VJHemOnc Podcast IPIG 2025 Highlights: challenging situations in PNH, updates from the COMMODORE trials, and more
Jun 6, 2025
Explore the intricacies of managing paroxysmal nocturnal hemoglobinuria (PNH) with insights from leading experts. Learn about the challenges of transitioning from anti-C5 to proximal complement inhibitors and the complexities of stopping anticoagulation therapy. Delve into the specialized care required for pregnant patients and discover advances in treatments like ravulizumab compared to eculizumab. The discussion also highlights the critical risks of thrombosis in PNH and effective preventive strategies to improve patient outcomes.
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Switching PNH Treatments Strategically
- Monitor PNH patients on C5 inhibitors for at least 6 to 12 months before assessing extravascular hemolysis.
- Choose personalized therapy considering patient reliability, preferences, and potential side effects like breakthrough hemolysis.
Anticoagulation Guidance in PNH
- Discontinue anticoagulation after 3 months in PNH patients without prior thrombosis while on complement inhibitors.
- Continue long-term anticoagulation in patients with prior or life-threatening thromboses.
Managing PNH in Pregnancy
- Use eculizumab and heparin anticoagulation for pregnant women with PNH, with close obstetric monitoring.
- More research is needed on new therapies like pegcetacoplan during pregnancy to expand safe options.