Myasthenia Gravis Treatment with Ultomiris: Insights and Details
Rewritten Article:
Let's dive into Ultomiris, a badass biologic solution that’s gonna help you out if you've got myasthenia gravis. This article covers the nitty-gritty details, like side effects, dosage, and how Ultomiris works its magic.
Ultomiris is an IV drip deal, administered by a pro. It belongs to the drug class called complement inhibitors, and you can't get it in a cheaper biosimilar version. Want more deets? Check out this inside scoop on Ultomiris.
Before you get Ultomiris, it has a serious warning from the FDA – this one's important. Read on to learn about the risk of serious meningococcal infections.
Myasthenia Gravis: The Lowdown
With myasthenia gravis, your muscles get tired quickly due to faulty communication between muscles and nerves. It's a long-term autoimmune condition that messes with your immune system, causing it to attack your own cells.
Symptoms Galore
Symptoms vary from person to person, but they usually worsen during active periods and improve with rest. Here's a rundown of common symptoms:
- Droopy eyelids
- Weak muscles in your arms, legs, and eyes
- Lethargy
- Blurry or double vision
- Trouble chewing, swallowing, talking, or breathing
Body weight
Who's It For?
Ultomiris is meant for adults with generalized myasthenia gravis (gMG) who are antibody-positive for acetylcholine receptors.
Loading dose
- "Generalized" means that muscle groups throughout the body are affected, differentiating it from ocular myasthenia gravis which exclusively affects the eye muscles.
- "Antibody-positive" means your immune system produces antibodies that block the acetylcholine receptors, essential neurotransmitters that signal muscles to contract.
Before prescribing Ultomiris, your doc might order a blood test to check if your gMG is antibody-positive. Your doctor can help clarify whether Ultomiris is a suitable treatment for your type of myasthenia gravis.
Maintenance dose
How Ultomiris Works Its Magic
If your doc prescribes Ultomiris, you might wonder how it helps treat myasthenia gravis. Here's the skinny:
The Science Behind It
The exact way Ultomiris works isn't fully understood, but it's believed to involve its ability to block the activity of a complement system protein called C5 at the neuromuscular junction (NMJ).
40 kg to less than 60 kg (approximately 88 lb to less than 132 lb)
The NMJ is where nerve cells communicate with muscles they control. By lowering C5 activity at the NMJ, Ultomiris helps nerve cell signals reach your muscles. This may reduce fatigue and muscle weakness and increase muscle strength.
The Proof's in the Pudding
2,400 mg
In clinical studies, Ultomiris showed solid results in improving adult gMG patients' abilities to perform daily tasks.
You can find more about these studies in the prescribing info for Ultomiris. Your doctor or pharmacist can also spill the beans about how well Ultomiris worked in these trials.
3,000 mg every 8 weeks
Gearing Up for Ultomiris Dosing
Here's a look at the usual Ultomiris dosages for myasthenia gravis. Your doctor will recommend the best dosage for you. Hit up your doctor if you have questions about your Ultomiris dosage or how you'll receive the medication.
Ultomiris comes in three strengths:
- 300 mg/30 mL
- 300 mg/3 mL
- 1,100 mg/11 mL
60 kg to less than 100 kg (approximately 132 lb to less than 220 lb)
Dosage: the Basics
Ultomiris treatments typically kick off with a loading dose. Two weeks post-loading dose, you'll continue with a maintenance dose, usually given every 8 weeks.
2,700 mg
Here's a chart to help you visualize recommended Ultomiris dosages based on body weight:
| | | || --- | --- | --- || Body weight | Loading dose | Maintenance dose || 40 kg to less than 60 kg (approx. 88 lb to less than 132 lb) | 2,400 mg | 3,000 mg every 8 weeks || 60 kg to less than 100 kg (approx. 132 lb to less than 220 lb) | 2,700 mg | 3,300 mg every 8 weeks || 100 kg or more (approx. 220 lb or more) | 3,000 mg | 3,600 mg every 8 weeks |
3,300 mg every 8 weeks
Note: Ultomiris has other uses too. Keep in mind that the drug's dosage may differ when treating other conditions. Talk with your doc to learn more.
How It's Given
Ultomiris is an IV drip solution, handled by healthcare professionals.
How Often It's Given
100 kg or more (approximately 220 lb or more)
You'll usually receive maintenance doses every 8 weeks. You'll likely start receiving maintenance doses 2 weeks after your loading dose.
"Check out this Ultomiris dosage breakdown" for more info on dosing schedules.
3,000 mg
Side Effect Central
The use of Ultomiris for myasthenia gravis might bring on some side effects, ranging from mild to severe.
3,600 mg every 8 weeks
Ultomiris is also approved to treat other conditions, and side effects may differ. Be sure to discuss potential side effects with your doc or pharmacist. For more side effect deets, hit up our "Ultomiris side effects article" or prescribing info.
Mild Side Effects
Mild side effects reported with Ultomiris include:
- Loose stools
- Common colds or upper respiratory infections
- Abdominal discomfort
- Urinary tract infections (UTIs)
- Back pain
- Dizziness
- Mild infusion responses, including muscle spasms and discomfort in arms or legs
These side effects might last a few days to weeks. But if they persist or get bothersome, it's crucial to chat with your doctor or pharmacist.
