1. How does it work?
Eculizumab is a complement inhibitor; the complement system is a part of the immune system that aids your body in attacking foreign microbes and promoting inflammation.
2. Who should not take this drug?
Do not receive Eculizumab if you have a meningococcal infection or have not been vaccinated against meningitis infection unless your doctor decides that urgent treatment with Eculizumab is needed.
3. How is it taken?
Intravascular (IV) infusion in an outpatient infusion center.
4. How often is it generally taken?
One infusion every two weeks; to start therapy, there is one infusion weekly for five weeks, followed by infusions every two weeks
5. What is the typical dosage?
900 mg every two weeks.
6. How much does it reduce my risk of relapse?
In the PREVENT clinical trial, Eculizumab reduced the risk of relapse by roughly 94%.
7. What are the side effects?
The most common side effects include headache, upper respiratory tract infections, high blood pressure, nausea, vomiting, and diarrhea. Infusion reactions may occur, ranging from flu-like symptoms, low blood pressure, hives to swelling, shortness of breath and, in more severe cases, shock. A serious infection called meningococcal meningitis may occur; this is from a bacterial infection that can cause inflammation around the brain.
8. What should I do to prepare for taking this?
Receive a meningococcal vaccine at least two weeks before starting this medication; speak with your doctors about which vaccine is best for you.
9. What ongoing monitoring should occur when taking this drug?
NMOSD patients receiving Soliris should be monitored for early signs of meningococcal infection. No ongoing monitoring is recommended following discontinuation of Soliris.
10. Who makes this medication?
Eculizumab is produced by Alexion.
11. How can I get help paying for it?
Alexion offers patient support through their OneSource program.
12. Can I take it if I’m pregnant?
There is no FDA pregnancy category assigned to Eculizumab. Eculizumab has been used safely for the treatment of other medical conditions during pregnancy on an individual basis, but has not been studied in large groups of pregnant people. It is unclear if this medication is generally safe for use in pregnancy and should be discussed with your doctor.
13. Clinical trial information
In the PREVENT clinical trial, 143 AQP-4 antibody positive individuals were studied. They received either Eculizumab or placebo, however, both groups were allowed to continue other immunosuppressive medications (steroids, azathioprine, mycophenolate modafinil, etc.).
14. Will my insurance cover it?
This will depend on your insurance company and the billing code your doctor uses. For specific questions, call the customer service phone number on the back of your insurance card with the name of the drug in question, as well as ICD (diagnostic) code your doctor uses.
15. Is it FDA approved for NMOSD?