{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:38:41Z","timestamp":1792643921553,"version":"4.5.0"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Eculizumab is a licensed treatment for several rare, complement-mediated diseases. Eculizumab use is associated with an approximately 2,000-fold increased meningococcal disease risk. In the United States, meningococcal vaccines are recommended for eculizumab recipients but there are no recommendations on use of long-term antibiotic prophylaxis. We describe characteristics of and meningococcal vaccine and antibiotic receipt in U.S. eculizumab recipients to inform meningococcal disease prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Persons in the IBM\u00ae MarketScan\u00ae Research Databases with \u22651 claim for eculizumab injection during 2007\u20132017 were included. Indication for eculizumab use, meningococcal vaccine receipt, and antibiotic receipt were assessed using International Classification of Diseases-9\/10 diagnosis codes, vaccine administration procedure codes, and antibiotic codes from pharmacy claims, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall 696 persons met the inclusion criteria. Paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS) were the most common indications for eculizumab use (41% and 37%, respectively); 20% had an undetermined indication. From June 2015 through December 2017, 28% (41\/148) of continuously-enrolled patients received \u22651 serogroup B vaccine dose. For serogroup ACWY conjugate vaccine, 45% (91\/201) of patients received \u22651 dose within five years of their most recent eculizumab dose, as recommended. Of eculizumab recipients with outpatient prescription data, 7% (41\/579) received antibiotics for \u226550% of the period of increased risk for meningococcal disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Many eculizumab recipients had an undetermined indication for eculizumab use; few were up-to-date for recommended meningococcal vaccines or were prescribed antibiotics long-term. These findings can inform further investigation of how to best protect this population from meningococcal disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0241989","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T13:47:33Z","timestamp":1605188853000},"page":"e0241989","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":25,"title":["Characteristics of and meningococcal disease prevention strategies for commercially insured persons receiving eculizumab in the United States"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6566-7138","authenticated-orcid":true,"given":"Catherine H.","family":"Bozio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Isenhour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy A.","family":"McNamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,11,12]]},"reference":[{"key":"pone.0241989.ref001","volume-title":"Soliris product insert","author":"Food and Drug Administration","year":"2019"},{"issue":"2","key":"pone.0241989.ref002","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jinf.2018.10.015","article-title":"Unusual Neisseria species as a cause of infection in patients taking eculizumab","volume":"78","author":"PE Crew","year":"2019","journal-title":"J Infect"},{"issue":"4","key":"pone.0241989.ref003","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1093\/cid\/ciy958","article-title":"Disseminated gonococcal infections in patients receiving eculizumab: A case series","volume":"69","author":"PE Crew","year":"2019","journal-title":"Clinical Infectious Diseases"},{"issue":"RR-7","key":"pone.0241989.ref004","first-page":"1","article-title":"Prevention and control of meningococcal disease. Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"54","author":"National Center for Infectious Diseases CfDC, Prevention","year":"2005","journal-title":"MMWR Recomm Rep"},{"issue":"19","key":"pone.0241989.ref005","doi-asserted-by":"crossref","first-page":"509","DOI":"10.15585\/mmwr.mm6619a6","article-title":"Updated Recommendations for Use of MenB-FHbp Serogroup B Meningococcal Vaccine\u2014Advisory Committee on Immunization Practices, 2016","volume":"66","author":"ME Patton","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"27","key":"pone.0241989.ref006","doi-asserted-by":"crossref","first-page":"734","DOI":"10.15585\/mmwr.mm6627e1","article-title":"High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab (Soliris) Despite Receipt of Meningococcal Vaccine","volume":"66","author":"LA McNamara","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"3","key":"pone.0241989.ref007","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-2452","article-title":"Meningococcal B Vaccine Failure With a Penicillin-Resistant Strain in a Young Adult on Long-Term Eculizumab","volume":"140","author":"SR Parikh","year":"2017","journal-title":"Pediatrics"},{"issue":"11","key":"pone.0241989.ref008","first-page":"2802","article-title":"Fatal meningococcemia due to Neisseria meningitidis serogroup Y in a vaccinated child receiving eculizumab","volume":"14","author":"M Polat","year":"2018","journal-title":"Hum Vaccin Immunother"},{"issue":"19","key":"pone.0241989.ref009","doi-asserted-by":"crossref","first-page":"2507","DOI":"10.1016\/j.vaccine.2018.03.087","article-title":"A rare case of septic shock due to Neisseria meningitidis serogroup B infection despite prior vaccination in a young adult with paroxysmal nocturnal haemoglobinuria receiving eculizumab","volume":"36","author":"D Reher","year":"2018","journal-title":"Vaccine"},{"key":"pone.0241989.ref010","unstructured":"PNH National Service Leeds. Meningococcal infection and Eculizumab\/Complement Inhibitors 2007. Available from: http:\/\/www.pnhleeds.co.uk\/professionals\/meningococcal-infection-and-eculizumab\/."