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Article Dans Une Revue European Journal of Haematology Année : 2023

Long-term effectiveness of eculizumab: Data from the International PNH Registry

Résumé

Objectives Data from the International PNH Registry (NCT01374360) were used to estimate the overall survival and first occurrence of thromboembolic events/major adverse vascular events (TEs/MAVEs) for eculizumab-treated patients with paroxysmal nocturnal hemoglobinuria (PNH) compared with a contemporaneous untreated cohort. Methods Patients enrolled in the Registry from March 16, 2007, to February 14, 2022, were included. Treated patients received eculizumab for >35 days; untreated patients did not receive eculizumab at any time. Univariable and multivariable analyses were performed using a Cox proportional hazards regression model comparing eculizumab treatment periods to untreated periods and were adjusted for baseline covariates (e.g., high disease activity [HDA], transfusion dependency, and eculizumab treatment status). Results The analysis included 4118 patients. The univariable hazard ratio (HR) (95% CI) for mortality in eculizumab-treated time versus untreated time was 0.51 (0.41–0.64; p < 0.0001). Significant baseline covariates included age, sex, history of bone marrow failure, ≥4 erythrocyte transfusions within 12 months before baseline, and an estimated glomerular filtration rate ≤ 60 mL/min/1.73 m2 (all p < 0.0001). In the adjusted analysis, patients with baseline HDA had the greatest reduction in mortality risk (HR [95% CI], 0.51 [0.36–0.72]). Treated patients had approximately 60% reduction in TE/MAVE risk during treated versus untreated time (HR [95% CI]: TE: 0.40 [0.26–0.62], MAVE: 0.37 [0.26–0.54]; p < 0.0001). Conclusion Using data from the largest Registry of patients with PNH, with ≥14 years of overall follow-up, we demonstrate that treatment with eculizumab conferred a 49% relative benefit in survival and an approximately 60% reduction in TE/MAVE risk.
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Licence : CC BY NC - Paternité - Pas d'utilisation commerciale

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hal-04482562 , version 1 (22-03-2024)

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Louis Terriou, Jong Wook Lee, Cecily Forsyth, Morag Griffin, Jeff Szer, et al.. Long-term effectiveness of eculizumab: Data from the International PNH Registry. European Journal of Haematology, 2023, European Journal of Haematology, ⟨10.1111/ejh.14080⟩. ⟨hal-04482562⟩

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