studies of ravulizumab versus eculizumab in adults with paroxysmal nocturnal hemoglobinuria[J]. Haematologica, 2021, 106: 230-237.
    [6]
    Kelly RJ, Hill A, Arnold LM, et al. Long-term treatment with eculizumab in paroxysmal nocturnal hemoglobinuria: sustained efficacy and improved survival[J]. Blood, 2011, 117: 6786-6792. doi: 10.1182/blood-2011-02-333997
    [7]
    Hillmen P, Muus P, Röth A, et al. Long-term safety and efficacy of sustained eculizumab treatment in patients with paroxysmal nocturnal haemoglobinuria[J]. Br J Haematol, 2013, 162: 62-73. doi: 10.1111/bjh.12347
    [8]
    Risitano AM, Marotta S. Toward complement inhibition 2.0: next generation anticomplement agents for paroxysmal nocturnal hemoglobinuria[J]. Am J Hematol, 2018, 93: 564-577. doi: 10.1002/ajh.25016
    [9]
    Kelly RJ, Hochsmann B, Szer J, et al. Eculizumab in pregnant patients with paroxysmal nocturnal hemoglobinuria[J]. N Engl J Med, 2015, 373: 1032-1039. doi: 10.1056/NEJMoa1502950
    [10]
    Kulasekararaj AG, Brodsky RA, Hill A. Monitoring of patients with paroxysmal nocturnal hemoglobinuria on a complement inhibitor[J]. Am J Hematol, 2021, 96: E232-E235.
    [11]
    Lee JW, Sicre de Fontbrune F, Wong Lee Lee L, et al. Ravulizumab (ALXN1210) vs eculizumab in adult patients with PNH naive to complement inhibitors: the 301 study[J]. Blood, 2019, 133: 530-539. doi: 10.1182/blood-2018-09-876136
    [12]
    Connell NT. Ravulizumab: a complementary option for PNH[J]. Blood, 2019, 133: 503-504. doi: 10.1182/blood-2018-12-891499
    [13]
    Nishimura J, Yamamoto M, Hayashi S, et al. Genetic variants in C5 and poor response to eculizumab[J]. N Engl J Med, 2014, 370: 632-639. doi: 10.1056/NEJMoa1311084
    [14]
    Röth A, Nagy Z, Gaàl-Weisinger J, et al. The complement C5 inhibitor crovalimab in paroxysmal nocturnal hemoglobinuria[J]. Blood, 2020, 135: 912-920. doi: 10.1182/blood.2019003399
    [15]
    Jokiranta TS. HUS and atypical HUS[J]. Blood, 2017, 129: 2847-2856. doi: 10.1182/blood-2016-11-709865
    [16]
    Loirat CA, Garnier AL, Sellier-Leclerc AL, et al. Plasma-therapy in atypical hemolytic uremic syndrome[J]. Semin Thromb Hemost, 2010, 36: 673-681. doi: 10.1055/s-0030-1262890
    [17]
    Nürnberger J, Philipp T, Witzke O, et al. Eculizumab for atypical hemolytic-uremic syndrome[J]. N Engl J Med, 2009, 360: 542-544. doi: 10.1056/NEJMc0808527
    [18]
    Legendre CM, Licht C, Muus P, et al. Terminal comple-ment inhibitor eculizumab in atypical hemolytic-uremic syndrome[J]. N Engl J Med, 2013, 368: 2169-2181. doi: 10.1056/NEJMoa1208981
    [19]
    Scully M, Cataland S, Coppo P, et al. Consensus on the standardization of terminology in thrombotic thrombocyto-penic purpura and related thrombotic microangiopathies[J]. J Thromb Haemost, 2017, 15: 312-322. doi: 10.1111/jth.13571
    [20]
    Licht C, Greenbaum LA, Muus P, et al. Efficacy and safety of eculizumab in atypical hemolytic uremic syndrome from 2-year extensions of phase 2 studies[J]. Kidney Int, 2015, 87: 1061-1073. doi: 10.1038/ki.2014.423
    [21]
    Muff-Luett M, Sanderson KR, Engen RM, et al. Eculizu-mab exposure in children and young adults: indications, practice patterns, and outcomes-a Pediatric Nephrology Research Consortium study[J]. Pediatr Nephrol, 2021, 36: 2349-2360. doi: 10.1007/s00467-021-04965-5
    [22]
    Ariceta G, Dixon BP, Kim SH, et al. The long-acting C5 inhibitor, ravulizumab, is effective and safe in pediatric patients with atypical hemolytic uremic syndrome naïve to complement inhibitor treatment[J]. Kidney Int, 2021, 100: 225-237. doi: 10.1016/j.kint.2020.10.046
    [23]
    Brodsky RA. Eculizumab and aHUS: to stop or not[J]. Blood, 2021, 137: 2419-2420. doi: 10.1182/blood.2020010234
    [24]
    Smith RJH, Appel GB, Blom AM, et al. C3 glomerulo-pathy-understanding a rare complement-driven renal disease[J]. Nat Rev Nephrol, 2019, 15: 129-143.
