SynthesisBlood advances2025
Efficacy of eculizumab discontinuation in atypical hemolytic uremic syndrome: a systematic review and meta-analysis.
Synthesis in Blood advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
- Erratum issued
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
abstractAtypical hemolytic uremic syndrome (aHUS), a life-threatening complement-mediated disorder, is now treatable with terminal complement inhibitors like eculizumab. Although effective, these therapies are costly, and increase susceptibility to infections, notably meningococcal disease, raising concerns about long-term use. The optimal duration of complement inhibition remains unclear, prompting efforts to explore the possibility of treatment discontinuation. We conducted a systematic review and meta-analysis to evaluate the benefits and risks of stopping terminal complement inhibitor therapy in aHUS. We searched PubMed, Scopus, and CINAHL for studies of continuing vs stopping anticomplement treatment in aHUS. Of 3303 identified studies, 13 observational studies (3 case control and 10 cohort) comprising 584 patients were included. Overall, continuing treatment was associated with an ∼76% reduction in the odds of relapse (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.09-0.62; P = .01). Study design influenced results: cohort studies showed a more modest effect (OR, 0.40 [95% CI, 0.15-1.09]), whereas case-control studies reported inflated estimates (OR, 0.04; 95% CI, 0.02-0.08; subgroup interaction P = .03). When the analysis was restricted to cohort studies, the effects became uncertain (statistically nonsignificant with large CIs, indicating the possibility that outcomes with continued treatment could be either superior or inferior to those observed after treatment withdrawal, or that there may be no true difference in relapse rates between the 2 therapies). Although current evidence is insufficient to provide personalized guidance on which patients with aHUS can safely discontinue anticomplement therapy, findings from higher-quality studies, which show no statistical difference between continued and discontinued treatment, suggest that discontinuation may be possible for at least some patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.