Transcripts
DR. BRANDT:
What does the future hold in terms of treatment? Controlled multicenter trials of promising therapies like plasma apheresis are
looking more promising for E. coli HUS. I think in the past pediatric nephrologists have been very slow or very reluctant to take up plasma apheresis for all children with HUS.
There are theoretical reasons as Dr. Tarr mentioned that make it less likely that it will be useful. And it's very difficult to do a study of plasma apheresis and HUS as compared to TTP because six months after HUS 90 percent of the kids look better. HUS is self-limited so that the HUS process stops.
TTP, on the other hand or the familial forms of HUS, are relatively chronic. So you can look at a group of patients six months or a year later with TTP and know whether your therapy has been useful.
With HUS you've probably got to look at them 40 years later to really know if plasma apheresis is going to be helpful over the long term because the great majority of those kids were getting better.
It's difficult to know about plasma apheresis. There is a study in Germany that's ongoing now in the use of plasma apheresis in childhood HUS. And hopefully that can give us some sort of answer once those studies finish.
Lastly, I think, if your child has high blood pressure or proteinuria, your child should be on an ACE inhibitor blood pressure medicine, as I mentioned. They have relatively few side effects but some side effects. So you need to monitor their use, in particular potassium levels and creatinine levels.
