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Prevention of invasive infections in patients treated with complement inhibitors

Treatments with complement inhibitors increase the risk of invasive infections caused by encapsulated bacteria: meningococci, pneumococci and Haemophilus influenzae type b in subjects receiving such treatments.

The French High Council for Public Health (HCSP) updates the statement of 13 November 2020 on Prophylaxis of invasive meningococcal disease in patients treated with ravulizumab and eculizumab and issues recommendations for patients treated with pegcecatoplan (Aspaveli®):

In order to prevent the risk of invasive infections caused by encapsulated bacteria in people to be treated with a complement inhibitor, the HCSP recommends:

  • Vaccination (or its update) against Neisseria meningitidis serogroups A, C, W, Y and B, Streptococcus pneumoniae and Haemophilus influenzae Type b according to the recommendations of the Haute Autorité de santé. This vaccination must be completed at least 2 weeks before the initiation of treatment;
  • Vaccination against Neisseria meningitidis serogroups A, C, W, Y and B for the family circle of treated patients;
  • Antibiotic prophylaxis with penicillin V (macrolides in case of allergy to penicillin). For those persons for whom complement inhibitors must be prescribed without delay and in whom the vaccination status is incomplete, antibiotic prophylaxis must be continued at least until 2 weeks after the administration of the primary or booster vaccine shots. Should antibiotic prophylaxis be prescribed for the entire duration of complement inhibitor treatment, it should be extended for 5 half-lives of the given complement inhibitor in case of treatment discontinuation.

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