What is the efficacy of eculizumab to treat paroxysmal nocturnal hemoglobinuria (PNH) during pregnancy?

Updated: May 20, 2021
  • Author: Emmanuel C Besa, MD; Chief Editor: Sara J Grethlein, MD, FACP  more...
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The use of eculizumab in pregnancy has proved beneficial. [57] In a review of 75 pregnancies in 61 women with PNH, Kelly and colleagues reported a high rate of fetal survival and a low rate of maternal complications. No maternal deaths occurred. There were three fetal deaths (4%) and six first-trimester miscarriages (8%). During pregnancy, patients demonstrated increased requirement of red blood cell transfusions, and approximately half required an increase in the eculizumab dosage. Ten hemorrhagic events occurred, and two postpartum thrombotic events. Eculizumab was detected in some infants' cord blood, but not in breast milk. [58]

 No information is available regarding the presence of eculizumab in human milk, the effects on the breastfed infant, or the effects on milk production. No information is available on the use of ravulizumab during breastfeeding, but the manufacturer recommends against breastfeeding during ravulizumab therapy and for 8 months after the final dose. [59]

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