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In this randomized, double-blind, time-to-event trial, 143 adults were randomly assigned in a 21 ratio to receive intravenous eculizumab at a dose of 900 mg weekly for the first four doses starting on day 1, followed 1,200 mg every 2 weeks starting week 4 or compatible placebo. Continued use of stable-dose immunosuppressive therapy was permitted. The primary endpoint was the first adjudicated relapse. Secondary outcome measures included adjudicated annualized recidivism rate, quality of life measures, and Expanded Disability Status Scale EDSS score, ranging from 0 no disability to 10. death. With 84.