SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Pharmacology of Infectious Diseases
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1538563
Incidence of infection associated with eculizumab: a meta-analysis of 9 randomized controlled trials
Provisionally accepted
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Background and Aims: Eculizumab is expected to lead to increased susceptibility to infection. We performed a meta-analysis of data from randomized controlled trials (RCTs) to determine the risk of infection in eculizumab-treated patients.: We searched PubMed, EMBASE, Web of Science and ClinicalTrials.gov (up to Oct 8, 2024) to identify published RCTs that focused on the occurrence of infection in patients treated with eculizumab regardless of the indications of the patients. Relative risks (RRs) and 95% confidence intervals (95% CIs) were calculated via the random effects model. (PROSPERO Code No. CRD42024562470)Results: Nine RCTs including 691 patients were eligible. Compared with the control (placebo or standard of care), eculizumab did not significantly increase the overall risk of infection (RR=1.07; 95% CI, 0.89-1.28; I 2 = 44%), regardless of whether the infection was a general infection (RR=1.07; 95% CI, 0.86-1.34; I 2 =39%) or a serious infection (RR=1.05; 95% CI, 0.75-1.47; I 2 =11%). Analyses of subgroups revealed that eculizumab significantly increased the risk of general urinary system infection (RR=1.33; 95% CI, 1.00-1.77; I 2 = 46%) and severe bacteremia (RR=2.31; 95% CI, 1.04-5.13; I 2 =0%).Compared with placebo or standard of care, although eculizumab did not significantly increase the overall risk of infection, it was associated with 33% and 131% increases in the risk of general urinary system infection and severe bacteremia, respectively.
Keywords: Eculizumab, Infection, Bacteremia, Meta-analysis, Urinary tract infection
Received: 12 Dec 2024; Accepted: 15 Apr 2025.
Copyright: © 2025 Jiang, Liu, Chunyan and Xiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Guirong Xiao, Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.