Complement-mediated renal diseases after kidney transplantation - current diagnostic and therapeutic options in de novo and recurrent diseases

Table 8 Eculizumab dosing in atypical hemolytic uremic syndrome based on dosing goal

Minimal dose	Discontinuation
Desire to continue dosing with the minimal dose required to achieve a pre-identified level of complement blockade1	Desire to discontinue complement blockade
Dose reduction or interval extension	No consensus exists regarding tapering of dose
Goal CH50 < 10% (recommended)
Goal AH50 < 10% (recommended)
Goal eculizumab trough >100 μg/mL

¹Additional monitoring may be required during intercurrent events (e.g., infection, surgery, vaccination) to detect unblocked complement activity. Adapted from Goodship et al[12]. AH50: Alternative pathway hemolytic activity; CH50: Total complement activity.