    [25]
    Avasare RS, Canetta PA, Bomback AS, et al. Mycopheno-late mofetil in combination with steroids for treatment of C3 glomerulopathy: a case series[J]. Clin J Am Soc Nephrol, 2018, 13: 406-413. doi: 10.2215/CJN.09080817
    [26]
    Licht C, Weyersberg A, Heinen S, et al. Successful plasma therapy for atypical hemolytic uremic syndrome caused by factor H deficiency owing to a novel mutation in the complement cofactor protein domain 15[J]. Am J Kidney Dis, 2005, 45: 415-421. doi: 10.1053/j.ajkd.2004.10.018
    [27]
    Schwertz R, de Jong R, Gretz N, et al. Outcome of idiopathic membranoproliferative glomerulonephritis in children. Arbeitsgemeinschaft Pädiatrische Nephrologie[J]. Acta Paediatr, 1996, 85: 308-312. doi: 10.1111/j.1651-2227.1996.tb14022.x
    [28]
    Rabasco C, Cavero T, Román E, et al. Effectiveness of mycophenolate mofetil in C3 glomerulonephritis[J]. Kidney Int, 2015, 88: 1153-1160. doi: 10.1038/ki.2015.227
    [29]
    Nester CM, Smith RJ. Complement inhibition in C3 glomerulopathy[J]. Semin Immunol, 2016, 28: 241-249. doi: 10.1016/j.smim.2016.06.002
    [30]
    Le Quintrec M, Lapeyraque AL, Lionet A, et al. Patterns of clinical response to eculizumab in patients with C3 glomerulopathy[J]. Am J Kidney Dis, 2018, 72: 84-92. doi: 10.1053/j.ajkd.2017.11.019
    [31]
    Wong EK, Praga M, Nester C, et al. Iptacopan, a novel oral complement factor b(fb) inhibitor, significantly reduces proteinuria and C3 deposit scores in native and transplanted kidneys C3 glomerulopathy (C3g) patients[EB/OL ]. (2021-05)[2022-04-07]. https://academic.oup.com/ndt/article/36/Supplement_1/gfab121.005/6289319.
    [32]
    US National Library of Medicine. A proof-of-concept study of danicopan for 6 months of treatment in participants with C3 glomerulopathy (C3G). 2017[EB/OL ]. (2021-11-04)[2022-02-21]. https://clinicaltrials.gov/ct2/show/results/NCT03369236.
    [33]
    Gilhus NE, Tzartos S, Evoli A, et al. Myasthenia gravis[J]. Nat Rev Dis Primers, 2019, 5: 30. doi: 10.1038/s41572-019-0079-y
    [34]
    Howard JF, Utsugisawa K, Benatar M, et al. Safety and efficacy of eculizumab in anti-acetylcholine receptor antibody- positive refractory generalised myasthenia gravis (REGAIN): a phase 3, randomised, double-blind, placebo-controlled, multicentre study[J]. Lancet Neurol, 2017, 16: 976-986. doi: 10.1016/S1474-4422(17)30369-1
    [35]
    Muppidi S, Utsugisawa K, Benatar M, et al. Long-term safety and efficacy of eculizumab in generalized myasthenia gravis[J]. Muscle Nerve, 2019, 60: 14-24.
