A subset of patients treated with a C5 inhibitor may experience extravascular hemolysis (EVH)1,2

PNH causes lysis of red blood cells (RBCs) and activation of white blood cells (WBCs) and platelets—due to terminal complement overactivation. Inhibition of C5-mediated terminal complement controls IVH of PNH RBCs. The PNH RBCs remaining in circulation are susceptible to C3 fragment deposition that may lead to EVH.3-8

EVH occurs when PNH RBCs are prematurely cleared by the liver and spleen8

Extravascular hemolysis visualization in liver and spleen

Patients with EVH may experience persistent anemia that impacts their ability to accomplish daily tasks.2,8

ULTOMIRIS® (ravulizumab-cwvz) is the #1 prescribed PNH treatment and the standard of care9-11,a

ULTOMIRIS, a terminal complement inhibitor, is designed to control IVH and reduce the risk of thrombotic events.11

ULTOMIRIS is designed to provide durable, every-8-weekb disease control for11:

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Immediate and sustained terminal complement control10,11

Complete C5 inhibitionC

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Rapid and sustained control of LDH11-14

Resulting in low rates of breakthrough hemolysis and MAVEs

The most frequent adverse reactions (≥10%) with ULTOMIRIS were upper respiratory tract infection and headache.11

ULTOMIRIS is designed to deliver critical PNH disease control.11,13,15,d

Patients with EVH may experience persistent signs and symptoms of anemia with or without the need for blood transfusion1,2,8,16

  • EVH is not considered life-threatening8
  • Patients with EVH are not at increased risk of thrombosis, the most common cause of death in PNH3,8

EVH does not indicate inadequate C5 inhibition.5

Identify if EVH is the cause of persistent anemia through clinical observations and key indicators1,2,8,16-18

A subset of patients with a confirmed treatment response (LDH <1.5 x ULN) to a C5 inhibitor may experience persistent signs and symptoms of anemia. There are multiple causes,e one of which may be EVH.1,2,7,14,17,19,20

EVH could be the cause if your patients have1,2,5,7,16-18,21,22,f:

Flow chart defining EVH disease characterestics.

To confirm if this persistent anemia is due to EVH, other causes should be eliminated by checking key hematological indicators such as hemoglobin levels and absolute reticulocyte count.17

If a patient is experiencing EVH, adding VOYDEYA™ may help address persistent anemia while ULTOMIRIS continues to provide reliable disease control of IVH and thrombosis.1,11,13,15

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Learn more about how to identify EVH with the Patient Identification Brochure.

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Add VOYDEYA to address
EVH while maintaining
critical PNH disease control
with ULTOMIRIS.1,11,i

DISCOVER VOYDEYA

aBased on US market share data.9

bStarting 2 weeks after the initial loading dose, maintenance doses are administered every 8 weeks.11

cDefined as serum-free C5 concentration of less than 0.5 mcg/mL.11

dULTOMIRIS was evaluated in two phase 3, randomized, open-label, active-controlled, noninferiority, multicenter studies evaluating the efficacy and safety of ULTOMIRIS with eculizumab in patients with PNH who were complement inhibitor naïve and had active hemolysis (Study 301) and in clinically stable adult patients with PNH who had received eculizumab treatment for ≥6 months and had LDH levels <1.5 x ULN (246 U/L) at screening (Study 302). After the primary evaluation period (26 weeks), patients initiated on ULTOMIRIS continued on maintenance treatment, while patients initiated with eculizumab switched from eculizumab to ULTOMIRIS for the open-label extension (OLE). Outcomes of interest included change in LDH level from baseline and the proportion of patients experiencing breakthrough IVH and major adverse vascular events.11,13,15

eOther causes of persistent anemia include low folate levels, relative erythropoietin deficiency, breakthrough intravascular hemolysis, hypersplenism, iron overload, and/
or the presence of alloantibodies.17,22

fBased on a clinical trial for an add-on treatment to ULTOMIRIS or SOLIRIS® (eculizumab).1

gLow levels of hemoglobin are considered to be ≤9.5 g/dL.1,2

hAn increased absolute reticulocyte count is considered to be ≥120 x 109/L.1,2

iVOYDEYA may also be taken with SOLIRIS.1

AA=aplastic anemia; BMF=bone marrow failure; IVH=intravascular hemolysis; LDH=lactate dehydrogenase; MAVE=major adverse vascular event; MDS=myelodysplastic syndromes; PNH=paroxysmal nocturnal hemoglobinuria; ULN=upper limit of normal.

