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High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab (Soliris) Despite Receipt of Meningococcal Vaccine.

Abstract Use of eculizumab (Soliris, Alexion Pharmaceuticals), a terminal complement inhibitor, is associated with a 1,000-fold to 2,000-fold increased incidence of meningococcal disease (1). Administration of meningococcal vaccines is recommended for patients receiving eculizumab before beginning treatment (2,3). Sixteen cases of meningococcal disease were identified in eculizumab recipients in the United States during 2008-2016; among these, 11 were caused by nongroupable Neisseria meningitidis. Fourteen patients had documentation of receipt of at least 1 dose of meningococcal vaccine before disease onset. Because eculizumab recipients remain at risk for meningococcal disease even after receipt of meningococcal vaccines, some health care providers in the United States as well as public health agencies in other countries recommend antimicrobial prophylaxis for the duration of eculizumab treatment; a lifelong course of treatment is expected for many patients. Heightened awareness, early care seeking, and rapid treatment of any symptoms consistent with meningococcal disease are essential for all patients receiving eculizumab treatment, regardless of meningococcal vaccination or antimicrobial prophylaxis status.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title mmwr. morbidity and mortality weekly report
Publication Year Start




PMID- 28704351
OWN - NLM
STAT- MEDLINE
DA  - 20170713
DCOM- 20170714
LR  - 20170714
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Linking)
VI  - 66
IP  - 27
DP  - 2017 Jul 14
TI  - High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab 
      (Soliris) Despite Receipt of Meningococcal Vaccine.
PG  - 734-737
LID - 10.15585/mmwr.mm6627e1 [doi]
AB  - Use of eculizumab (Soliris, Alexion Pharmaceuticals), a terminal complement
      inhibitor, is associated with a 1,000-fold to 2,000-fold increased incidence of
      meningococcal disease (1). Administration of meningococcal vaccines is
      recommended for patients receiving eculizumab before beginning treatment (2,3).
      Sixteen cases of meningococcal disease were identified in eculizumab recipients
      in the United States during 2008-2016; among these, 11 were caused by
      nongroupable Neisseria meningitidis. Fourteen patients had documentation of
      receipt of at least 1 dose of meningococcal vaccine before disease onset. Because
      eculizumab recipients remain at risk for meningococcal disease even after receipt
      of meningococcal vaccines, some health care providers in the United States as
      well as public health agencies in other countries recommend antimicrobial
      prophylaxis for the duration of eculizumab treatment; a lifelong course of
      treatment is expected for many patients. Heightened awareness, early care
      seeking, and rapid treatment of any symptoms consistent with meningococcal
      disease are essential for all patients receiving eculizumab treatment, regardless
      of meningococcal vaccination or antimicrobial prophylaxis status.
FAU - McNamara, Lucy A
AU  - McNamara LA
AD  - Division of Bacterial Diseases, National Center for Immunization and Respiratory 
      Diseases, CDC.
FAU - Topaz, Nadav
AU  - Topaz N
AD  - Division of Bacterial Diseases, National Center for Immunization and Respiratory 
      Diseases, CDC.
FAU - Wang, Xin
AU  - Wang X
AD  - Division of Bacterial Diseases, National Center for Immunization and Respiratory 
      Diseases, CDC.
FAU - Hariri, Susan
AU  - Hariri S
AD  - Division of Bacterial Diseases, National Center for Immunization and Respiratory 
      Diseases, CDC.
FAU - Fox, LeAnne
AU  - Fox L
AD  - Division of Bacterial Diseases, National Center for Immunization and Respiratory 
      Diseases, CDC.
FAU - MacNeil, Jessica R
AU  - MacNeil JR
AD  - Division of Bacterial Diseases, National Center for Immunization and Respiratory 
      Diseases, CDC.
LA  - eng
PT  - Journal Article
DEP - 20170714
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Meningococcal Vaccines)
RN  - A3ULP0F556 (eculizumab)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/*therapeutic use
MH  - Humans
MH  - Meningococcal Infections/*epidemiology/microbiology/prevention & control
MH  - Meningococcal Vaccines/*administration & dosage
MH  - Neisseria meningitidis/genetics/isolation & purification
MH  - Risk Assessment
MH  - Serogroup
MH  - United States/epidemiology
EDAT- 2017/07/14 06:00
MHDA- 2017/07/15 06:00
CRDT- 2017/07/14 06:00
AID - 10.15585/mmwr.mm6627e1 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2017 Jul 14;66(27):734-737. doi:
      10.15585/mmwr.mm6627e1.