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#Update: Increase in #Human #Infections with #Avian #Influenza #H7N9 Viruses During the 5th #Epidemic — #China, Oct. ‘16–Aug. 7 ‘17 (@CDCgov, edited)

Title : #Update: Increase in #Human #Infections with #Avian #Influenza #H7N9 Viruses During the 5th #Epidemic — #China, Oct. ‘16–Aug. 7 ‘17....

7 Jul 2017

High #Risk for Invasive #Meningococcal #Disease Among #Patients Receiving #Eculizumab (Soliris) Despite Receipt of Meningococcal #Vaccine (@CDCgov, abstract)

 

Title: High #Risk for Invasive #Meningococcal #Disease Among #Patients Receiving #Eculizumab (Soliris) Despite Receipt of Meningococcal #Vaccine.

Subject: Meningococcal disease and treatment with Soliris, advice to the public.

Source: US Centers for Disease Control and Prevention (CDC), MMWR Morbidity and Mortality Weekly Report, full page: (LINK). Abstract, edited.

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High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab (Soliris) Despite Receipt of Meningococcal Vaccine

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Early Release / July 7, 2017 / 66

Format: [ PDF [127K] ]

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Lucy A. McNamara, PhD1; Nadav Topaz, MSc1; Xin Wang, PhD1; Susan Hariri, PhD1; LeAnne Fox, MD1; Jessica R. MacNeil, MPH1

Corresponding author: Lucy A. McNamara, LMcNamara@cdc.gov, 404-639-8743.

1Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC.

Suggested citation for this article: McNamara LA, Topaz N, Wang X, Hariri S, Fox L, MacNeil JR. High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab (Soliris) Despite Receipt of Meningococcal Vaccine. MMWR Morb Mortal Wkly Rep . ePub: 7 July 2017. DOI: http://dx.doi.org/10.15585/mmwr.mm6627e1.

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Summary

  • What is already known about this topic?
    • Eculizumab (Soliris, Alexion Pharmaceuticals), a terminal complement inhibitor, is associated with a 1,000-fold to 2,000-fold increased incidence of meningococcal disease among persons receiving the drug.
    • The Food and Drug Administration (FDA)–approved prescribing information includes a boxed warning regarding increased risk for meningococcal disease in eculizumab recipients.
    • The Advisory Committee on Immunization Practices recommends both MenACWY and MenB vaccination for patients taking eculizumab.
  • What is added by this report?
    • Following review of existing meningococcal disease case investigation records, 16 cases of meningococcal disease were identified in eculizumab recipients in the United States for the period 2008–2016.
    • The majority of cases were caused by nongroupable Neisseria meningitidis and occurred in patients who had documentation of receipt of at least 1 dose of meningococcal vaccine before disease onset.
  • What are the implications for public health practice?
    • Health care providers should continue to follow recommendations from the Advisory Committee on Immunization Practices for eculizumab recipients to receive both MenACWY and MenB vaccines and could consider antimicrobial prophylaxis for the duration of eculizumab treatment to potentially reduce the risk for meningococcal disease.
    • However, neither vaccination nor antimicrobial prophylaxis can be expected to prevent all cases of meningococcal disease in eculizumab recipients.
    • Heightened awareness, early care seeking, and rapid treatment of any symptoms consistent with meningococcal disease are essential in all patients receiving eculizumab treatment, regardless of meningococcal vaccination or antimicrobial prophylaxis status.


Abstract

Use of eculizumab (Soliris, Alexion Pharmaceuticals), a terminal complement inhibitor, is associated with a 1,000-fold to 2,000-fold increased incidence of meningococcal disease (1). Administration of meningococcal vaccines is recommended for patients receiving eculizumab before beginning treatment (2,3). Sixteen cases of meningococcal disease were identified in eculizumab recipients in the United States during 2008–2016; among these, 11 were caused by nongroupable Neisseria meningitidis. Fourteen patients had documentation of receipt of at least 1 dose of meningococcal vaccine before disease onset. Because eculizumab recipients remain at risk for meningococcal disease even after receipt of meningococcal vaccines, some health care providers in the United States as well as public health agencies in other countries recommend antimicrobial prophylaxis for the duration of eculizumab treatment; a lifelong course of treatment is expected for many patients. Heightened awareness, early care seeking, and rapid treatment of any symptoms consistent with meningococcal disease are essential for all patients receiving eculizumab treatment, regardless of meningococcal vaccination or antimicrobial prophylaxis status.


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Keywords: USA; US CDC; Updates; Drugs Safety; Meningococcal Disease.

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