ArticleFrontiers in immunology2026
Eculizumab in rapidly progressive glomerulonephritis: a case-series report.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To describe the clinical outcomes and safety profile of eculizumab as adjunctive therapy in a case series of patients with rapidly progressive glomerulonephritis (RPGN) due to anti-glomerular basement membrane (GBM) disease and anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods: We reported 7 patients with AAV and 5 patients with anti-GBM disease who presented to our center between March 2025 and January 2026. All patients received eculizumab (900 mg, 1-4 doses) in addition to standard immunosuppressive therapy. Serum creatinine (Scr), urinary red blood cell (uRBC) count, urine protein-to-creatinine ratio (UPCR), and dialysis dependence were assessed at baseline and at 3 months. Adverse events were monitored throughout follow-up. Results: In AAV patients, mean Scr decreased from 407.38 μmol/L to 231.27 μmol/L ( Conclusion: In this descriptive case series, we observed trends toward improved renal function and hematuria at 3 months in patients with severe RPGN who received eculizumab in addition to standard immunosuppression, with earlier initiation and milder baseline renal impairment appearing to correlate with more favorable outcomes. Nevertheless, the lack of a control group and the marked interpatient variability in baseline characteristics and concomitant therapies preclude any conclusion regarding a causal effect of eculizumab. Instead, these data serve as real-world observations that can generate hypotheses for future studies. Definitive evidence on the efficacy and safety of eculizumab in RPGN must await larger, prospective, controlled investigations.
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