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Eculizumab

Eculizumab
Monoclonal antibody
Type Whole antibody
Source Humanized (from mouse)
Target Complement protein C5
Clinical data
Trade names Soliris
AHFS/Drugs.com Monograph
License data
Pregnancy
category
  • US: C (Risk not ruled out)
Routes of
administration
Intravenous infusion
ATC code
Legal status
Legal status
Pharmacokinetic data
Biological half-life 8 to 15 days (mean 11 days)
Identifiers
CAS Number
DrugBank
ChemSpider
  • none
UNII
ChEMBL
Chemical and physical data
Molar mass 148 kg/mol
 NYesY (what is this?)  

Eculizumab (INN and USAN; trade name Soliris) is a humanized monoclonal antibody that is a terminal complement inhibitor. In people with paroxysmal nocturnal hemoglobinuria (PNH) it improves quality of life but does not appear to affect the risk of death. Its safety is unclear as of 2014. It is the first approved therapy for paroxysmal nocturnal hemoglobinuria. Eculizumab is also the first agent approved treatment of atypical hemolytic uremic syndrome (aHUS) with likely benefit based on two small trials.

Eculizumab was developed and is manufactured and marketed by Connecticut-based Alexion Pharmaceuticals. It was approved by the United States Food and Drug Administration (FDA) on March 16, 2007 for the treatment of PNH, and on September 23, 2011 for the treatment of aHUS. It was approved by the European Medicines Agency for the treatment of PNH on June 20, 2007, and on November 24, 2011 for the treatment of aHUS. Eculizumab is currently being investigated as a potential treatment for other rare disorders. Eculizumab has exclusivity rights until 2017 which protects it from competition from biosimilar applications until 2017.

In 2010, Soliris was the most expensive drug in the world. It costs £340,200 (approximately €430,000) per year for ongoing treatment in the UK, $500,000 a year in Canada, and US$409,500 a year in the United States (2010). "Before testing Soliris for PNH, Alexion tested the drug for rheumatoid arthritis, which afflicts 1 million Americans. The trials failed. But if it had worked for arthritis, Alexion would likely have had to charge a much lower price for this use, as it would have to compete against drugs that cost a mere $20,000." Alexion started selling Soliris in 2008 making $295 million in 2007 with its stock price rising 130% in 2010.

In people with paroxysmal nocturnal hemoglobinuria (PNH) it improves quality of life and decreases the need for blood transfusions but does not appear to affect the risk of death. It does not appear to change the risk of blood clots, myelodysplastic syndrome, acute myelogenous leukemia, or aplastic anemia.


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