IPIG 2025 | Rescue doses of crovalimab for managing breakthrough hemolysis during treatment for PNH

So again we are very much used to using rescue doses of eculizumab historically when we had eculizumab as the one and only available treatment in patients who came in with breakthrough hemolysis for any reason, pharmacokinetic or pharmacodynamic. So in view of that, giving additional or rescue doses of crovalimab was permitted in this trial. So if a clinician suspects that a patient has come in with breakthrough, you can give an additional dose of crovalimab to rescue them from this episode of breakthrough. 

So interestingly what we found was although there were multiple episodes of clinicians assuming that this patient had a breakthrough and gave rescue doses, it was only pertinent in a couple of patients because the study went very deep to look at the crovalimab levels, to look at the pharmacokinetics and the pharmacodynamics and found out that other than a couple of patients, the rest of the patients could have avoided having rescue doses because these were not clearly signs of breakthrough hemolysis. So potentially avoiding extra doses of complement inhibition which obviously has got implications on the cost side of things but thankfully did not have any side effect profile by giving additional doses.

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