},{"key":"pone.0241989.ref011","unstructured":"Haut Conseil de la sant\u00e9 publique. Avis: actualisation de l'avis relatif \u00e0 l'antibioprophylaxie et la vaccination m\u00e9ningococcique des personnes trait\u00e9es par eculizumab (Soliris 300 mg solution \u00e0 diluer pour perfusion) [French] Paris, France: Haut Conseil de la sant\u00e9 publique; 2017. Available from: http:\/\/www.hcsp.fr\/Explore.cgi\/avisrapportsdomaine?clefr=447."},{"issue":"6","key":"pone.0241989.ref012","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s00228-016-2027-z","article-title":"Off-label use of the expensive orphan drug eculizumab in France 2009\u20132013 and the impact of literature: focus on the transplantation field","volume":"72","author":"J Castaneda-Sanabria","year":"2016","journal-title":"Eur J Clin Pharmacol"},{"issue":"RR-2","key":"pone.0241989.ref013","first-page":"1","article-title":"Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"62","author":"AC Cohn","year":"2013","journal-title":"MMWR Recomm Rep"},{"issue":"2","key":"pone.0241989.ref014","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.kint.2018.02.029","article-title":"Clinical and genetic predictors of atypical hemolytic uremic syndrome phenotype and outcome","volume":"94","author":"F Scheaefer","year":"2018","journal-title":"Kidney Int. Aug"},{"issue":"1","key":"pone.0241989.ref015","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/bjh.12347","article-title":"Long-term safety and efficacy of sustained eculizumab treatment in patients with paroxysmal nocturnal haemoglobinuria","volume":"162","author":"P Hillmen","year":"2013","journal-title":"Br J Haematol"},{"issue":"18","key":"pone.0241989.ref016","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1007\/s40265-013-0147-7","article-title":"Eculizumab: a review of its use in atypical haemolytic uraemic syndrome","volume":"73","author":"GM Keating","year":"2013","journal-title":"Drugs"},{"issue":"25","key":"pone.0241989.ref017","doi-asserted-by":"crossref","first-page":"6786","DOI":"10.1182\/blood-2011-02-333997","article-title":"Long-term treatment with eculizumab in paroxysmal nocturnal hemoglobinuria: sustained efficacy and improved survival","volume":"117","author":"RJ Kelly","year":"2011","journal-title":"Blood"},{"issue":"17","key":"pone.0241989.ref018","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.2165\/11208300-000000000-00000","article-title":"Eculizumab: a review of its use in paroxysmal nocturnal haemoglobinuria.","volume":"71","author":"K. McKeage","year":"2011","journal-title":"Drugs"},{"issue":"17","key":"pone.0241989.ref019","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1056\/NEJMra0902814","article-title":"Atypical hemolytic-uremic syndrome","volume":"361","author":"M Noris","year":"2009","journal-title":"N Engl J Med"},{"issue":"12","key":"pone.0241989.ref020","doi-asserted-by":"crossref","first-page":"3699","DOI":"10.1182\/blood-2005-04-1717","article-title":"Diagnosis and management of paroxysmal nocturnal hemoglobinuria","volume":"106","author":"C Parker","year":"2005","journal-title":"Blood"},{"issue":"8","key":"pone.0241989.ref021","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1007\/s00467-011-1879-9","article-title":"Prophylactic eculizumab prior to kidney transplantation for atypical hemolytic uremic syndrome","volume":"26","author":"M Weitz","year":"2011","journal-title":"Pediatr Nephrol"},{"issue":"8","key":"pone.0241989.ref022","doi-asserted-by":"crossref","first-page":"e340","DOI":"10.3324\/haematol.2018.209692","article-title":"Differential effects of therapeutic complement inhibitors on serum bactericidal activity against non-groupable meningococcal isolates recovered from patients treated with eculizumab","volume":"104","author":"DM Granoff","year":"2019","journal-title":"Haematologica"},{"issue":"2","key":"pone.0241989.ref023","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1111\/bjh.15790","article-title":"Eculizumab in paroxysmal nocturnal haemoglobinuria and atypical haemolytic uraemic syndrome: 10-year pharmacovigilance analysis","volume":"185","author":"G Socie","year":"2019","journal-title":"Br J Haematol"},{"issue":"3","key":"pone.0241989.ref024","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s40265-019-01068-2","article-title":"Ravulizumab: First Global Approval","volume":"79","author":"K. McKeage","year":"2019","journal-title":"Drugs"},{"issue":"4","key":"pone.0241989.ref025","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1002\/ajh.25016","article-title":"Toward complement inhibition 2.0: Next generation anticomplement agents for paroxysmal nocturnal hemoglobinuria","volume":"93","author":"AM Risitano","year":"2018","journal-title":"Am J Hematol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0241989","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T13:47:59Z","timestamp":1605188879000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0241989"}},"subtitle":[],"editor":[{"given":"Daniela Flavia","family":"Hozbor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,11,12]]},"references-count":25,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11,12]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0241989","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,12]]}}}