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Prophylaxis of invasive meningococcal disease in patients treated with ravulizumab and eculizumab

Treatment with monoclonal antibodies that inhibit the terminal pathway of complement increases the risk of invasive meningococcal infection in people receiving such treatment.

The Haut Conseil de la Santé Publique therefore recommends, for people receiving treatment with ravulizumab (Ultomiris®) and eculizumab (Soliris®):

  • antibiotic prophylaxis using penicillin V (macrolides in case of allergy to penicillins) up to 60 days after stopping eculizumab (consistent with the HCSP opinion of 2014) and continued up to 8 months after stopping eculizumab;
  • vaccination against meningococcal serogroups A, C, Y, W and B.

The HCSP also recommends vaccination against pneumococcus and Haemophilus influenzae type b as treatment also promotes invasive pneumococcal and H. influenzae type b infections.

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