Important safety
information

IMPORTANT SAFETY INFORMATION FOR VOYDEYA

WARNING: SERIOUS INFECTIONS CAUSED BY ENCAPSULATED BACTERIA

VOYDEYA, a complement inhibitor, increases the risk of serious
infections, especially those caused by encapsulated bacteria, such as Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae type B [see Warnings and Precautions (5.1)]. Life-threatening and fatal infections with encapsulated bacteria have occurred in patients treated with complement inhibitors. These infections may become
rapidly life-threatening or fatal if not recognized and treated early.

  • Complete or update vaccination for encapsulated bacteria specifically, Neisseria meningitidis and Streptococcus pneumoniae at least 2 weeks prior to the first dose of VOYDEYA, unless the risks
    of delaying therapy with VOYDEYA outweigh the risk of developing a serious infection. Comply with the most current Advisory Committee on Immunization Practices (ACIP) recommendations for vaccinations against encapsulated bacteria in patients receiving a complement inhibitor.
    See Warnings and Precautions (5.1) for additional guidance on the management of the risk of serious infections caused by encapsulated bacteria.

  • Patients receiving VOYDEYA are at increased risk for invasive disease
    caused by encapsulated bacteria, even if they develop antibodies following vaccination. Monitor patients for early signs and symptoms
    of serious
    infections and evaluate immediately if infection is
    suspected.

Because of the risk of serious infections caused by encapsulated bacteria,
VOYDEYA is available only through a restricted program under
a Risk Evaluation and Mitigation Strategy (REMS) called the VOYDEYA REMS [see Warnings and Precautions (5.2)].

CONTRAINDICATIONS

Initiation in patients with unresolved serious infection caused by encapsulated bacteria, including Neisseria meningitidis, Streptococcus pneumoniae, or Haemophilus influenzae type B.

WARNINGS AND PRECAUTIONS

Serious Infections Caused by Encapsulated Bacteria

VOYDEYA, a complement inhibitor, increases a patient’s susceptibility to serious, life-threatening, or fatal infections caused by encapsulated bacteria, including Neisseria meningitidis (caused by any serogroup,
including non-groupable strains), Streptococcus pneumoniae, and Haemophilus influenzae type
B. Life-threatening and fatal infections with encapsulated bacteria have occurred in both vaccinated and unvaccinated patients treated with complement inhibitors.

Complete, update, or revaccinate patients in accordance with ACIP recommendations considering the duration of VOYDEYA therapy. Note that ACIP recommends an administration schedule in patients receiving complement inhibitors that differs from the administration schedule in the vaccine prescribing information. If urgent VOYDEYA therapy is indicated in a patient who is not up to date with vaccines against encapsulated bacteria according to ACIP recommendations, provide antibacterial drug prophylaxis and administer these vaccines as soon as possible. Various durations and regimens of antibacterial drug prophylaxis have been considered, but the optimal durations and drug regimens for prophylaxis and their efficacy have
not been studied in unvaccinated or vaccinated patients receiving complement inhibitors, including VOYDEYA. The benefits and risks of treatment with VOYDEYA, as well as those associated with antibacterial drug prophylaxis in unvaccinated or vaccinated patients, must be considered against the known risks for serious infections caused by encapsulated bacteria.

Vaccination does not eliminate the risk of serious encapsulated bacterial infections, despite development of antibodies following vaccination. Closely monitor patients for early signs and symptoms of serious infection and evaluate patients immediately if an infection is suspected. Inform patients of these signs and symptoms and instruct patients to seek immediate medical care if they occur. Promptly treat known infections. Serious infection may become rapidly life-threatening or fatal if not recognized and treated early. Consider interruption of VOYDEYA in patients who are undergoing treatment for serious infections.

