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Médecine du travail du personnel hospitalier

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

Auteur     Lucy A. McNamara
Auteur     Nadav Topaz
Auteur     Xin Wang
Auteur     Susan Hariri
Auteur     LeAnne Fox
Auteur     Jessica R. MacNeil
Volume     66
Numéro     27
Pages     734-737
Publication     MMWR. Morbidity and mortality weekly report
ISSN     1545-861X
Date     Jul 14, 2017
Extra     PMID: 28704351
Abrév. de revue     MMWR Morb. Mortal. Wkly. Rep.
DOI     10.15585/mmwr.mm6627e1
Catalogue de bibl.     PubMed
Langue     eng
Résumé     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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