Crovalimab

How it works

It binds complement component C5 and inhibits its cleavage, preventing formation of the terminal membrane attack complex and thereby reducing complement-mediated intravascular haemolysis in PNH.

Prescribing in practice

• Terminal complement inhibition markedly increases susceptibility to meningococcal disease; meningococcal vaccination and a clear plan for febrile illness are essential before starting.
• Confirm meningococcal vaccination status is current and consider antibiotic cover when treatment must begin before immunity is established.
• Switching to or from other complement inhibitors requires care to avoid drug-drug interaction effects and breakthrough haemolysis.

Monitoring

Monitor for signs of haemolysis and, critically, for any features of meningococcal or other encapsulated-organism infection.

Counselling the patient

• Carry a patient safety card and seek urgent medical care for fever, headache, neck stiffness or rash.
• Ensure you are up to date with meningococcal vaccination as advised by your team.
• Do not stop treatment abruptly without discussing the risk of breakthrough haemolysis.

Evidence & guidelines

Crovalimab demonstrated control of haemolysis in PNH in the COMMODORE programme; consult the SPC and current prescribing references for use.