Eculizumab

How it works

It binds complement protein C5 and prevents its cleavage, blocking formation of the terminal complement complex and reducing complement-mediated haemolysis and tissue injury.

Prescribing in practice

• By blocking terminal complement it markedly increases susceptibility to serious meningococcal infection, so meningococcal vaccination is required before treatment and antibiotic prophylaxis may be needed.
• Patients should be issued with a patient safety card and educated to seek urgent care if signs of meningococcal infection develop.
• Vaccination status against encapsulated organisms should be reviewed and treatment delivered through a specialist service with risk-management requirements.

Monitoring

Monitor for signs and symptoms of meningococcal and other infections, and assess haemolysis markers and disease control during treatment.

Counselling the patient

• Carry your patient safety card at all times and seek urgent medical attention for fever, headache or neck stiffness.
• Ensure your meningococcal vaccinations are up to date before and during treatment.

Evidence & guidelines

The meningococcal infection risk and vaccination requirement for eculizumab are emphasised in MHRA safety advice and the SPC.