    [36]
    Narayanaswami P, Sanders DB, Wolfe G, et al. Interna-tional Consensus Guidance for Management of Myasthenia Gravis: 2020 Update[J]. Neurology, 2021, 96: 114-122. doi: 10.1212/WNL.0000000000011124
    [37]
    Jiao L, Li H, Guo S. Eculizumab treatment for myasthenia gravis subgroups: 2021 update[J]. J Neuroimmunol, 2022, 362: 577767. doi: 10.1016/j.jneuroim.2021.577767
    [38]
    Yeo CJJ, Pleitez MY. Eculizumab in refractory myasthenic crisis[J]. N Engl J Med, 2018, 58: E13-E15.
    [39]
    Howard JF, Nowak RJ, Wolfe GI, et al. Clinical effects of the self-administered subcutaneous complement inhibitor zilucoplan in patients with moderate to severe generalized myasthenia gravis: results of a phase 2 randomized, double-blind, placebo-controlled, multicenter clinical trial[J]. JAMA Neurol, 2020, 77: 582-592. doi: 10.1001/jamaneurol.2019.5125
    [40]
    UCB Newsroom. UCB announces positive data in myasthenia gravis with zilucoplan phase 3 study results, 2022[EB/OL ]. (2022-02-03)[2022-04-07]. https://www.ucb.com/stories-media/Press-Releases/article/UCB-announces-posi-tive-data-in-myasthenia-gravis-with-zilucoplan-phase-3-study-results.
    [41]
    Tuan Vu, Andreas M, Renato M, et al. Efficacy and safety of ravulizumab, a long-acting terminal complement inhibitor, in adults with anti- acetylcholine receptor antibody-positive generalized myasthenia gravis: results from the phase 3 CHAMPION MG study[EB/OL ]. (2022-04-07)[2022-05-10]. https://index.mirasmart.com/aan2022/PDFfiles/AAN2022-000791.html.
    [42]
    Howard JF, Tuan Vu, Mantegazza R, et al. Long-term efficacy and safety of ravulizumab, a long-acting terminal complement inhibitor, in adults with anti-acetylcholine receptor antibody-positive generalized myasthenia gravis: results from the phase 3 CHAMPION MG open-label extension[EB/OL ]. (2022-04-07)[2022-05-10]. https://index.mirasmart.com/aan2022/PDF-files/AAN2022-000853.html.
    [43]
    US National Library of Medicine. Safety and efficacy study of ravulizumab in adults with generalized myasthenia gravis. 2019[EB/OL ]. (2022-05-26)[2022-07-04]. https://www.clinicaltrials.gov/ct2/show/NCT03920293.
    [44]
    Zyl T, Weyne J, Chaudhari U, et al. Interim analysis of an open-label, ascending-dose, phase 1 study of the safety, tolerability, pharmacokinetics, and pharmacodyna-mics of single doses of the subcutaneously administered human monoclonal antibody pozelimab in combination with single doses of the subcutaneously administered siRNA cemdisiran in healthy volunteers[J]. Blood, 2021, 138: 1998.
