MyastheniaGravis Treatment with Ultomiris: Exploring Its Mechanism and Additional Details
Revamped Article:
Hey there! Let's dive into the lowdown on Ultomiris, the brand-name IV drip that's prescribed for myasthenia gravis. This article will cover side effects, dosage, and the science behind how Ultomiris works.
Ultomiris is an IV infusion solution, given by a healthcare professional. It belongs to a drug class called complement inhibitors, and, hey, it don't got no biosimilar version!
Wanna learn more about Ultomiris? Check out this informative article!
There's a serious warning on Ultomiris: it has a boxed warning from the Food and Drug Administration (FDA). For the nitty-gritty details, head to the "Before receiving Ultomiris" section.
Myasthenia gravis, defined
Myasthenia gravis is a chronic (long-term) autoimmune condition where your muscle and nerve connections don't communicate properly. This leads to your voluntary muscles tiring quickly and weakening.
Symptoms of myasthenia gravis
Myasthenia gravis symptoms can vary from person to person, but they usually worsen during busy periods and improve with rest. Some common symptoms include:
Body weight
- drooping eyelids
- weak muscles in your limbs, neck, and eyes
- fatigue
- blurry or double vision
- difficulty chewing, swallowing, speaking, and breathing
For whom is Ultomiris prescribed?
Loading dose
Ultomiris is designed for adults with generalized myasthenia gravis (gMG) who are anti-acetylcholine receptor (AChR) antibody-positive.
- With "generalized," we mean muscle groups throughout the body are impacted, not just the eyes. This is different from ocular myasthenia gravis, which affects only the eye muscles.
- Being "AChR antibody-positive" means your immune system generates antibodies that block acetylcholine receptors. Acetylcholine is a neurotransmitter sending signals that make muscles contract.
Maintenance dose
Before prescribing Ultomiris, your doc might run a blood test to check if your myasthenia gravis is AChR antibody-positive. Your doc can give you more details about whether Ultomiris is the right treatment for your type of myasthenia gravis.
How Ultomiris tackles myasthenia gravis
If your doctor greenlights Ultomiris for your myasthenia gravis, you might wonder, "How exactly does this medication work?"
The mechanism behind Ultomiris
40 kg to less than 60 kg (approximately 88 lb to less than 132 lb)
The specific way Ultomiris works to treat myasthenia gravis isn't fully understood. However, it's assumed to involve the drug's ability to knock out activity in a complement system protein called C5 at the neuromuscular junction (NMJ).
The NMJ is the connection point where nerve cells talk to the muscles they control. By decreasing C5 activity at the NMJ, Ultomiris helps signals from nerve cells reach your muscles. This may reduce fatigue and muscle weakness, potentially boosting muscle strength.
2,400 mg
Success rate of Ultomiris for myasthenia gravis
In clinical studies, Ultomiris showed positive results in improving the ability of adults with generalized myasthenia gravis (gMG) to carry out daily tasks.
3,000 mg every 8 weeks
Curious about these studies? Check out Ultomiris's prescribing information or chat with your doctor or pharmacist for the scoop.
Getting your Ultomiris dose
Now, let's discuss the typical Ultomiris dosages for treating myasthenia gravis. Your doc will determine the best dosage for you. If you've got questions about your Ultomiris dosage or how you'll receive the medication, don't hesitate to ask your doc!
Ultomiris comes in three forms:
60 kg to less than 100 kg (approximately 132 lb to less than 220 lb)
- 300mg/30mL
- 300mg/3mL
- 1,100mg/11mL
Dosage info
2,700 mg
The recommended Ultomiris dosages for treating myasthenia gravis depend on your body weight in kilograms (kg). One kilogram roughly equates to 2.2 pounds (lb).
Ultomiris treatment often starts with a loading dose. Two weeks post-loading dose, you'll continue treatment with a maintenance dose, typically given every 8 weeks.
3,300 mg every 8 weeks
These tables break down the recommended Ultomiris dosages based on body weight:
| | | || --- | --- | --- || Body weight | Loading dose | Maintenance dose || 40 kg – 60 kg (about 88 lb – 132 lb) | 2,400 mg | 3,000mg every 8 weeks || 60 kg – 100 kg (about 132 lb – 220 lb) | 2,700 mg | 3,300mg every 8 weeks || 100 kg or more (about 220 lb or more) | 3,000 mg | 3,600mg every 8 weeks |
Reminder: In addition to treating myasthenia gravis, Ultomiris can be used for other conditions. Different dosages might be applied for these purposes. Get in touch with your doctor for more information.
How Ultomiris is administered
100 kg or more (approximately 220 lb or more)
Ultomiris is an IV infusion solution. A healthcare professional will handle your Ultomiris infusions at an infusion center.
Frequency of Ultomiris doses
3,000 mg
You usually receive your Ultomiris maintenance doses every 8 weeks. You'll likely start getting maintenance doses 2 weeks after your loading dose.
For more dosing schedule details about Ultomiris, check out this rewritten Ultomiris dosage article. Your doctor or pharmacist can also provide insights on it.
3,600 mg every 8 weeks
Side effects of Ultomiris
The use of Ultomiris for myasthenia gravis may lead to various side effects, some mild and others serious.
Keep in mind that side effects from Ultomiris may differ depending on the condition it's used to treat. Here's a rundown of common side effects:
- Diarrhea
- Upper respiratory infections (like the common cold)
- Abdominal pain
- Urinary tract infections (UTIs)
- Back pain
- Dizziness
- Mild infusion reactions, including muscle spasms, discomfort in arms or legs
Some side effects might be temporary, persisting only a few days to weeks. But if they last longer or bother you, it's essential to consult your doctor or pharmacist.
