Table 5.

Eculizumab dosing in atypical hemolytic uremic syndrome based on dosing goal, one additional monitoring may be required during intercurrent events (e.g., infection, surgery, vaccination) to detect unblocked complement activity

Minimal dose
Desire to continue dosing with the minimal dose required to achieve a pre-identified level of complement blockade 1 Dose reduction or interval extension Goal CH50 < 10% (recommended) Goal AH50 < 10% (recommended) Goal eculizumab trough > 100 μg/mL
Discontinuation
Desire to discontinue complement blockade: No consensus exists regarding tapering of dose

Adapted from: Goodship et al[58]. AH50: Alternative pathway hemolytic activity; CH50: Total complement activity.