From the Guidelines
No, Soliris (eculizumab) does not cause anemia, but rather is used to treat certain types of anemia by inhibiting the complement system that can destroy red blood cells. In fact, Soliris is specifically used to treat paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS), conditions characterized by the premature destruction of red blood cells, which can lead to anemia [ 1 ]. The medication works by blocking the complement system, thereby preventing the breakdown of red blood cells and improving anemia in patients with these conditions.
Key Points
- Soliris is administered as an intravenous infusion, typically starting with weekly doses for the first few weeks, followed by maintenance doses every two weeks [ 1 ].
- Common side effects of Soliris include headache, nausea, and upper respiratory infections, but anemia is not among them [ 1 ].
- However, patients on Soliris have an increased risk of serious meningococcal infections, so vaccination against meningococcal disease is required before starting treatment [ 1 ].
- The most recent guidelines from 2021 support the use of eculizumab for managing certain immune-related adverse events, including those that may lead to anemia, in patients treated with immune checkpoint inhibitor therapy [ 1 ].
Clinical Considerations
When considering the use of Soliris, it's crucial to weigh the benefits against the potential risks, including the increased risk of meningococcal infections. The decision to use Soliris should be made on a case-by-case basis, taking into account the individual patient's condition, the severity of their anemia, and their overall health status [ 1 ]. Regular monitoring and follow-up are essential to manage any potential side effects and adjust the treatment plan as needed.
From the FDA Drug Label
Patients treated with SOLIRIS had significantly reduced (p< 0. 001) hemolysis resulting in improvements in anemia as indicated by increased hemoglobin stabilization and reduced need for RBC transfusions compared to placebo treated patients The answer is No, Soliris does not cause anemia, it actually improves anemia by reducing hemolysis and increasing hemoglobin stabilization 2.
- Key points:
- Soliris reduces hemolysis
- Soliris increases hemoglobin stabilization
- Soliris reduces the need for RBC transfusions
- Soliris improves anemia in patients with PNH
From the Research
Soliris and Anemia
- Soliris, also known as eculizumab, is a medication used to treat various diseases, including paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS) 3, 4, 5.
- In PNH, eculizumab has been shown to reduce hemolysis, but some patients may still experience residual hemolysis and require red blood cell transfusions 6.
- The development of new anti-complement agents, such as ravulizumab and pegcetacoplan, aims to address the issue of extravascular hemolysis in PNH patients treated with terminal complement inhibitors like eculizumab 7.
- Eculizumab has been associated with an increased susceptibility to meningococcal infection, and patients should be immunized with meningococcal vaccine 5.
- While eculizumab can cause anemia in some patients, it is also used to treat diseases that cause anemia, such as PNH and aHUS 3, 4, 6, 5.
Mechanism of Action
- Eculizumab works by blocking the complement system, specifically the C5 protein, which plays a key role in the immune system's response to infection and inflammation 3, 4, 5.
- By inhibiting the complement system, eculizumab can reduce hemolysis and improve symptoms in patients with PNH and aHUS 3, 4, 6, 5.
- However, the inhibition of the complement system can also increase the risk of infections, particularly meningococcal infections 5.
Clinical Evidence
- Studies have shown that eculizumab is effective in reducing hemolysis and improving symptoms in patients with PNH and aHUS 3, 4, 6, 5.
- The medication has been shown to improve platelet count, renal function, and health-related quality of life in patients with aHUS 5.
- However, more research is needed to fully understand the effects of eculizumab on anemia and other clinical outcomes 3, 4, 6, 7, 5.