Testing for evidence of complement blockade by CH50 and AP100 and soluble C5b-9 is recommended when a patient has commenced complement inhibition.
For patients commencing eculizumab:
- Samples should be sent for monitoring once patients are stable on eculizumab: (pre-3rd dose at 1200mg for adults, and variable for children according to weight). The aHUS Specialist Nurses will liaise with the local team to inform them on a case-by-case basis when these bloods are due (Both for adult and paediatric patients).
For patients commencing ravulizumab:
- Samples should be sent for monitoring once patients are stable on ravulizumab:
- For patients over 20kg, these should be taken prior to the 18 week dose
- For patients under 20kg, these should be taken prior to the 10 week dose
Additional samples may be required and will be discussed with the referring consultant on a case-by-case basis. These may be the case if results are indeterminate or if they necessitate a change in dose. We may also recommend further sampling if we have been notified of clinical concern about the patient or in the case of patients who have commenced eculizumab pre-emptively at time of transplantation.