{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:20:18Z","timestamp":1790911218822,"version":"4.1.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T00:00:00Z","timestamp":1607990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organization for Health Research and Development","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Goed Gebruik Geneesmiddelen","award":["836031008"],"award-info":[{"award-number":["836031008"]}]},{"name":"Dutch Board of Health Insurance Companies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The introduction of eculizumab has significantly improved the outcome of patients with atypical haemolytic uraemic syndrome (aHUS). Because of the risk of relapse after discontinuation, eculizumab was proposed as life-long therapy. However, data on the outcome of relapse are limited. In the Netherlands, patients with aHUS are treated with a restrictive eculizumab regime and are included in a national observational study (CUREiHUS, Dutch Trial Register NTR5988\/NL5833).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>For this interim safety analysis, we evaluated the outcome of all adult patients with a suspected relapse, defined as the need to intensify eculizumab after tapering or withdrawal of therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We describe 11 patients who received renewed eculizumab therapy because of suspected relapse. In three patients with aHUS in native kidneys, estimated glomerular filtration rate (eGFR) returned to baseline value and remained stable without overt proteinuria after follow-up. Six out of eight transplanted patients responded to eculizumab therapy with improvement in eGFR. After a median follow-up of 24.6\u2009months, a reduction of eGFR \u226525% was observed in three of these transplanted patients, which was attributed to the aHUS relapse in only one patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This interim analysis suggests that re-treatment with eculizumab after relapse is safe and feasible. We will continue to use our restrictive treatment strategy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfaa241","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T20:25:40Z","timestamp":1604521540000},"page":"1939-1945","source":"Crossref","is-referenced-by-count":12,"title":["Outcome of atypical haemolytic uraemic syndrome relapse after eculizumab withdrawal"],"prefix":"10.1093","volume":"14","author":[{"given":"Caroline","family":"Duineveld","sequence":"first","affiliation":[{"name":"Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romy","family":"Bouwmeester","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost W","family":"van der Heijden","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Amsterdam University Medical Center, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan P","family":"Berger","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole C A J","family":"van de Kar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack F M","family":"Wetzels","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Dutch aHUS Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,15]]},"reference":[{"key":"2021073010132673000_sfaa241-B1","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1053\/j.ajkd.2015.12.034","article-title":"Terminal complement inhibitor eculizumab in adult patients with atypical hemolytic uremic syndrome: a single-arm, open-label trial","volume":"68","author":"Fakhouri","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"2021073010132673000_sfaa241-B2","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1007\/s00467-018-4091-3","article-title":"Eculizumab in atypical hemolytic uremic syndrome: strategies toward restrictive use","volume":"34","author":"Wijnsma","year":"2019","journal-title":"Pediatr Nephrol"},{"key":"2021073010132673000_sfaa241-B3","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1056\/NEJMoa1208981","article-title":"Terminal complement inhibitor eculizumab in atypical hemolytic-uremic syndrome","volume":"368","author":"Legendre","year":"2013","journal-title":"N Engl J Med"},{"key":"2021073010132673000_sfaa241-B4"},{"key":"2021073010132673000_sfaa241-B5","volume-title":"Outcome of First Relapse after Eculizumab Withdrawal in Atypical Hemolytic Uremic Syndrome","author":"Duineveld","year":"2019"},{"key":"2021073010132673000_sfaa241-B6","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.kint.2016.10.005","article-title":"Atypical hemolytic uremic syndrome and C3 glomerulopathy: conclusions from a \u201cKidney Disease: Improving Global Outcomes\u201d (KDIGO) Controversies Conference","volume":"91","author":"Goodship","year":"2017","journal-title":"Kidney Int"},{"key":"2021073010132673000_sfaa241-B7","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1111\/tri.13022","article-title":"Outcomes of patients with atypical haemolytic uraemic syndrome with native and transplanted kidneys treated with eculizumab: a pooled post hoc analysis","volume":"30","author":"Legendre","year":"2017","journal-title":"Transpl Int"},{"key":"2021073010132673000_sfaa241-B8","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1007\/s00467-018-4186-x","article-title":"Correction to: eculizumab in atypical hemolytic uremic syndrome: strategies toward restrictive use","volume":"34","author":"Wijnsma","year":"2019","journal-title":"Pediatr Nephrol"},{"key":"2021073010132673000_sfaa241-B9","doi-asserted-by":"crossref","first-page":"2449","DOI":"10.1681\/ASN.2019040331","article-title":"Use of highly individualized complement blockade has revolutionized clinical outcomes after kidney transplantation and renal epidemiology of atypical hemolytic uremic syndrome","volume":"30","author":"Zuber","year":"2019","journal-title":"J Am Soc Nephrol"},{"key":"2021073010132673000_sfaa241-B10","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1053\/j.ajkd.2017.06.024","article-title":"Living donor kidney transplantation in atypical hemolytic uremic syndrome: a case series","volume":"70","author":"Duineveld","year":"2017","journal-title":"Am J Kidney Dis"},{"key":"2021073010132673000_sfaa241-B11","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.ekir.2018.11.010","article-title":"Eculizumab use for kidney transplantation in patients with a diagnosis of atypical hemolytic uremic syndrome","volume":"4","author":"Siedlecki","year":"2019","journal-title":"Kidney Int Rep"},{"key":"2021073010132673000_sfaa241-B12"}],"container-title":["Clinical Kidney 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