Rozanolixizumab

How it works

It binds FcRn and blocks the recycling of immunoglobulin G, accelerating the degradation of circulating IgG including the pathogenic autoantibodies that drive myasthenia gravis.

Prescribing in practice

• Because it lowers total IgG, it increases susceptibility to infection, particularly of the respiratory and urinary tracts, and treatment should be deferred during active infection.
• Aseptic meningitis and headache have been reported following administration and warrant prompt assessment.
• Immunisation status should be reviewed before starting, and live vaccines are generally avoided during treatment.

Monitoring

Monitor for signs of infection during and after treatment cycles and assess clinical response in myasthenic symptoms and function.

Counselling the patient

• Report symptoms of infection, such as fever or productive cough, promptly to your care team.
• Seek urgent advice for a severe or persistent headache with neck stiffness, as meningitis-like reactions can occur.
• Tell your clinician about planned vaccinations so timing can be optimised.

Evidence & guidelines

Rozanolixizumab's efficacy in generalised myasthenia gravis was demonstrated in the randomised placebo-controlled MycarinG trial.