# Clinical Profile, Humanistic and Economic Burden of Paroxysmal Nocturnal Hemoglobinuria in Patients Treated With C5 Inhibitors

**Authors:** Shreyans Gandhi, Markus P. Radsak, Yasutaka Ueda, Maria‐Magdalena Balp, Anggie Wiyani, Olivier Somenzi, Josefin Snellman, Yasmin Taylor, Alice Simons, Jens Panse

PMC · DOI: 10.1002/jha2.70248 · EJHaem · 2026-02-18

## TL;DR

This study assesses the health and economic impact of paroxysmal nocturnal hemoglobinuria in patients treated with C5 inhibitors.

## Contribution

The study provides real-world data on patient outcomes and quality of life under C5 inhibitor treatment in PNH.

## Key findings

- Many patients remained anemic despite C5 inhibitor treatment.
- Patients reported significant fatigue and reduced work productivity.
- Quality of life scores indicated substantial impairment.

## Abstract

To evaluate disease burden among paroxysmal nocturnal hemoglobinuria (PNH) patients prescribed C5 inhibitors (C5i).

Data were drawn from the Adelphi Real World PNH Disease Specific Programme, a cross‐sectional survey of physicians and PNH patients in Australia, Canada, France, Germany, Italy, Spain, the United Kingdom, and Japan from January–December 2022. Physicians reported patient demographics, laboratory parameters, and treatments. Patients completed the EQ‐5D‐5L, Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT‐Fatigue), and Work Productivity and Activity Impairment (WPAI) questionnaire. Analyses were descriptive.

Overall, 81 physicians reported on 288 patients receiving C5i. Median (IQR) age was 50.0 (38.3–65.0) years, 79.2% were white, and 54.5% were male. Median (IQR) C5i duration was 1.0 (0–3.0) years; 77.4% received eculizumab, 22.6% ravulizumab. At time of survey, median (IQR) hemoglobin (Hb) was 11.0 (9.9–12.0) g/dL, 73.5% of patients had Hb < 12 g/dL. Lactate dehydrogenase was >1.5× upper limit of normal for 16.7% of patients. Mean (SD) EQ‐5D‐5L was 0.76 (0.20), FACIT‐Fatigue was 36.1 (9.7), WPAI work impairment was 27.5% (22.3) and activity impairment was 35.3% (24.6).

Despite C5i treatment, a notable proportion of patients remained anemic and reported impaired quality of life, indicating the need for novel, efficacious therapies.

## Linked entities

- **Diseases:** paroxysmal nocturnal hemoglobinuria (MONDO:0100244), anemia (MONDO:0002280)

## Full-text entities

- **Genes:** PIGA (phosphatidylinositol glycan anchor biosynthesis class A) [NCBI Gene 5277] {aka GPI3, MCAHS2, NEDEPH, PIG-A, PNH1}, CD59 (CD59 molecule (CD59 blood group)) [NCBI Gene 966] {aka 16.3A5, 1F5, EJ16, EJ30, EL32, G344}, CD55 (CD55 molecule (Cromer blood group)) [NCBI Gene 1604] {aka CHAPLE, CR, CROM, DAF, TC}
- **Diseases:** Fatigue (MESH:D005221), aplastic anemia (MESH:D000741), impaired HRQoL. (MESH:D000076082), depression (MESH:D003866), Chronic Illness (MESH:D002908), hemolysis (MESH:D006461), hypertension (MESH:D006973), blood disorder (MESH:D006402), pain (MESH:D010146), Nocturnal Hemoglobinuria (MESH:D006457), impaired quality of life (MESH:D003643), deficiency (MESH:D007153), anemia (MESH:D000740), headaches (MESH:D006261), thrombosis (MESH:D013927), hemoglobinuria (MESH:D006456), work impairment (MESH:D000073397), anxiety (MESH:D001007), Impairment (MESH:D060825), Activity Impairment (MESH:D001523), infection (MESH:D007239), shortness of breath (MESH:D004417), diabetes (MESH:D003920)
- **Chemicals:** Ravulizumab (MESH:C000629409), iron (MESH:D007501), vitamin B12 (MESH:D014805), folate (MESH:D005492), C5 Inhibitors (-), Eculizumab (MESH:C481642)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

42 references — full list in the complete paper: https://tomesphere.com/paper/PMC12916017/full.md

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Source: https://tomesphere.com/paper/PMC12916017