Myasthenia Gravis Treatment with Ultomiris: Insights, Explanations, and More
Get the lowdown on Ultomiris, a brand-name treatment for myasthenia gravis. Here's what you need to know about using this fresh infusion solution, its side effects, and how it treats the condition.
Untangle the nerves with myasthenia gravis, a condition where faulty communication between muscles and nerves makes voluntary muscles weary and weak. Myasthenia gravis is a chronic autoimmune disorder, meaning your immune system mistakenly attacks your own cells.
Symptoms of Myasthenia Gravis
Myasthenia gravis symptoms vary from person to person but usually worsen during periods of activity and improve with rest. Symptoms include:
Body weight
- Droopy eyelids
- Weakened limbs, neck, and eye muscles
- Fatigue
- Blurry or double vision
- Difficulty chewing, swallowing, speaking, and breathing
Loading dose
Who Ultomiris is Prescribed For
Maintenance dose
Ultomiris is prescribed for adults with generalized myasthenia gravis (gMG) who are anti-acetylcholine receptor (AChR) antibody-positive.
- Generalized means muscle groups throughout the body are affected. gMG differs from ocular myasthenia gravis, which only affects eye muscles.
- Anti-acetylcholine receptor (AChR) antibody-positive means your immune system makes antibodies that block acetylcholine receptors. Acetylcholine is a neurotransmitter that sends signals that allow muscles to contract.
40 kg to less than 60 kg (approximately 88 lb to less than 132 lb)
Before prescribing Ultomiris, your doctor may perform a blood test to confirm whether your gMG is AChR antibody-positive. They can offer more information about whether Ultomiris is suitable for your form of myasthenia gravis.
2,400 mg
How Ultomiris Treats Myasthenia Gravis
3,000 mg every 8 weeks
If your doctor greenlights Ultomiris for treating myasthenia gravis, you may be curious about how the medication works to ease your symptoms.
The Way Ultomiris Works
60 kg to less than 100 kg (approximately 132 lb to less than 220 lb)
Although the exact mechanism by which Ultomiris treats myasthenia gravis isn't completely understood, it's believed to work by blocking the activity of a complement system protein called C5 at the neuromuscular junction (NMJ).
2,700 mg
The NMJ is the spot where nerve cells communicate with the muscles they control. By reducing C5 activity at the NMJ, Ultomiris enables signals from nerve cells to reach your muscles, potentially lessening fatigue and muscle weakness and enhancing muscle strength.
3,300 mg every 8 weeks
How Well Ultomiris Works for Myasthenia Gravis
In clinical trials, Ultomiris demonstrated improved ability to carry out daily activities in adults with generalized myasthenia gravis (gMG) who were anti-acetylcholine receptor (AChR) antibody-positive. You can read about these studies in the prescribing information for Ultomiris.
100 kg or more (approximately 220 lb or more)
Receiving Ultomiris for Myasthenia Gravis
3,000 mg
Ultomiris is administered as an IV infusion by a healthcare professional at an infusion center. Typically, you receive maintenance doses every 8 weeks following a loading dose.
3,600 mg every 8 weeks
Ultomiris comes in three strengths: 300 mg/30 mL, 300 mg/3 mL, and 1,100 mg/11 mL. Your doctor will advise the appropriate dosage for you. If you have any questions about your Ultomiris dosage, discuss them with your doctor or pharmacist.
Ultomiris Side Effects
As with any medication, using Ultomiris may cause side effects.
Mild Side Effects
Ultomiris
Mild side effects reported with Ultomiris use include:
Vyvgart
- Diarrhea
- Upper respiratory infection (common cold)
- Abdominal pain
- Urinary tract infection (UTI)
- Back pain
- Dizziness
- Mild infusion reactions
Serious Side Effects
Form
Serious side effects have been recorded with Ultomiris, including:
solution for IV infusion
- Severe infections like COVID-19 and pneumonia
- Severe infusion reactions
- Risk of serious meningococcal infections (see "Before receiving Ultomiris")
solution for IV infusion
If you develop serious side effects while using Ultomiris, contact your doctor right away. If they seem life-threatening or you believe it's an emergency, call 911 or your local emergency number.
Allergic Reaction
Dosage frequency
Ultomiris can cause an allergic reaction in some people.
once every 8 weeks
inda:
once weekly for 4 weeks; your doctor may prescribe additional cycles based on how well Vyvgart works for your symptoms
- Symptoms of allergic reactions can be mild or severe.
- Mild allergic reaction symptoms, such as a mild rash, should be reported to your doctor promptly.
- Severe allergic reaction symptoms, such as swelling or trouble breathing, require immediate medical attention. If you've experienced a severe allergic reaction to a drug, ask your doctor if a different medication is a suitable alternative.
Before Receiving Ultomiris
Drug class
Before starting Ultomiris, you should be aware of certain medical conditions that might prevent or require special precautions during treatment.
complement inhibitor
Boxed Warning: Risk of Serious Meningococcal Infections
neonatal Fc receptor blocker
Ultomiris has a boxed warning for the risk of serious meningococcal infections (like meningitis). Prior to your first Ultomiris infusion, your doctor will ensure you've received or updated your meningococcal vaccinations. If you require urgent treatment, your doctor may prescribe antibiotics to help prevent infection for the first 2 weeks of Ultomiris treatment.
More Warnings
In addition to the boxed warning, Ultomiris carries other warnings. Share the following information with your doctor before receiving Ultomiris if:
- You have an active infection
- You are pregnant or breastfeeding
- You consume alcohol
- You have had an allergic reaction to Ultomiris or any of its ingredients
References:
- Ultomiris Medication Guide
- Ultomiris Prescribing Information
- Ultomiris (ravulizumab-cwvz): Background, Mechanism of Action, Pharmacokinetics, and Efficacy
- U.S. Food and Drug Administration. Ultomiris: Medication Guide. Accessed February 14, 2023.
- The immune system mistakenly attacks the body in cases of myasthenia gravis, a chronic autoimmune disorder that weakens voluntary muscles.
- Ultomiris is prescribed for adults with generalized myasthenia gravis (gMG) who are anti-acetylcholine receptor (AChR) antibody-positive, and it works by blocking the activity of a complement system protein called C5 at the neuromuscular junction.
- Other autoimmune disorders and neurological disorders may require the attention of medical professionals and the consideration of other treatments or medications.
- side effects reported with Ultomiris use include diarrhea, upper respiratory infection, abdominal pain, urinary tract infection, back pain, dizziness, mild infusion reactions, and the potential for serious infections like COVID-19 and pneumonia.
- It's essential to discuss any concerns about Ultomiris dosage, potential side effects, or other medical-conditions like pregnancy or alcohol consumption with a healthcare professional, and to follow up on recommended vaccinations or precautions, such as the meningococcal vaccination.
