ENERGY Trial Shows Early Fatigue Benefit With Nipocalimab in wAIHA: Irina Murakhovskaya, MD

Nipocalimab reportedly improved fatigue among patients with warm autoimmune hemolytic anemia (wAIHA) in the phase 2/3 ENERGY trial (NCT04119050) as early as week 2, with investigator Irina Murakhovskaya, MD, considering the results a meaningful step toward bringing safe, fast-acting, durable therapies to patients with wAIHA.

In part 1 of her interview with The American Journal of Managed Care^® at the European Hematology Association (EHA) 2026 Congress earlier this month, Murakhovskaya explained that nipocalimab demonstrated rapid, durable hemoglobin responses in patients with wAIHA in the phase 2/3 ENERGY trial, with some responses occurring as early as week 1, potentially reducing reliance on corticosteroids and transfusions.

She added that the treatment was also safe and well tolerated, offering a reversible mechanism that preserves broader immune function compared with commonly used therapies such as rituximab.

In this clip, Murakhovskaya built on these results by highlighting that nipocalimab led to early improvements in patient-reported fatigue, with benefits emerging as early as 2 weeks after treatment initiation. These findings were reported in the abstract “Assessment of Nipocalimab Effects on Fatigue in Warm Autoimmune Hemolytic Anemia: Results From the Double-Blind Phase 2/3 ENERGY Trial,” which she presented at the EHA 2026 Congress.

Murakhovskaya noted that physicians typically anchor treatment success to firm clinical end points, such as hemoglobin improvement or reduced transfusion need. For patients, however, the more meaningful measure is whether they feel well enough to resume daily activities and normal life. Therefore, the rapid symptomatic benefit seen with fatigue represents a substantial gain in quality of life and should be regarded as an important end point for patients and physicians alike, she explained.

Additionally, she noted that the correlation between hemoglobin improvement and fatigue improvement was only mild to moderate, not complete. This indicates that factors beyond hemoglobin levels, such as inflammation or complement activation, may also drive fatigue in patients with wAIHA, suggesting nipocalimab could improve well-being through multiple mechanisms.

Murakhovskaya concluded by describing ENERGY as the largest trial to date evaluating therapies for wAIHA and called the demonstrated benefit a meaningful step forward for a patient population with limited treatment options. She expressed hope that these results will help open the door to additional safe, fast-acting therapies capable of producing durable hemoglobin improvement.

“The fact that we now have a drug that demonstrated benefit in these patients is really important,” she concluded. “This would hopefully allow us to bring more therapies to patients, including the therapies that are safe, fast-acting, and have durable hemoglobin improvement, particularly in those who respond to the treatment.”