Serious Side Effects
Although not common, serious side effects have been reported with Ultomiris. Here's what to look out for:
- Serious infections, like COVID-19 and pneumonia
- Severe infusion responses, including extreme blood pressure fluctuations, fever, and intense shivering
- Elevated risk of serious meningococcal infections (see "Before receiving Ultomiris")
Ultomiris
If you experience serious side effects while using Ultomiris, play it safe and call your doctor right away. In the event that symptoms feel life-threatening or you believe you're in an emergency, dial 911 or your local emergency number immediately.
Before Receiving Ultomiris
Vyvgart
Before you dive into Ultomiris, there are some crucial things to keep in mind. Ultomiris might not be a safe option if you have certain medical conditions or other factors that impact your health. Here are some highlights:
Boxed Warning: Elevated Risk of Serious Meningococcal Infections
Ultomiris carries a boxed warning for the elevated risk of serious meningococcal infections. This is the most serious warning from the Food and Drug Administration (FDA).
Treatment with Ultomiris enhances the risk for serious meningococcal infections, such as meningitis. These infections can be fatal. Symptoms of a meningococcal infection include:
Form
- Abrupt fever, headache, or stiff neck
- Nausea and vomiting
- Sensitivity to light
- Confusion
- Drowsiness
What to Do
solution for IV infusion
Before beginning Ultomiris treatment, your doctor will ensure you're up-to-date with meningococcal vaccines. If needed, they'll administer any missing vaccines at least 2 weeks before you start Ultomiris treatment. If your doc determines you need immediate Ultomiris treatment, they might prescribe antibiotics to help prevent infection. You’ll take these for the first 2 weeks following your first Ultomiris infusion.
The risk of serious meningococcal infections persists throughout treatment with Ultomiris and for at least 8 months after your last dose. Contact your doctor immediately if you think you have symptoms of a meningococcal infection during this time. But call 911 or go to the closest emergency room if your symptoms seem life-threatening.
solution for IV infusion
Due to this risk, Ultomiris is only available under a risk evaluation and mitigation strategy (REMS) program. As part of this program, you'll have to carry the Ultomiris Patient Safety Card throughout treatment and for at least 8 months after your last dose. You can learn more about the Ultomiris REMS program at the program website or by calling 1-888-765-4747.
Frequently Asked Questions
Here are answers to some commonly asked questions about Ultomiris for treating myasthenia gravis.
How Does Ultomiris Compare to Vyvgart?
Dosage frequency
Ultomiris and Vyvgart are both prescribed for gMG patients who are AChR antibody-positive. Check out this table for a comparison:
| | Ultomiris | Vyvgart ||-----|------------|---------|| Form | IV drip solution | IV drip solution || Dosage frequency | once every 8 weeks | weekly for 4 weeks; additional cycles prescribed based on response || Drug class | complement inhibitor | neonatal Fc receptor blocker |
once every 8 weeks
Ultomiris is also approved for other conditions, while Vyvgart is not. Your doc or pharmacist can offer more information on how Ultomiris and Vyvgart compare.
Can I Get Ultomiris Infusions at Home?
once weekly for 4 weeks; your doctor may prescribe additional cycles based on how well Vyvgart works for your symptoms
It's possible! Your doctor may be able to prescribe Ultomiris for home infusions. With home infusion services, a healthcare professional visits your residence to administer the medication.
Chat with your doc to learn more about this option.
neonatal Fc receptor blocker
Ultomiris Cost
The final cost of Ultomiris depends on numerous factors, like your treatment plan, insurance coverage, and location. The price also includes the cost of the doctor's appointment for receiving Ultomiris infusions.
Drug class
Ultomiris is a brand-name biologic drug, meaning it's made from living organisms and cannot be exactly copied like traditional generics. So, no biosimilars are available for Ultomiris.
A program called the Alexion OneSource CoPay Program is available for Ultomiris. To find out if you're eligible for support or more details, call 888-765-4747 or visit the program website.
complement inhibitor
Disclaimer: Medical News Today has made every effort to ensure that all information is accurate, comprehensive, and up-to-date. However, this article should not be used in place of a licensed healthcare professional's knowledge and expertise. Always consult your doctor or another healthcare professional before taking any medication. The drug information provided here is not intended to cover all potential uses, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not imply that the drug or drug combination is safe, effective, or appropriate for all patients or for all uses.
- Ultomiris belongs to a class of drugs known as complement inhibitors, which differ from cheaper biosimilar versions.
- Before prescribing Ultomiris, healthcare professionals may order blood tests to check for antibodies that block acetylcholine receptors in people with myasthenia gravis.
- By blocking the activity of a complement system protein called C5 at the neuromuscular junction, Ultomiris helps nerve cell signals reach muscles, potentially reducing fatigue and muscle weakness.
- Common side effects of Ultomiris include loose stools, common colds or upper respiratory infections, abdominal discomfort, urinary tract infections, back pain, dizziness, and mild infusion responses.
- Serious side effects of Ultomiris include serious infections, severe infusion responses, and an elevated risk of meningococcal infections, which can be fatal.
- Prior to Ultomiris treatment, patients should be up-to-date with meningococcal vaccines, and may need antibiotics for the first 2 weeks following the first Ultomiris infusion.
- Meningococcal infections may cause symptoms such as abrupt fever, headache, stiff neck, nausea and vomiting, sensitivity to light, confusion, and drowsiness.
