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Journal of Comparative Effectiveness Research logoLink to Journal of Comparative Effectiveness Research
. 2025 Jul 4;14(8):e250022. doi: 10.57264/cer-2025-0022

Long-term effectiveness and safety of ravulizumab in paroxysmal nocturnal hemoglobinuria: a plain language summary

Celso Arrais 1, Natalia Carnelutto 2, Jheremy Reyes 3
PMCID: PMC12308549  PMID: 40611794

Abstract

What is this summary about?

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disease where red blood cells break apart because they lack certain protective proteins. This makes them easy targets for the immune system, which can also affect other blood cells. PNH can lead to blood clots and serious organ damage.

Ravulizumab and eculizumab block C5, part of the immune system that destroys blood cells in PNH. Ravulizumab is given every 8 weeks, reducing treatment burden compared to eculizumab's 2-week schedule.

Ravulizumab was studied in two 26-week trials (301 and 302) for PNH. One compared it to eculizumab in participants new to treatment, and the other looked at switching from eculizumab. Both medicines were equally effective and well-tolerated.

This summary covers the extension period – an extra phase after the main study – of studies 301 and 302, to see if ravulizumab stayed safe and effective over up to 2 years. Participants on ravulizumab continued treatment, while those on eculizumab switched to ravulizumab. It also includes an additional analysis from studies 301 and 302 on breakthrough intravascular hemolysis (BTH), where red blood cells can break apart during treatment due to insufficient medication or health issues such as infections.

What were the results?

A total of 434 people continued taking ravulizumab during the extension period. For up to 2 years, 90–95% of participants maintained a low level of LDH, a blood marker of red blood cell breakdown, indicating that PNH was under control. Most participants did not need blood transfusions. The improvement in participants' quality of life lasted over the 2 years. Ravulizumab was well tolerated.

In studies 301 and 302, ravulizumab had a lower risk of BTH compared to eculizumab.

What do the results of the studies mean?

This study shows that ravulizumab remains safe and effective for longterm PNH treatment.

Keywords: Eculizumab, Paroxysmal nocturnal hemoglobinuria, plain language summary, ravulizumab


This is an abstract of the Plain Language Summary of Publication article.

To read the full Plain Language Summary of this article, click here to view the PDF.

Link to original articles here and here

Acknowledgments

The authors thank the participants, their families, and caregivers, as well as the study teams and investigators.

Footnotes

Financial disclosure

This plain language summary of publication was funded by Alexion, AstraZeneca Rare Disease.

Competing interests disclosure

The authors of this summary have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the summary apart from those disclosed.

Writing disclosure

Dr Pablo Rivas, on behalf of Content Ed Net, provided medical writing support.


Articles from Journal of Comparative Effectiveness Research are provided here courtesy of Becaris Publishing

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