Caregivers, aHUS patients prefer Ultomiris over Soliris: Survey
Both therapies specifically target a complement protein called C5
Most patients and caregivers living with atypical hemolytic uremic syndrome (aHUS) prefer Ultomiris (ravulizumab-cwvz) over Soliris (eculizumab), a new study reports.
The fact that Ultomiris is administered less often than Soliris was viewed as a key factor that separates the two medications and patients on Ultomiris were far less likely to report that the treatment disrupted their daily life and ability to go to work or school.
“These findings should help doctors, patients and caregivers to decide whether [Ultomiris] or [Soliris] is best for the patient,” the researchers wrote in “Treatment preference and quality of life impact: ravulizumab vs eculizumab for atypical hemolytic uremic syndrome,” which was published in the Journal of Comparative Effectiveness Research. The work was funded by Alexion, a subsidiary of AstraZeneca, which markets both treatments.
Ultomiris and Soliris are widely approved to treat aHUS and have virtually identical mechanisms. Both block the activation of the complement cascade, a group of immune proteins that play a central role in the autoimmune attack that causes aHUS. The therapies specifically target a complement protein called C5.
Ultomiris and Soliris are both administered via infusions into the bloodstream, though at different schedules. After initial loading doses, Soliris is given every other week. Ultomiris is administered every eight weeks.
Patient, caregivers’ opinions on Ultomiris, Soliris
Scientists at Alexion and other institutions surveyed patients and caregivers to better understand their views on both therapies. One survey was answered by 50 adults with aHUS. The second was answered by 16 caregivers of children with the disease.
“To our knowledge, prior to this study, the only published patient survey that examined patient satisfaction with complement C5 inhibitor treatment for aHUS focused solely on” Soliris, the researchers said, adding that patients’ preferences and the impact on their and caregivers’ daily lives must be considered.
In both groups, most respondents identified as non-Hispanic white and most were female and college-educated. The lack of people from other backgrounds was noted as a limitation because the results might not be applicable to more diverse populations.
When asked about their overall preference between the treatments, all the caregivers and 47 of the 50 adult patients (94%) said they prefer Ultomiris. One adult patient preferred Soliris, while two reported no preference.
Less frequent infusions with Ultomiris was reported as the main reason for preferring it to Soliris. Most patients said Ultomiris had a better effect on their quality of life. Caregivers said Ultomiris was better for their child’s life quality and their own.
Most respondents said Ultomiris made it easier to travel, plan social activities, or attend school/work. Only 4% of patients said Ultomiris interfered with their day-to-day life, compared with 72% for Soliris.
Similarly, 6% of patients said the frequency of Ultomiris infusions made it harder to attend work/school, compared with 60% for Soliris. Caregivers gave similar responses for the impact of treatment on them and their child.
“Most participants indicated preference for [Ultomiris] over [Soliris] for the treatment of aHUS and [Ultomiris] was shown to have a more positive effect on patient and caregiver quality of life than [Soliris]. This preference was primarily driven by the reduced infusion frequency of [Ultomiris], allowing patients more freedom,” the scientists wrote.
Adult patients said they had to spend significantly less time per month managing their disease, on average, with Ultomiris compared to Soliris (2.8 vs. 5.4 hours).
Caregivers also reported less average time managing the disease with Ultomiris, though the difference wasn’t statistically significant. The small number of caregivers who responded to the survey likely reduced the ability to find statistically meaningful differences, the researchers said.
Perceptions about the effectiveness of the two therapies at controlling aHUS, as well as side effect profiles, were generally comparable. The time needed for each individual therapy infusion also was comparable.
The results “add to the emerging body of real-world evidence on treatment impact and treatment preferences of patients with aHUS,” the researchers said.
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