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A myPNHteam Member asked a question 💭

From my internet research, I believe I have classic PNH. My dr says I have a large clone. My LDH was 514. He suggested blood thinners as a beginning treatment for my PNH. He said he needs to do some research on this. I am not on any medication for PNH

October 4
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A myPNHteam Member

I’m glad to hear you’re doing well, Jenna. If you’re only feeling a bit of fatigue, your levels are stable, and you’ve already started preventative anticoagulant treatment, it seems everything is under control—which is reassuring news.

From now on, your doctor will want to monitor your clinical progress, and blood tests will be sufficient for that.

Take good care of yourself 😊

October 12
A myPNHteam Member

Thank you. I am four days in on a starter pack of Eliquis. I appreciate your response. I see you responding to so many. I think that is wonderful you share so much. Take care.

October 14
A myPNHteam Member

The hematologist started me on Eliquis. I do not have any symptoms with only mild tiredness. My clone is almost 57%. That is why he wants me to start the blood thinners. My blood counts are all in normal ranges with some close to either high or low normal. He is not ready to start the compliment inhibitors because of the risks. He says my body is handling PNH well right now. I am 50 years old and not sick so he does not want to start them. I will follow up in November. This is day two on the blood thinners. Thank goodness so far I feel fine. Nervous still. Thank you very much for responding. 😊

October 11
A myPNHteam Member

Hi Jenna! Welcome to Mypnhteam. I’m sorry that the first response you’re receiving is from an AI.

First of all, how are you feeling? Are you experiencing any symptoms associated with PNH? Yellowing of the skin, abdominal pain, severe fatigue, shortness of breath, difficulty eating, etc.?

Flow cytometry is the diagnostic test used to measure the percentage of the PNH clone; it helps determine how your body is coping with the disease and guides medical decisions.

Anticoagulants are prescribed to prevent and manage complications arising from PNH, particularly the formation of blood clots or thrombosis. I also received anticoagulants early on—both Sintrom and injectable heparin—as a preventive measure while waiting for approval to use the only treatment available at the time: Eculizumab (Soliris).

Anticoagulants are preventive, but disease symptoms can still be present, though every patient experiences them differently. Some patients suffer from more symptoms, while others may remain asymptomatic.

When dealing with active PNH, it is recommended to start treatment with complement inhibitors—drugs specifically developed for PNH. They don't cure the disease, but they help reduce the strain on your body and allow you to lead a better life.

Have your doctors considered starting treatment with these drugs?

If you have any questions and I can help, please feel free to reach out.

Sending you lots of encouragement and strength for this new journey.

Best regards,
Juan

October 7
myPNHteam

That's a really important question, and it's great that you're doing your own research and advocating for yourself. Blood thinners can play a role in PNH management, but they're generally not considered a standalone first-line treatment — especially with a large clone and an elevated LDH like yours.

Here's what's generally Show Full Answer

That's a really important question, and it's great that you're doing your own research and advocating for yourself. Blood thinners can play a role in PNH management, but they're generally not considered a standalone first-line treatment — especially with a large clone and an elevated LDH like yours.

Here's what's generally understood about blood thinners and PNH:

- Blood thinners help reduce the risk of dangerous blood clots, which is a serious concern with PNH
- They are often used *alongside* complement inhibitors, not instead of them
- Newer complement inhibitors have been shown to reduce clot risk enough that blood thinners may not even be needed in some cases
- Whether someone needs a blood thinner is decided case by case, based on clot history and other factors With a large clone and an LDH of 514 (which suggests active red blood cell breakdown), complement inhibitors are typically the main treatment approach. These medications work by stopping the immune system from destroying red blood cells.

Currently approved complement inhibitors include:

- Crovalimab-akkz (PiaSky)
- Danicopan (Voydeya)
- Eculizumab (Soliris) and its biosimilars
- Iptacopan (Fabhalta)
- Pegcetacoplan (Empaveli)
- Ravulizumab (Ultomiris) It's worth having a deeper conversation with your doctor — or seeking a second opinion from a hematologist who specializes in PNH — about whether a complement inhibitor might be appropriate for your situation. The fact that your doctor mentioned needing to do more research is a signal that getting a specialist involved could be really valuable for you right now.

October 4

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