Terminal complement inhibition
Patients using either eculizumab or ravulizumab for the treatment of aHUS showed improvements in kidney function even avoiding dialysis and minimizing death. Markers of disease activity in the blood also had a great improvement. However, the only available evidence has substantial bias and low quality and therefore there should be careful considerations for futures studies in treatment duration, adverse outcomes and risk of disease recurrence associated with this treatment. Historical Prognosis
Prior to the use of monoclonal antibodies(e.g., Soliris, Ultomiris) patients with aHUS had an extremely poor prognosis. Among those with the most commonly identified aHUS genetic mutation, the proportion of patients experiencing negative outcomes (e.g., need for dialysis, permanent kidney damage, death) within the first year rose to 70%. However, sudden morbidity and mortality could occur regardless of mutational status. aHUS can arise at any age, with more than 40% of cases first reported after 18 years of age. The oldest presentation in one study was at age 83. As noted above, kidney transplantation for aHUS patients with ESRD was rarely considered because of a high incidence of graft loss due to TMA recurrence in the transplanted organ in up to 90% of patients. Consequently, most untreated aHUS patients develop ESRD and undergo chronic dialysis, which is associated with significant morbidities and worsened prognosis.
Caffeine/ergotamine (trade name Cafergot) is the proprietary name of a medication consisting of ergotamine tartrate and caffeine. This combination is used for the treatment of headaches, such as migraine headache. Use
Correct timing of use is important. Cafergot is an abortive headache treatment, which prevents the development of the headache, rather than a treatment for an established headache. The medication should be administered at the first sign of headache. There exist some limitations as to the maximum number of tablets that can be taken per day per week. Different sources of drug information may carry different information, and patients are encouraged to ask their pharmacist or prescriber about such details. Cafergot is currently available as a generic drug (ergotamine tartrate/caffeine)

Mechanism of action
According to a topic review on UpToDate, "ergotamine and dihydroergotamine (DHE 45) bind to 5HT 1b/d receptors, just as triptans do." This along with binding to other serotonergic and dopaminergic receptors is their presumed mechanism of action in treating migraine. Adverse effects
Because the vasoconstrictive effects of ergotamine and caffeine are not selective for the brain, adverse effects due to systemic vasoconstriction can occur. Cold feet or hands, angina pectoris, myocardial infarction, or dizziness are some examples. == References ==