[The revolution of monoclonal antibodies in the treatment of thrombotic microangiopathy]

Rev Med Interne. 2015 May;36(5):328-38. doi: 10.1016/j.revmed.2014.10.364. Epub 2014 Oct 31.
[Article in French]


Thrombotic microangiopathies (TMA) define a syndrome characterized by the association of microangiopathic haemolytic anaemia with schistocytes, peripheral thrombocytopenia, and organ injury of variable severity. Thrombotic thrombocytopenic purpura (TTP) and atypical haemolytic uremic syndrome (HUS) are the main forms of TMA. Recent advances in the pathophysiology of those two diseases, which include in HUS the identification of a deregulation of the alternative complement pathway, and in TTP a severe deficiency in ADAMTS-13, allowed to develop specific, pathophysiology-based therapies. Therefore, rituximab and eculizumab tends to be increasingly used, and there is an urgent need to define consensual modes of administration at the international level, as well as common definitions of response evaluation and follow-up explorations.

Keywords: Eculizumab; Haemolytic and uremic syndrome; Microangiopathie thrombotique; Purpura thrombotique thrombocytopénique; Rituximab; Syndrome hémolytique et urémique; Thrombotic microangiopathy; Thrombotic thrombocytopenic purpura; Éculizumab.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Anemia, Hemolytic / therapy
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Atypical Hemolytic Uremic Syndrome / therapy
  • Humans
  • Immunotherapy / methods
  • Immunotherapy / trends*
  • Purpura, Thrombotic Thrombocytopenic / therapy
  • Rituximab / therapeutic use
  • Thrombotic Microangiopathies / therapy*


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Rituximab
  • eculizumab