The effect on the immunology laboratory of the expansion in complement therapeutics.

The approval in the US and Europe of Eculizumab in 2007 marked a change in complement therapeutics, and with it the landscape for complement testing in the clinical immunology laboratory changed. The change had begun even before that when C1-Inhibitor preparations were approved in the 1980s in Europe. There are now two classes of approved drugs that may impact the immunology laboratory, with two dozen more with novel modalities and potential indications that are in various stages of development. Every pathway and about every component of complement has been targeted by these drug development programs, and the modalities of the drugs in development are diverse. These developments will likely result in more laboratories offering more complement testing, so this review looks forward to some of those possible changes in testing.