Abstract
INTRODUCTION: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal hematologic disorder treated with complement inhibitors. Currently, patients with suboptimal response to C5 inhibitors may be switched to proximal complement inhibitors, such as pegcetacoplan, danicopan, or iptacopan. However, data on switching strategies between proximal inhibitors remain limited. RESULTS: We report the first case of a direct switch from iptacopan to pegcetacoplan without re-exposure to C5 inhibitors. CONCLUSION: Direct switching between proximal complement inhibitors may represent a feasible and safe strategy, although further validation in larger cohorts is required.