Infusion Medications
Briumvi (ublituximab)
Briumvi treats relapsing forms of multiple sclerosis (MS) by targeting certain immune cells called B cells. These cells normally help the immune system fight infections, but in MS, they mistakenly attack nerve tissue in the brain and spinal cord. By reducing these specific immune cells, Briumvi significantly decreases the frequency of MS relapses and prevents new lesions on MRI scans. Patients receive the infusion twice per year, making it convenient for ongoing management. Common side effects include infusion-related reactions like rash or fever, and there’s a slightly higher risk of respiratory infections. Most patients tolerate Briumvi well, and side effects typically resolve quickly with supportive treatments or medication adjustments.
Kisunla (donanemab)
Kisunla is designed to treat early Alzheimer’s disease by directly targeting and helping clear amyloid plaques—sticky protein clusters that accumulate in the brains of Alzheimer’s patients and contribute to cognitive decline. The goal of Kisunla is to slow this decline by reducing plaque buildup. Infusions are administered approximately once a month. Patients need regular MRI scans to detect potential side effects such as brain swelling or small bleeding events known as amyloid-related imaging abnormalities (ARIA). Most ARIA cases resolve on their own but still require careful monitoring. Genetic testing might be recommended to assess individual risk levels. While Kisunla does not reverse Alzheimer’s, clinical studies have demonstrated measurable slowing of cognitive and functional decline compared to untreated patients. Our practice participated in Kisunla clinical trials prior to FDA approval.
Leqembi (lecanemab)
Leqembi is used for patients with early-stage Alzheimer’s disease. It targets amyloid plaques, binding to and removing amyloid proteins in the brain. This removal process aims to modestly slow the progression of cognitive impairment associated with Alzheimer’s. Infusions typically occur every two weeks, and patients undergo regular MRI scans due to risks such as brain swelling or small brain bleeds (ARIA). Genetic factors may influence these risks, so genetic testing is sometimes recommended. Clinical trials have shown that patients on Leqembi retain more cognitive abilities over time compared to those not receiving treatment, translating to better quality of life and independence for a longer period. Our practice served as a clinical trial site for Leqembi before its approval.
Ocrevus (Ocrelizumab)
Ocrevus is used to treat both relapsing and primary progressive forms of multiple sclerosis by binding to the CD20 receptor on B-cells, which form a minor subset of immune cells. These cells mistakenly attack the nervous system in MS. By limiting these cells, Ocrevus decreases relapse frequency, slows disability progression, and prevents new lesions. Treatments are given via infusions every six months. Side effects include manageable infusion reactions like itching or nausea and a slightly increased risk of infections. Patients typically experience substantial improvement in disease control and quality of life. ANA was honored as a site of the phase 3 trial: https://clinicaltrials.gov/ct2/show/NCT01412333
Octagam (intravenous immune globulin)
Octagam is an intravenous immune globulin (IVIG) therapy containing pooled antibodies collected from healthy donors. It provides essential antibodies to patients with immune deficiencies who cannot produce enough antibodies themselves, helping protect them from infections. Additionally, it helps patients with autoimmune neurological conditions, such as CIDP or Guillain-Barré syndrome, by correcting abnormal immune responses that cause nerve damage. Treatment frequency varies based on individual needs, typically every 3–4 weeks. Side effects can include temporary flu-like symptoms such as headaches, chills, or fatigue during or after infusions. Most patients experience significant symptom improvement or disease stabilization with regular IVIG treatments.
Panzyga (intravenous immune globulin)
Panzyga is an intravenous immune globulin (IVIG) therapy containing pooled antibodies collected from healthy donors. It is frequently used to rapidly stabilize conditions like CIDP or immune thrombocytopenia (ITP), a disorder in which the immune system mistakenly attacks platelets. Panzyga helps correct the immune system’s abnormal activity, reducing harmful inflammation. Infusion schedules vary depending on patient-specific needs but are often given monthly. Side effects can include mild flu-like symptoms and occasional infusion reactions such as headaches or nausea. Patients are regularly supervised during infusions to promptly address any reactions. Panzyga has been shown to effectively control autoimmune symptoms and improve overall patient health.
Reclast (zoledronic acid)
Reclast treats osteoporosis and other bone-density conditions by slowing down bone-resorbing cells called osteoclasts, which break down bone tissue. By reducing osteoclast activity, Reclast effectively strengthens bones and significantly reduces fracture risks. Reclast is administered through a once-yearly infusion lasting about 30 minutes. Patients might experience temporary flu-like symptoms, such as joint or muscle aches, lasting several days afterward. Rarely, jawbone health can be affected, so dental check-ups before treatment are recommended. Reclast provides substantial fracture protection with the convenience of less frequent dosing compared to daily or weekly medications, leading to better adherence and consistent protection.
