IPIG 2025 | Anchored indirect treatment comparison of pegcetacoplan and iptacopan for PNH

Yeah, so this was trying to find a way around the fact that there will almost certainly never be a head-to-head study of these two proximal complement inhibitors in PNH and attempted to do a patient-level comparison between similar patients in both studies and these were patients who had had previous treatment with a C5 inhibitor, either eculizumab or ravulizumab and had had a suboptimal response in some way and most of it was assumed to be due to extravascular hemolysis. So the outcome I think of the study as it was put together was that there was not much to choose between the response rates of these two proximal inhibitors and that may well be correct. The individual studies are always very difficult to compare because the patient factors are different and there are many uncontrollable factors in that. So it’s a sort of way to legitimize something that we often do in our heads and don’t dare to say out loud that we think this drug is at least as good as that one. There are some minor differences in response rates but in general I think the outcome of all of the studies of the proximal inhibitors that work either alone or in combination is that they do improve outcomes in PNH patients with suboptimal response to C5 inhibitor for whatever reason.

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