Chan Tze Wei, Than Hein, Tuy Tertius, Goh Yeow Tee
Department of Haematology, Singapore General Hospital, Singapore, Singapore.
Expert Rev Hematol. 2025 Jan;18(1):11-20. doi: 10.1080/17474086.2024.2440101. Epub 2024 Dec 16.
Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder of hematopoietic stem cells, characterized by somatic mutations of the Phosphatidylinositol Glycan Class A Gene, resulting in increased hemolysis. The advent of complement inhibitors has since changed the way clinicians approach treating PNH. Pegcetacoplan is a C3 inhibitor that has shown promise in this field and improved outcomes for patients who have been diagnosed with PNH.
This review article will aim to examine the pathophysiology of PNH and the current treatments available, with a focus on pegcetacoplan. It will focus on the pharmacodynamics, pharmocokinetics and evidence in the use of pegcetacoplan in PNH. Electronic sources including PubMed, MEDLINE, were utilized with studies in the last 5 years prioritized, especially the phase 3 Prince and Pegasus studies.
The results from phase 3 studies for pegcetacoplan have been promising, showing good efficacy and improvements in patients' conditions. More research is required to evaluate the use of pegcetacoplan, especially in combination with existing treatment in patients who are having suboptimal results. Nonetheless, with more results on the way and new agents to treat PNH in the vicinity, this remains a very exciting time for both clinicians and patients.
阵发性睡眠性血红蛋白尿(PNH)是一种罕见的造血干细胞获得性疾病,其特征是磷脂酰肌醇聚糖A类基因发生体细胞突变,导致溶血增加。自补体抑制剂问世以来,临床医生治疗PNH的方式发生了改变。培克西普单抗是一种C3抑制剂,在该领域已显示出前景,并改善了已诊断为PNH患者的治疗效果。
本综述文章旨在研究PNH的病理生理学和现有的治疗方法,重点是培克西普单抗。它将关注培克西普单抗在PNH应用中的药效学、药代动力学及证据。利用包括PubMed、MEDLINE在内的电子资源,优先选取过去5年的研究,尤其是3期Prince和Pegasus研究。
培克西普单抗的3期研究结果令人鼓舞,显示出良好的疗效并改善了患者病情。需要更多研究来评估培克西普单抗的应用,尤其是在疗效欠佳的患者中与现有治疗联合使用的情况。尽管如此,随着更多结果的出现以及附近有新的治疗PNH的药物,这对临床医生和患者来说仍然是一个非常激动人心的时刻。