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See the challenge

See the challenge

C5i treatment is life-saving but many patients are left to battle residual anaemia1,2

C5i treatments effectively address intravascular haemolysis (IVH), but act downstream of C3 in the complement pathway and do not resolve C3-mediated extravascular haemolysis (EVH).1,2

C3-mediated EVH is the main cause of residual anaemia in C5i-treated patients2

Discover the indicators of ongoing EVH

A combination of these haematologic indicators may suggest EVH:3-5

  • Elevated ARC
  • Normal or slightly elevated LDH
  • Elevated levels of bilirubin
  • Below normal levels of Hb

ARC=absolute reticulocyte count; C3=complement 3; C5i=complement 5 inhibitor; EVH=extravascular haemolysis; Hb=haemoglobin; IVH=intravascular haemolysis; LDH=lactate dehydrogenase; PNH=paroxysmal nocturnal haemoglobinuria. 

References: 1. Risitano AM, Marotta S, Ricci P, et al. Anti-complement treatment for paroxysmal nocturnal hemoglobinuria: time for proximal complement inhibition? A position paper from the SAAWP of the EBMT. Front Immunol. 2019;10:1157. 2. Risitano AM and de Latour RP. How we(‘ll) treat paroxysmal nocturnal haemoglobinuria: diving into the future. BJH. 2021;doi: 10.1111/ bjh.17753. 3. Hill A, Rother RP, Arnold R, et al. Eculizumab prevents intravascular hemolysis in patients with paroxysmal nocturnal hemoglobinuria and unmasks low-level extravascular hemolysis occurring through C3 opsonization. Haematologica. 2010;95(4):567–573. 4. Brodsky RA. Paroxysmal nocturnal hemoglobinuria. Blood. 2014;124(18):2804–2811. 5. Barcellini W et al. Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia. Dis Markers. 2015;635–670.