A Systematic Review of Infectious Complications of Eculizumab

Eculizumab, first-line therapy for paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS) has infectious side effects in addition to its therapeutic benefits. The mechanism of development of infections, treatment modalities and preventive strategies for the associated infections have been discussed in this systematic review. The study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist and reporting guidelines. Inclusion and exclusion criteria were determined. A total of 18 research papers were extracted after exploring the databases from 2001 to 2024. The New Castle Ottawa Questionnaire for non-randomized clinical trials and observational studies, the National Institutes of Health (NIH) quality assessment tool for case reports and case series, and the scale for the quality assessment of narrative review articles checklist for literature review were used to assess the risk of bias. The bacteria causing infection secondary to eculizumab are Neisseria meningitidis, Neisseria gonorrhoeae, unusual Neisseria species, Moraxella lacunata, and Pseudomonas aeruginosa and fungus causing infection secondary to eculizumab is Aspergillus niger. Health care providers should maintain a high index of suspicion for these adverse effects for early identification and treatment.