VOYDEYA REMS

Due to the risk of serious infections caused by encapsulated bacteria, VOYDEYA is available only through a restricted program called VOYDEYA
REMS. Per the REMS requirements:

Prescribers must enroll in the REMS, counsel patients about the risk of serious infections caused by encapsulated bacteria, provide patients with the REMS educational materials, assess patient vaccination status for vaccines against encapsulated bacteria, and vaccinate if needed according to current ACIP recommendations 2 weeks prior to the first
dose of VOYDEYA. Antibacterial drug prophylaxis must be prescribed if treatment must be started urgently and the patient is not up to date with vaccines against encapsulated bacteria according to current ACIP recommendations at least 2 weeks prior to the first dose of VOYDEYA.

Pharmacies that dispense VOYDEYA must be certified in the VOYDEYA REMS and must verify prescribers are certified.

Patients must receive counseling from the prescriber about the need to
receive vaccinations against encapsulated bacteria per ACIP recommendations, to take antibiotics as directed, the early signs and symptoms of serious infection, and be instructed to carry the Patient Safety Card at all times during and for 1 week following the last dose of VOYDEYA.

Further information is available at www.voydeyarems.com or 1-888-765-4747.

Hepatic Enzyme Increases

Hepatic enzyme elevations have been observed in patients treated with VOYDEYA. A total of
14% of patients receiving VOYDEYA had elevations in serum alanine aminotransferase (ALT). ALT elevations >3× the upper limit of normal (ULN) and ≤5× ULN occurred in 9% of VOYDEYA-treated patients, and ALT elevations >5× ULN and ≤10× ULN occurred in 5% of VOYDEYA-treated patients.

Assess liver enzyme test results prior to the initiation of VOYDEYA and periodically during treatment. Consider treatment interruption or discontinuation if elevations are clinically significant or if the patient becomes symptomatic. VOYDEYA has not been studied in patients with severe hepatic impairment.

Monitoring of PNH Manifestations After VOYDEYA Discontinuation

After discontinuing treatment with VOYDEYA, closely monitor patients for at least 2 weeks after the last dose for signs and symptoms of hemolysis. If discontinuation of VOYDEYA is necessary, continue background treatment
with ravulizumab or eculizumab or consider alternative therapy if necessary. The signs and symptoms of hemolysis may include sudden decrease in hemoglobin or fatigue.

If hemolysis occurs after discontinuation of VOYDEYA, consider restarting treatment with VOYDEYA, if appropriate.

Hyperlipidemia

VOYDEYA increases total cholesterol and LDL-cholesterol. Of the 50
VOYDEYA-treated
patients who had a normal total cholesterol
level at baseline, 30% developed Grade 1 hypercholesterolemia. Of the 6 VOYDEYA-treated patients who had Grade 1 hypercholesterolemia at baseline, 1 patient experienced increased total cholesterol that worsened to Grade 2. Of the 54 VOYDEYA-treated patients who had LDL-cholesterol ≤130 mg/dL at baseline, 13% developed LDL-cholesterol >130-160 mg/dL, and 9% developed LDL-cholesterol >160-190 mg/dL.

Some patients required cholesterol-lowering medications. Monitor serum lipid parameters periodically during treatment with VOYDEYA
and initiate cholesterol-lowering medication, if indicated.

ADVERSE REACTIONS

The most common adverse reaction reported in ≥10% of patients treated with VOYDEYA was headache. Serious adverse reactions were reported in 5% of patients who received VOYDEYA and included pancreatitis, cholecystitis, and increased blood bilirubin. No specific serious adverse reaction was reported in more than 1 patient treated with VOYDEYA. Adverse reactions reported in ≥5% of patients treated with VOYDEYA and greater than placebo in the randomized, controlled period included vomiting, pyrexia, increased alanine aminotransferase, hypertension, and pain in the extremities. Clinically relevant adverse reactions in <5% of patients included increased serum triglycerides.

