Soliris reduces kidney risks from pregnancy-associated aHUS: Study
Women with aHUS given Soliris had 80% lower risk of chronic kidney disease
Soliris (eculizumab) largely reduces the risk of long-term kidney problems in women who develop atypical hemolytic uremic syndrome (aHUS) during or after pregnancy, a meta-analysis study has found.
“This analysis highlights the severe kidney and pregnancy outcomes associated with [pregnancy-associated aHUS],” researchers wrote, noting Soliris treatment is beneficial for reducing the risk of chronic and end-stage kidney disease.
The study, “Kidney and pregnancy outcomes in pregnancy-associated atypical hemolytic uremic syndrome: A systematic review and meta-analysis,” was published in the journal Medicine. It was conducted by a team of researchers in India and Nepal.
The complement system is a component of the immune system that protects the body against infection. In aHUS, it becomes overly active, causing clots to form in small blood vessels. These clots can block blood flow to the body’s organs, particularly the kidneys, causing damage.
Kidney problems caused by aHUS can progress to end-stage kidney disease
aHUS can develop during or after pregnancy, with risks for both mothers and their babies. Without timely treatment, kidney problems caused by aHUS are likely to progress to end-stage kidney disease, which occurs when the kidneys fail to work properly, requiring patients to start dialysis or undergo a kidney transplant.
To better understand the likely course of pregnancy-associated aHUS, the researchers combined data from 10 studies published from 2000 to 2024. The studies included a total of 386 pregnancies in 380 women diagnosed with aHUS during or after pregnancy.
“A meta-analysis of the available literature on this topic can help to provide a more comprehensive understanding of the association between [pregnancy-associated aHUS], pregnancy, and kidney outcomes,” the researchers wrote.
The number of women with aHUS varied across studies, from 9% to 26%. The mean age ranged from 26 to 32, and many women were first-time mothers (36% to 90%). For 25 (6.5%), there was a family history of aHUS, and 12 (3.2%) had undergone a kidney transplant.
While the severity of kidney problems varied, two-thirds (66.6%) of the women required dialysis. Up to 25% developed chronic kidney disease or progressed to end-stage kidney disease.
During pregnancy, some of the women experienced complications like preeclampsia or high blood pressure associated with organ damage (36.4%) and HELLP syndrome (29.7%). HELLP syndrome also causes damage to organs and is often confused with aHUS due to overlapping symptoms.
Problems outside kidneys occurred in 30% of women in study
Problems outside the kidneys, such as breathing difficulty and heart failure, occurred in 117 women (30.3%). Severe bleeding occurred in 14 (1.6%), and 19 (5%) women died. For babies, complications included death, being born too early, or being too small due to poor development.
Of the 380 women, 105 (27.2%) received Soliris, a complement inhibitor approved for use in aHUS to prevent the formation of clots in small blood vessels. Treatment with Soliris started as early as four days to two months after the onset of symptoms.
Compared with women who did not receive Soliris, those who did had an 80% lower chance of developing chronic kidney disease or end-stage kidney disease.
The therapy was also well tolerated, so in view of its benefits, “widespread and equitable access to eculizumab in early therapy and long-term maintenance to all patients is the need of the hour,” the researchers wrote.
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