Do you consider prophylactically increasing eculizumab frequency for pregnant or postpartum PNH patients?

Yes, there have been several case series and reports indicating that eculizumab may need to be prophylactically increased in dose or frequency (because the pregnancy state may further increase complement activation in PNH patients). This efficacy of eculizumab may be monitored by standard hemolysis lab tests. Another test that can be used to monitor the effectiveness of eculizumab is 50% hemolytic complement or CH50 test. Both clinical hemolysis labs and CH50 may be checked every 2 weeks corresponding to the treatment cycle for eculizumab.

Thus far, there have been over 400 pregnancies with known in-utero exposure to eculizumab with 70% resulting in live births. However, there are currently only limited data on the use of ravulizumab in pre...