{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:02:15Z","timestamp":1787983335019,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Atypical haemolytic uraemic syndrome (aHUS) is a rare thrombotic microangiopathy resulting from dysregulation of the alternative complement pathway, leading to multi\u2010organ dysfunction and chronic kidney disease. Eculizumab is an anti\u2010C5 monoclonal antibody therapy that has significantly improved aHUS disease control and patient outcomes, however it requires fortnightly intravenous dosing. This often necessitates long term central access and a high hospital attendance burden. Ravulizumab is a novel, next\u2010generation anti\u2010C5 monoclonal antibody engineered from eculizumab to reduce endosomal degradation of the antibody, increasing the dosing interval up to 8\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Series<\/jats:title><jats:p>In this retrospective case series we present the transition of three children with aHUS from eculizumab to ravulizumab from a single tertiary paediatric nephrology service. All patients underwent genomic and immunological work up for aHUS, with no cause found. After stabilisation with eculizumab, two patients developed macrovascular thrombotic complications associated with indwelling central vascular catheters, ultimately leading to central access failure. All patients were transitioned from eculizumab to ravulizumab without relapse of aHUS. One patient successfully underwent deceased donor kidney transplantation with ravulizumab for complement inhibition. All patients have transitioned to peripheral access for infusions given the reduced frequency of dosing, maintaining good control of aHUS for 2\u20134\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ravulizumab permits sufficiently reduced frequency of infusion to allow for administration by peripheral cannulation \u2013 removing the risks of long term central vascular access often required to deliver eculizumab to paediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16552","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T11:15:01Z","timestamp":1714043701000},"page":"183-187","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ravulizumab facilitates reduced burden of vascular access, a major benefit in paediatric atypical haemolytic uraemic syndrome"],"prefix":"10.1111","volume":"60","author":[{"given":"Freya","family":"Bleathman","sequence":"first","affiliation":[{"name":"Department of Nephrology Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua Y","family":"Kausman","sequence":"additional","affiliation":[{"name":"Department of Nephrology Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Kidney Flagship Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laine M","family":"Hosking","sequence":"additional","affiliation":[{"name":"Immunology Laboratory Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6635-8855","authenticated-orcid":false,"given":"Thomas A","family":"Forbes","sequence":"additional","affiliation":[{"name":"Department of Nephrology Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Kidney Flagship Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Department of Paediatrics University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2015.11.026"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.10.046"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04760512"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02210310"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195909"},{"key":"e_1_2_6_7_1","first-page":"7","article-title":"Long\u2010term remission with eculizumab in atypical haemolytic uraemic syndrome","volume":"22","author":"Carter S","year":"2017","journal-title":"Nephrol. 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