DRUG INTERACTIONS

BCRP Substrates

Danicopan is a Breast Cancer Resistance Protein (BCRP) inhibitor.
Concomitant use of VOYDEYA with a BCRP substrate increases the plasma concentrations of the BCRP substrate, which may increase the risk for adverse reactions associated with the BCRP substrate.
If used together, monitor patients more frequently for adverse reactions, associated
with the BCRP substrate and consider dose reduction of the BCRP substrate according to
its prescribing information.

Rosuvastatin

Danicopan significantly increased rosuvastatin exposure. The dose of rosuvastatin should not exceed 10mg once daily when concomitantly used
with VOYDEYA.

P-glycoprotein Substrates

Danicopan is an inhibitor of P-glycoprotein (P-gp). Concomitant administration of VOYDEYA with P-gp substrates may increase the plasma concentrations of the P-gp substrates. Dose adjustment might be necessary for P-gp substrates where minimal concentration changes may lead to serious adverse reactions.

USE IN SPECIFIC POPULATIONS

Pregnancy

There are no available data on VOYDEYA use in pregnant individuals to
evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. There are risks to the mother and fetus associated with untreated PNH in pregnancy. The use of VOYDEYA in pregnant women or women planning to become pregnant may be considered following an assessment of the risks and benefits.

Lactation

There are no data on the presence of VOYDEYA in human milk, the effects on the breastfed
child, or the effect on milk production.
VOYDEYA is present in animal milk. When a
drug is present in animal milk, it is likely that the drug will be present in human milk.

Because of the potential for serious adverse reactions in the breastfed child, including serious infections with encapsulated bacteria and liver enzyme increases, advise patients not to breastfeed during treatment with VOYDEYA and for 3 days after the last dose.

Hepatic Impairment

No dose adjustment is required in patients with mild to moderate hepatic impairment. Studies have not been conducted in patients with severe hepatic impairment, therefore, avoid use of VOYDEYA in this patient population.

INDICATION

VOYDEYA is indicated as an add-on therapy to ravulizumab or eculizumab for the treatment of extravascular hemolysis (EVH) in adults with paroxysmal nocturnal hemoglobinuria (PNH).

Limitation of Use:

VOYDEYA has not been shown to be effective
as monotherapy and should only be prescribed
as an add-on to ravulizumab or eculizumab.

To report SUSPECTED ADVERSE REACTIONS, contact Alexion Pharmaceuticals, Inc. at
1-844-259-6783 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please see full Prescribing Information for VOYDEYA, including Boxed WARNING
regarding serious and life-threatening or
fatal infections.

IMPORTANT SAFETY INFORMATION FOR ULTOMIRIS

WARNING: SERIOUS MENINGOCOCCAL INFECTIONS

ULTOMIRIS, a complement inhibitor, increases the risk of serious infections caused by Neisseria meningitidis [see Warnings and Precautions (5.1)] Life-threatening and fatal meningococcal infections have occurred in patients treated with complement inhibitors. These infections may become rapidly life-threatening or fatal if not
recognized and treated early.

  • Complete or update vaccination for meningococcal bacteria (for serogroups A, C, W, Y, and B) at least 2 weeks prior to the first dose
    of ULTOMIRIS, unless the risks of delaying ULTOMIRIS therapy outweigh the risk of developing a serious infection. Comply with the most current Advisory Committee on Immunization Practices (ACIP) recommendations for vaccinations against meningococcal bacteria in patients receiving a complement inhibitor. See Warnings and Precautions (5.1) for additional guidance on the management of the risk of serious infections caused by meningococcal bacteria.

  • Patients receiving ULTOMIRIS are at increased risk for invasive
    disease caused by Neisseria meningitidis, even if they develop antibodies following vaccination. Monitor patients for early signs and symptoms of serious meningococcal infections and evaluate immediately if infection is suspected.

Because of the risk of serious meningococcal infections, ULTOMIRIS is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called ULTOMIRIS and SOLIRIS REMS [see Warnings and Precautions (5.2)].

CONTRAINDICATIONS

  • Initiation in patients with unresolved serious Neisseria meningitidis infection.