  • Related Articles

    [1]ZHENG Lu, YANG Ting, CHEN Chaoyang, WEI Ran, ZHANG Xuanling, MA Yijie, ZHOU Ying. Progress in the Diagnosis and Treatment of Infantile Epileptic Spasm Syndrome[J]. Journal of Rare Diseases, 2024, 3(2): 260-268. DOI: 10.12376/j.issn.2097-0501.2024.02.017
    [2]YU Zi, WU Yi. The Research Progress of Visual Snow Syndrome[J]. Journal of Rare Diseases, 2024, 3(1): 136-143. DOI: 10.12376/j.issn.2097-0501.2024.01.019
    [3]PENG Xiaoyan, CHEN Chaoying, YANG Hongxian, XIA Hua, TU Juan. A Case of Childhood-Onset Bartter Syndrome Type 1 with Renal Dysfunction[J]. Journal of Rare Diseases, 2024, 3(1): 124-130. DOI: 10.12376/j.issn.2097-0501.2024.01.017
    [4]CAO Yaqing, GUO Baocheng, NIE Min. Genotype-Phenotype Correlation Analysis of WT1 Gene Variants in Denys-Drash Syndrome and Frasier Syndrome[J]. Journal of Rare Diseases, 2024, 3(1): 63-76. DOI: 10.12376/j.issn.2097-0501.2024.01.009
    [5]LIU Zhouliang, YANG Chao, WANG Huijun, LIN Zhimiao. Clinical Features and Mutation Analysis of the SMARCAD1 Gene in a Family with Basan Syndrome and a Literature Review[J]. Journal of Rare Diseases, 2023, 2(2): 178-185. DOI: 10.12376/j.issn.2097-0501.2023.02.006
    [6]LI Mengping, WANG Jianshe. Recent Progress in Hepatic Involvement in Shwachman-Diamond Syndrome[J]. Journal of Rare Diseases, 2022, 1(3): 347-351. DOI: 10.12376/j.issn.2097-0501.2022.03.019
    [7]NI Jie, CHEN Zhi, LING Chen, LIU Xiaorong. Clinical, Pathological and Genetic Analysis of Alport Syndrome in Children[J]. Journal of Rare Diseases, 2022, 1(3): 259-267. DOI: 10.12376/j.issn.2097-0501.2022.03.006
    [8]WANG Yu, WANG Suyue, JIN Ping, ZHU Yulong, XIA Kun, SUN Dandan, AI Wenlong, FU Xiaoming, YE Qunrong, LI Kai, WANG Xun. O'Sullivan-McLeod Syndrome: A Case Report[J]. Journal of Rare Diseases, 2022, 1(2): 189-195. DOI: 10.12376/j.issn.2097-0501.2022.02.013
    [9]WANG Wenqing, ZHAO Yuying, YAN Chuanzhu. Congenital Myasthenic Syndrome[J]. Journal of Rare Diseases, 2022, 1(2): 110-121. DOI: 10.12376/j.issn.2097-0501.2022.02.004
    [10]YUE Cai, LIU Yan, QIN Yan, JIAO Yuhao, SU Longxiang, XU Jun, LIU Wei, ZHAO Sen, YANG Lu, WANG Qian, LI Ningning, CHEN Youxin, HAN Bing, ZHANG Bo, LI Xuemei, CHEN Limeng. Anuria, Sudden Blindless, Confusion: A Case of Unusual "Adult Still Disease"[J]. Journal of Rare Diseases, 2022, 1(1): 51-55. DOI: 10.12376/j.issn.2097-0501.2022.01.009
  • Cited by

    Periodical cited type(7)

    1. 唐凤敏,黄滔敏. 眼科玻璃体内注射药物的临床应用研究进展. 中国临床药学杂志. 2025(01): 71-76 .
    2. 张磊,乐偲,刘岩,陈丽萌. 遗传性罕见肾脏病:精准肾脏病学的窗口. 罕见病研究. 2024(01): 1-11 . 本站查看
    3. 北京大学医学部肾脏病学系专家组. 补体相关性肾病诊断和治疗专家共识. 中华内科杂志. 2024(03): 258-271 .
    4. 邱婧妍,秘红岭. 依库珠单抗治疗阵发性睡眠性血红蛋白尿的研究进展. 医药前沿. 2024(03): 37-39+43 .
    5. 刘爽,刘畅,江丹沁,苏畅,唐一楠. 重症肌无力治疗药物zilucoplan. 中国新药杂志. 2024(24): 2546-2549 .
    6. 林颖,韩露,高圣乔,罗丹,肖智勇,周文霞. 基于转录组数据分析的六味地黄方活性组分LWD-b抗补体作用的发现与验证. 中国药理学与毒理学杂志. 2023(03): 168-177 .
    7. 时念民,李林康,邵祝军,张文宏,吴疆,吕敏,郑佳音,陈直平,刘晓强,张宏,谭颖,刘小荣,赵明辉,罗哲,吕继成,路丽明. 补体相关性肾病人群中脑膜炎球菌疫苗和补体抑制剂联用的专家共识. 慢性病学杂志. 2023(08): 1156-1159 .

    Other cited types(0)

Catalog

    Article views (519) PDF downloads (162) Cited by(7)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return