Serious side effects
While not common, serious side effects have been reported. These include:
- serious infections, like COVID-19 and pneumonia
- serious infusion reactions, which can show symptoms like increased or decreased blood pressure, severe shivering, chills, and fever
- heightened risk of severe meningococcal infections (see "Before receiving Ultomiris")
Ultomiris
Contact your doctor instantly if you develop serious side effects while using Ultomiris. If the side effects feel life-threatening or you think you're experiencing a medical emergency, call 911 or your local emergency number right away.
ALERT: Serious allergic reactions to Ultomiris are possible. In general, signs of allergic reactions can range from mild to severe.
Vyvgart
For minor allergic reaction symptoms, like a mild rash, get in touch with your doctor promptly. They might suggest treatments to help manage your symptoms. They'll also inform you whether you should keep taking the medication.
For severe allergic reaction symptoms, like swelling or difficulty breathing, call 911 or your local emergency number immediately. These symptoms could become life-threatening. If you've had a severe allergic reaction to another drug, your doctor might recommend an alternative medication instead.
Before receiving Ultomiris
Before receiving Ultomiris, there are crucial details to keep in mind. The drug might not be suitable if you have certain medical conditions or other factors affecting your health. Here are some health factors to consider:
Form
Boxed warning: Meningococcal infections risk
Ultomiris carries a boxed warning concerning the risk of severe meningococcal infections. This is the most serious warning from the FDA.
solution for IV infusion
Treatment with Ultomiris increases the risk of serious meningococcal infections like meningitis. These infections can be life-threatening. Symptoms of a meningococcal infection include:
- sudden fever, headache, or stiff neck
- nausea and vomiting
- sensitivity to light
- confusion
- drowsiness
solution for IV infusion
What to do
Before starting Ultomiris, your doctor will ensure you're up to date with meningococcal vaccines. If not, they'll give you any needed vaccines at least 2 weeks before you start Ultomiris treatment. If your doctor thinks you urgently need to receive Ultomiris, they may have you start treatment sooner than 2 weeks after meningococcal vaccination. If this applies to you, they'll likely prescribe antibiotics to help prevent infection, which you'll take for the first 2 weeks following your first Ultomiris infusion.
The risk of serious meningococcal infections continues throughout Ultomiris treatment and for at least 8 months after your last dose. If you suspect you have symptoms of a meningococcal infection during this time, contact your doctor immediately, but in an emergency, call 911 or go to the nearest emergency room.
Due to this risk, Ultomiris is only available under a risk evaluation and mitigation strategy (REMS) program. As part of this program, you'll need 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.
Dosage frequency
Other warnings
Apart from the boxed warning, Ultomiris also includes other warnings.
once every 8 weeks
If any of the following medical conditions or other health factors are applicable to you, discuss it with your doctor before receiving Ultomiris if you:
- have an active infection
- are pregnant or breastfeeding
- drink alcohol
- have experienced an allergic reaction to Ultomiris or any of its ingredients
once weekly for 4 weeks; your doctor may prescribe additional cycles based on how well Vyvgart works for your symptoms
Frequently Asked Questions
Below are answers to some frequently asked questions about Ultomiris for treating myasthenia gravis.
How does Ultomiris compare to Vyvgart?
Ultomiris and Vyvgart are both given as IV infusions for treating generalized myasthenia gravis (gMG) in adults who are anti-acetylcholine receptor (AChR) antibody-positive. Here's a comparison of these medications:
Drug class
| | || --- | --- || Ultomiris | Vyvgart || Form | solution for IV infusion | solution for IV infusion || Dosage frequency | once every 8 weeks | once weekly for 4 weeks; your doctor may prescribe additional cycles based on how well Vyvgart works for your symptoms || Drug class | complement inhibitor | neonatal Fc receptor blocker |
Ultomiris is also approved for other conditions, unlike Vyvgart.
complement inhibitor
Your doctor or pharmacist can provide further insights about how Ultomiris and Vyvgart compare.
Can I receive Ultomiris infusions at home?
neonatal Fc receptor blocker
It might be possible! Your doctor could potentially prescribe Ultomiris for home infusions. With home-based infusion services, a healthcare professional comes to your residence to administer a medication infusion.
Reach out to your doctor to learn more about whether this solution is available and suitable for you.
- For individuals with other autoimmune disorders, it's essential to consult their doctor, as Ultomiris might affect their health-and-wellness and chronic-diseases context, given its impact on the immune system.
- Ultomiris's action at the neuromuscular junction may not be limited to myasthenia gravis, as the science behind how it works involves suppressing the activity of a complement system protein (C5) in nerve cell communication, potentially influencing other medical-conditions.
- Patients undergoing Ultomiris treatment may face an increased risk for contracting serious infections like pneumonia and meningitis because of the immunesystem's compromised state; it is crucial to be aware of this risk and seek immediate medical-attention if any symptoms arise.
- Besides Ultomiriris, pharmacy alternatives like Vyvgart can also be prescribed for treating myasthenia gravis; knowing your treatment options can help you make informed decisions about your health-and-wellness.
- To combat the risk of serious meningococcal infections associated with Ultomiris, it is crucial to ensure that patients are up-to-date with their meningococcal vaccines and follow the prescribed dosing schedule and other safety measures; failure to do so could jeopardize an individual's health-and-wellness.