WARNINGS AND PRECAUTIONS

Serious Meningococcal Infections

ULTOMIRIS, a complement inhibitor, increases a patient’s susceptibility to serious, life-threatening, or fatal infections caused by meningococcal bacteria (septicemia and/or meningitis) in any serogroup, including non-groupable strains. Life-threatening and fatal meningococcal infections have occurred in both vaccinated and unvaccinated patients treated with complement inhibitors.

Revaccinate patients in accordance with ACIP recommendations considering the duration of ULTOMIRIS therapy. Note that ACIP
recommends an administration schedule in patients receiving complement inhibitors that differs from the administration schedule in the vaccine prescribing information. If urgent ULTOMIRIS therapy is indicated in a
patient who is not up to date with meningococcal vaccines according to ACIP recommendations, provide antibacterial drug prophylaxis and administer meningococcal vaccines as soon as possible. Various durations and regimens of antibacterial drug prophylaxis have been considered, but the optimal durations and drug regimens for prophylaxis and their efficacy have not been studied in unvaccinated or vaccinated patients receiving complement inhibitors, including ULTOMIRIS. The benefits and risks of treatment with ULTOMIRIS, as well as those associated with antibacterial drug prophylaxis in unvaccinated or vaccinated patients, must be considered against the known risks for serious infections caused by Neisseria meningitidis.

Vaccination does not eliminate the risk of serious meningococcal
infections, despite development of antibodies following vaccination.

Closely monitor patients for early signs and symptoms of meningococcal infection and evaluate patients immediately if infection is suspected. Inform patients of these signs and symptoms and instruct patients to seek immediate medical care if they occur. Promptly treat known infections. Meningococcal
infection may become rapidly life-threatening or fatal if not recognized and treated early. Consider interruption of ULTOMIRIS in
patients who are undergoing treatment for serious meningococcal infection depending on the risks of interrupting treatment in the disease being treated.

ULTOMIRIS and SOLIRIS REMS

Due to the risk of serious meningococcal infections, ULTOMIRIS is available only through
a restricted program called ULTOMIRIS and SOLIRIS REMS.

Prescribers must enroll in the REMS, counsel patients about the risk of serious meningococcal infection, provide patients with the REMS educational materials, assess patient vaccination status for meningococcal vaccines (against serogroups A, C, W, Y, and B) and vaccinate if needed according to current ACIP recommendations two weeks prior to the first dose of ULTOMIRIS. Antibacterial drug prophylaxis must be prescribed if treatment must be started urgently, and the patient is not up to date with both meningococcal vaccines according to current ACIP recommendations at least two weeks prior to the first dose of ULTOMIRIS. Patients must receive counseling about the need to receive meningococcal vaccines and to take antibiotics as directed, signs and symptoms of meningococcal infection, and be instructed to carry the Patient Safety Card at all times during and for 8 months following ULTOMIRIS treatment.

Further information is available at www.UltSolREMS.com or
1-888-765-4747.

Other Infections

Serious infections with Neisseria species (other than Neisseria meningitidis), including disseminated gonococcal infections, have been reported.

ULTOMIRIS blocks terminal complement activation; therefore, patients may have increased susceptibility to infections, especially with encapsulated bacteria, such as infections caused by Neisseria meningitidis but also Streptococcus pneumoniae, Haemophilus influenzae, and to a lesser extent, Neisseria gonorrhoeae. Children treated with ULTOMIRIS may be at increased risk of developing serious infections due to Streptococcus pneumoniae
and Haemophilus influenzae type b (Hib). Administer vaccinations for the prevention of Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) infections according to ACIP recommendations. Patients receiving ULTOMIRIS are at increased risk for infections due to these organisms, even if they develop antibodies following vaccination.

Monitoring Disease Manifestations after ULTOMIRIS Discontinuation

After discontinuing treatment with ULTOMIRIS, closely monitor for signs
and symptoms of hemolysis, identified by elevated LDH along with sudden decrease in PNH clone size or hemoglobin, or re-appearance of symptoms such as fatigue, hemoglobinuria, abdominal pain, shortness of breath (dyspnea), major adverse vascular event (including thrombosis), dysphagia, or erectile dysfunction. Monitor any patient who discontinues ULTOMIRIS
for at
least 16 weeks to detect hemolysis and other reactions. If signs and symptoms of hemolysis occur after discontinuation, including elevated LDH, consider restarting treatment with ULTOMIRIS.

