Myasthenia Gravis Treatment with Ultomiris: Function, Details, and Beyond
The down-low on Ultomiris (ravulizumab-cwvz): Your go-to guide for battling myasthenia gravis
Ultomiris is a badass IV infusion treatment prescribed to combat stiff-as-a-board muscles and blurry vision—hello, myasthenia gravis (MG). This article covers the nitty-gritty details like side effects, dosage, and how Ultomiris turns your fatigue into a thing of the past.
What is Ultomiris exactly?
Ultomiris is a biologic drug that belongs to the drug class called complement inhibitors. It's an intravenous (IV) infusion solution, meaning a healthcare professional does the heavy lifting of administering the treatment. And just so you know, this medication ain't got no biosimilar cousin—it's unique AF.
Wanna know more about Ultomiris? Read this comprehensive guide for all the deets.
Body weight
Gotcha! Boxed warnings ahead.
Loading dose
Ultomiris comes with the Food and Drug Administration's (FDA) most serious warning—a boxed warning. It's all about the risk of developing serious meningococcal infections, which can be downright life-threatening. More on that later.
Maintenance dose
Myasthenia gravis explained
When your muscles and nerves can't communicate properly, it leads to weakness, tiring muscles, and, well, myasthenia gravis. This chronic autoimmune condition happens when your immune system attacks your own cells, leading to a host of body-wide symptoms.
40 kg to less than 60 kg (approximately 88 lb to less than 132 lb)
Symptoms to watch out for:
2,400 mg
- Droopy eyelids
- Weak limbs, neck, and eye muscles
- Fatigue
- Double vision
- Trouble swallowing, chewing, speaking, or breathing
3,000 mg every 8 weeks
Who's Ultomiris for?
Ultomiris is prescribed for adults with generalized MG (gMG) who test positive for anti-acetylcholine receptor (AChR) antibodies. To break it down for ya:
60 kg to less than 100 kg (approximately 132 lb to less than 220 lb)
- "Generalized" means your bodily muscles are affected. gMG is different from ocular MG, which only focuses on the eye muscles.
- "Anti-acetylcholine receptor (AChR) antibody-positive" means your immune system is producing antibodies that block acetylcholine receptors. Acetylcholine is a neurotransmitter that sends signals to muscles to contract.
2,700 mg
Your doc might order a blood test to check if your MG is indeed AChR antibody positive. Chat with your doc to get the lowdown on how Ultomiris will help your specific type of MG.
3,300 mg every 8 weeks
How Ultomiris treats myasthenia gravis
If your doc prescribes Ultomiris for your MG, you may wanna know how this magic potion operates. Here's the deal:
100 kg or more (approximately 220 lb or more)
Ultomiris works by blocking the activity of C5, a complement system protein, at the neuromuscular junction (NMJ), the communication center between your nerve cells and muscles. By reducing C5 activity, Ultomiris allows nerve signals to better reach your muscles, potentially reducing muscle fatigue and weakness and improving muscle strength.
3,000 mg
How well does Ultomiris work?
3,600 mg every 8 weeks
In clinical studies, Ultomiris significantly improved adult patients' ability to perform daily activities. Check out these studies for more info or ask your doc or pharmacist to fill you in on the details.
Receiving Ultomiris for myasthenia gravis
Here's the need-to-know on receiving Ultomiris:
- Available strengths: 300 mg/30 mL, 300 mg/3 mL, 1,100 mg/11 mL
- Typical dosages: Based on body weight in kilograms (kg); loading dose followed by maintenance doses every 8 weeks
- Where it's given: Infusion center by a healthcare professional
- How often it's given: Every 8 weeks following a loading dose (2 weeks after initial treatment)
Ultomiris
FYI: Ultomiris is also used to treat paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), and neuromyelitis optica (NMO) spectrum disorder. Keep that in mind if you're taking Ultomiris for reasons other than MG.
Vyvgart
Ultomiris side effects
Using Ultomiris for MG may bring on side effects—some mild, some serious. Keep in mind that side effects from Ultomiris for other conditions may vary.