Remicade (infliximab)
Remicade treats autoimmune inflammatory diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, ankylosing spondylitis, psoriasis, psoriatic arthritis, and Behçet’s disease. Infliximab binds and neutralizes a cell signaling protein called tumor necrosis factor-alpha (TNF-alpha), a key factor in inflammation. By inhibiting TNF-alpha, Remicade effectively reduces inflammation and associated symptoms. Infusions are given every few weeks to every couple of months based on disease severity. Potential side effects include infusion reactions, increased susceptibility to infections, and very rarely, certain cancers. Regular monitoring, including health screenings, helps manage these risks. Remicade frequently leads to significant symptom improvement, tissue healing, and sustained remission in many patients.
Rituxan (rituximab)
Drug for the treatment of various autoimmune diseases. Like ocrelizumab above, this monoclonal antibody binds to the CD20 receptor on B-cells, which form a minor subset of immune cells. By significantly reducing these B cells, Rituxan can control autoimmune conditions and effectively manage blood cancers, often when other treatments haven’t worked. It is on the World Health Organization’s list of Essential Medicines. Infusions are typically scheduled every few months, with frequency depending on the specific condition being treated. Side effects may include mild to moderate infusion-related reactions (such as rash, itching, or throat irritation), and there is an increased risk of infections due to lowered immune defenses. In rare cases, patients can experience more serious complications such as hepatitis B reactivation or a very rare brain infection called progressive multifocal leukoencephalopathy (PML). Patients undergoing Rituxan therapy receive regular monitoring, including blood tests and careful assessments, to ensure risks remain minimized. Many patients experience substantial symptom relief, improved daily function, and prolonged disease stabilization with ongoing treatment.
Tysabri (natalizumab)
Tysabri is used to treat relapsing forms of multiple sclerosis (MS). This monoclonal antibody binds to a cell adhesion molecule called α4-integrin, preventing cells from crossing the blood-brain barrier. This prevents those immune cells from damaging the myelin within the brain. Patients receive Tysabri infusions every four weeks, typically noticing fewer MS relapses, fewer new brain lesions on MRI scans, and better control of disease progression. The key risk associated with Tysabri is progressive multifocal leukoencephalopathy (PML), a rare but serious brain infection caused by reactivation of the JC virus. Due to this risk, patients on Tysabri require careful monitoring, including regular blood tests to check JC virus antibody levels and periodic MRI scans. Adverse effects during infusion include fatigue and allergic reactions, but most infusions occur without any reaction.
Vyepti (eptinezumab)
Vyepti is a preventive treatment for chronic migraine, administered by infusion once every three months. This monoclonal antibody binds to and blocks calcitonin gene-related peptides (CGRP), a molecule involved in triggering migraine attacks, leading to fewer migraine days and reduced symptom severity. Trials showed that treated patients have fewer migraine days relative to placebo. The quarterly dosing schedule is convenient for many patients who prefer fewer treatment sessions compared to monthly or weekly medications. Benefits are greater than risks for many patients, but risks include nasopharyngitis, upper respiratory infection, nausea, and urinary tract infection. Serious side effects are uncommon, and most patients tolerate the medication very well. ANA was honored as a site of the phase 3 trial: https://www.clinicaltrials.gov/ct2/show/NCT02275117
Vyvgart (efgartigimod)
Vyvgart is a therapy approved to treat generalized myasthenia gravis (gMG), an autoimmune disorder causing muscle weakness. It reduces harmful antibodies circulating in the blood that interfere with normal nerve-to-muscle communication, significantly improving muscle strength and daily functioning in many patients. Vyvgart treatment consists of a cycle of four weekly infusions followed by a monitoring period to see how long symptom relief lasts before potentially repeating the cycle. This tailored approach allows personalized dosing intervals based on patient response. Side effects are typically mild and may include headaches, respiratory infections (such as common colds), and rare infusion-related reactions like rash or shortness of breath. Because it lowers certain immune proteins, there can be an increased susceptibility to infections, requiring careful patient monitoring and periodic blood tests. Vyvgart has been shown to meaningfully enhance daily activities and reduce reliance on other medications like steroids or IVIG in many gMG patients.