Thromboembolic Event Management

The effect of withdrawal of anticoagulant therapy during treatment with ULTOMIRIS has
not been established. Treatment should not
alter anticoagulant management.

Infusion-Related Reactions

Intravenous administration may result in systemic infusion-related
reactions, including
anaphylaxis and hypersensitivity reactions. In clinical trials, infusion-related reactions
occurred in approximately 1 to 7% of patients treated with ULTOMIRIS. These events included lower back pain, drop in blood pressure, limb discomfort, drug hypersensitivity (allergic reaction), dysgeusia (bad taste), and drowsiness. These reactions did not require discontinuation of ULTOMIRIS. If signs of cardiovascular instability or respiratory compromise occur, interrupt ULTOMIRIS
infusion and institute appropriate supportive measures.

ADVERSE REACTIONS

Adverse reactions reported in ≥10% or more of patients with PNH were upper respiratory tract infection and headache. Serious adverse reactions were reported in 15 (6.8%) patients receiving ULTOMIRIS. The serious adverse reactions in patients treated with ULTOMIRIS included
hyperthermia and pyrexia. No serious adverse reaction was reported in
more than 1 patient treated with ULTOMIRIS. One fatal case of sepsis was identified in a patient treated with ULTOMIRIS. In clinical studies, clinically relevant adverse reactions in 1% of adult patients
include infusion-related reactions.

Adverse reactions reported in ≥10% of pediatric patients treated with ULTOMIRIS who were treatment-naïve vs. Eculizumab-experienced were anemia (20% vs. 25%), abdominal pain (0% vs. 38%), constipation (0% vs. 25%), pyrexia (20% vs. 13%), upper respiratory tract infection (20% vs. 75%), pain in extremity (0% vs. 25%), and headache (20% vs. 25%).

DRUG INTERACTIONS

Plasma Exchange, Plasmapheresis, and Intravenous Immunoglobulins

Concomitant use of ULTOMIRIS with plasma exchange (PE),
plasmapheresis (PP), or intravenous immunoglobulin (IVIg) treatment can reduce serum ravulizumab concentrations and requires a supplemental dose of ULTOMIRIS.

Neonatal Fc Receptor Blockers

Concomitant use of ULTOMIRIS with neonatal
Fc receptor (FcRn) blockers (e.g., efgartigimod) may lower systemic exposures and reduce
effectiveness of ULTOMIRIS. Closely monitor
for reduced effectiveness of ULTOMIRIS.

INDICATION

ULTOMIRIS is indicated for the treatment of adult and pediatric patients one month of age and older with paroxysmal nocturnal hemoglobinuria (PNH).

To report SUSPECTED ADVERSE REACTIONS, contact Alexion Pharmaceuticals, Inc. at
1-844-259-6783 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please see full Prescribing Information for ULTOMIRIS, including Boxed WARNING regarding serious and life-threatening or fatal meningococcal infections.