Form
Common side effects:*
solution for IV infusion
- Diarrhea
- Upper respiratory infection (like a common cold)
- Abdominal pain
- Urinary tract infections
- Back pain
- lightheadedness
- Mild infusion reactions (e.g., muscle spasms, discomfort in arms or legs)
solution for IV infusion
Serious side effects:*
- Serious infections (e.g., COVID-19, pneumonia)
- Serious infusion reactions (e.g., increased or decreased blood pressure, severe shivering, chills, fever)
- Life-threatening meningococcal infections (see "Before receiving Ultomiris")
Dosage frequency
Contact your doc right away if any serious side effects occur. If they feel life-threatening or a medical emergency arises, call 911 or your local emergency number immediately.
once every 8 weeks
Before receiving Ultomiris
once weekly for 4 weeks; your doctor may prescribe additional cycles based on how well Vyvgart works for your symptoms
Before you receive a dose of Ultomiris, there are some essential tidbits to consider:
Boxed Warning: Risk of serious meningococcal infections
Drug class
Ultomiris increases the risk of developing serious meningococcal infections (like meningitis), which can be life-threatening.
complement inhibitor
- Symptoms to watch out for: sudden fever, headache, stiff neck, nausea, vomiting, sensitivity to light, confusion, drowsiness
- What to do: To prevent infection, you'll need to be up-to-date with meningococcal vaccines before starting Ultomiris treatment. If your doc determines you urgently need Ultomiris, they may prescribe antibiotics to help prevent infection for the first 2 weeks following your first infusion. The risk of serious meningococcal infections persists throughout treatment and for at least 8 months after your last dose. Contact your doc immediately if you suspect an infection during this time.
- Important note: Ultomiris is only available under a risk evaluation and mitigation strategy (REMS) program. You'll need to carry the Ultomiris Patient Safety Card and comply with the program requirements throughout treatment and for at least 8 months after your last dose.
neonatal Fc receptor blocker
Other warnings:
- Active infection
- Pregnancy
- Breastfeeding
- Alcohol use
- Allergic reactions to Ultomiris, ingredients, or other medications
Now, kick back and relax. With Ultomiris on your team, you're one step closer to saying goodbye to MG-related fatigue. And if questions remain, chat with your doc or healthcare provider. Study up, stick to your treatment plan, and stay on top of your MG management game!
[1] US Food and Drug Administration. (2022, January 7). Ultomiris prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/125058s008lbl.pdf
[2] National Institute of Neurological Disorders and Stroke. (2022, January 8). Myasthenia gravis fact sheet. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Myasthenia-Gravis-Fact-Sheet
[3] Centers for Disease Control and Prevention. (2022, January 7). Meningococcal disease. https://www.cdc.gov/meningococcal/index.html
- Ultomiris is a drug that belongs to the class called complement inhibitors, used to treat myasthenia gravis (MG), a chronic autoimmune condition, and also other medical-conditions like paroxysmal nocturnal hemoglobinuria (PNH), atypical hemolytic uremic syndrome (aHUS), and neuromyelitis optica (NMO) spectrum disorder.
- The intravenous (IV) infusion solution of Ultomiris is unique as it doesn't have a biosimilar cousin and a healthcare professional administers the treatment.
- Ultomiris comes with a Food and Drug Administration's (FDA) most serious warning—a boxed warning about the risk of developing serious meningococcal infections, including symptoms like sudden fever, headache, stiff neck, nausea, vomiting, sensitivity to light, confusion, drowsiness, and the need for meningococcal vaccines before starting treatment.
- The immune system plays a vital role in myasthenia gravis, as it attacks the own body cells, leading to muscle weakness, tiring muscles, and other health-and-wellness related symptoms.
- Ultomiris works by blocking the activity of C5, a complement system protein, at the neuromuscular junction (NMJ), the communication center between nerve cells and muscles, allowing nerve signals to better reach muscles, reducing muscle fatigue and weakness, and potentially improving muscle strength.