References: 1. VOYDEYA. Prescribing information. Alexion Pharmaceuticals, Inc. 2. Kulasekararaj A, Mellor J, Earl L, et al. PB2056: prevalence of clinically significant extravascular hemolysis in stable C5 inhibitor-treated patients with PNH and its association with disease control, quality of life and treatment satisfaction. Hemasphere. 2023;7(suppl 3):e35238f0. 3. Hill A, Kelly RJ, Hillmen P. Thrombosis in paroxysmal nocturnal hemoglobinuria. Blood. 2013;121(25):4985-4996. 4. Lee JW, Brodsky RA, Nishimura JI, Kulasekararaj AG. The role of the alternative pathway in paroxysmal nocturnal hemoglobinuria and emerging treatments. Expert Rev Clin Pharmacol. 2022;15(7):851-861. 5. Hill A, Rother RP, Arnold L, et al. Eculizumab prevents intravascular hemolysis in patients with paroxysmal nocturnal hemoglobinuria and unmasks low-level extravascular hemolysis occurring through C3 opsonization. Haematologica. 2010;95(4):567-573. 6. Risitano AM, Frieri C, Urciuoli E, Marano L. The complement alternative pathway in paroxysmal nocturnal hemoglobinuria: from a pathogenic mechanism to a therapeutic target. Immunol Rev. 2023;313(1):262-278. 7. Kulasekararaj AG, Risitano AM, Maciejewski JP, et al. Phase 2 study of danicopan in patients with paroxysmal nocturnal hemoglobinuria with an inadequate response to eculizumab. Blood. 2021;138(20):1928-1938. 8. Hill A, DeZern AE, Kinoshita T, Brodsky RA. Paroxysmal nocturnal haemoglobinuria. Nat Rev Dis Primers. 2017;3:17028. 9. Data on file. Alexion Pharmaceuticals, Inc. 10. Kulasekararaj AG, Brodsky RA, Nishimura JI, Patriquin CJ, Schrezenmeier H. The importance of terminal complement inhibition in paroxysmal nocturnal hemoglobinuria. Ther Adv Hematol. 2022;13:20406207221091046. 11. ULTOMIRIS. Prescribing information. Alexion Pharmaceuticals, Inc. 12. Kulasekararaj A, Brodsky R, Griffin M, et al. P772: long-term ravulizumab treatment in complement inhibitor-experienced patients with PNH provides durable control of intravascular hemolysis with low incidence of major adverse vascular events and death. Hemasphere. 2023;7(S3):e6327336. 13. Lee JW, Sicre de Fontbrune F, Wong Lee Lee L, et al. Ravulizumab (ALXN1210) vs eculizumab in adult patients with PNH naive to complement inhibitors: the 301 study. Blood. 2019;133(6):530-539. 14. Schrezenmeier H, Kulasekararaj A, Mitchell L, et al. One-year efficacy and safety of ravulizumab in adults with paroxysmal nocturnal hemoglobinuria naïve to complement inhibitor therapy: open-label extension of a randomized study. Ther Adv Hematol. 2020;11:2040620720966137. 15. Kulasekararaj AG, Hill A, Rottinghaus ST, et al. Ravulizumab (ALXN1210) vs eculizumab in C5-inhibitor-experienced adult patients with PNH: the 302 study. Blood. 2019;133(6):540-549. 16. Risitano AM, Notaro R, Marando L, et al. Complement fraction 3 binding on erythrocytes as additional mechanism of disease in paroxysmal nocturnal hemoglobinuria patients treated by eculizumab. Blood. 2009;113(17):4094-4100. 17. Röth A, Dührsen U. Treatment of paroxysmal nocturnal hemoglobinuria in the era of eculizumab. Eur J Haematol. 2011;87(6):473-479. 18. Lee JW, Griffin M, Kim JS, et al. Addition of danicopan to ravulizumab or eculizumab in patients with paroxysmal nocturnal haemoglobinuria and clinically significant extravascular haemolysis (ALPHA): a double-blind, randomised, phase 3 trial. Lancet Haematol. 2023;10(12):e955-e965. 19. Risitano AM, Kulasekararaj AG, Lee JW, et al. Danicopan: an oral complement factor D inhibitor for paroxysmal nocturnal hemoglobinuria. Haematologica. 2021;106(12):3188-3197. 20. Lee JW, Jang JH, Kim JS, et al. Clinical signs and symptoms associated with increased risk for thrombosis in patients with paroxysmal nocturnal hemoglobinuria from a Korean Registry. Int J Hematol. 2013;97(6):749-757. 21. Shammo J, Gajra A, Patel Y, et al. Low rate of clinically evident extravascular hemolysis in patients with paroxysmal nocturnal hemoglobinuria treated with a complement C5 inhibitor: results from a large, multicenter, US real-world study. J Blood Med. 2022;13:425-437. 22. Kulasekararaj AG, Kuter DJ, Griffin M, Weitz IC, Röth A. Biomarkers and laboratory assessments for monitoring the treatment of patients with paroxysmal nocturnal hemoglobinuria: differences between terminal and proximal complement inhibition. Blood Rev. 2023;59:101041.