Ublituximab (Briumvi)
Ublituximab is a disease modifying therapy (DMT) for ‘active’ relapsing MS. Its brand name is Briumvi and you take it as an infusion. It’s a monoclonal antibody, one of the more effective types of MS drugs.
Who can take ublituximab (Briumvi)?
How does ublituximab (Briumvi) work?
How well does ublituximab (Briumvi) work?
What are the side effects of ublituximab (Briumvi)?
Ublituximab (Briumvi) and pregnancy, breastfeeding and contraception
Who can take ublituximab (Briumvi)?
You can have ublituximab (Briumvi) across the UK if:
- you have ‘active’ relapsing MS. That means you’ve had a recent relapse and/or MRI scans show that you have new lesions.
You might be offered ublituximab (Briumvi) as your first DMT, or if the one you’re already taking isn’t controlling your MS well enough.
How does ublituximab (Briumvi) work?
Special types of cells in your immune system called B cells are thought to cause a lot of the damage in MS. They normally kill viruses and bacteria that get into your body, but in MS they damage nerves. They do this by stripping off the covering of myelin from nerves in your brain and spinal cord. Myelin protects nerves from damage, and helps messages travel along them.
Ublituximab (Briumvi) is a monoclonal antibody drug. These artificial antibodies, made in a laboratory, stick to the surface of the B cells and kill them. This leads to fewer B cells that can damage the myelin covering around your nerves. This means you get relapses much less often.
You also get far fewer lesions. Lesions are areas of damage to the nerves in your brain or spinal cord. A doctor can see lesions on your MRI scans.
This drug also slows down how fast people’s disability gets worse.
After your first infusion (on a lower starting dose), you only need an hour-long infusion of ublituximab (Briumvi) twice a year. An infusion is when doctors give you a drug through a drip in your arm. This happens in a hospital.
How well does ublituximab (Briumvi) work?
Two trials compared ublituximab (Briumvi) to a drug already used to treat MS called teriflumonide (teriflunomide’s brand name is Aubagio). Ublituximab (Briumvi) was much better than teriflunomide at reducing how many relapses people got. It was also better at reducing how many lesions doctors could see on MRI scans.
Relapses dropped by: 49-59% compared to teriflunomide
This means that in the trials, over two years, on average people saw a drop of 49-59% in the number of relapses they had. This was compared to people who took teriflunomide.
When it came to how well ublituximab (Briumvi) slowed down disability getting worse, in these trials it had about the same effect as teriflunomide. Terifunomide reduces disability getting worse by around 30%.
What are the side effects of ublituximab (Briumvi)?
Within 24 hours of the first infusion of the drug, around half of people get an infusion reaction. After the second infusion this drops to under one in ten people, falling even lower for infusions after that.
These reactions can involve fever, chills, headache, a faster heartbeat, feeling sick, stomach pain, sore throat, or a rash or red or itchy skin. To lower the risk of a reaction, before each infusion you’re given a steroid and an anti-histamine (an anti-allergy medicine). You’ll be monitored during and after the first infusion in case you get a more serious reaction.
Ublituximab (Briumvi) lowers your levels of white blood cells. These cells fight infections. As a result, over half of people in trials got some kind of infection, mostly mild to moderate ones. Very common were things like colds, and nose and throat infections (around one in three people got these). Less than one in 10 got pain in the arms or legs, or infections caused by herpes viruses. Around one in 20 people got chest infections like bronchitis or pneumonia.
Ublituximab (Briumvi) and pregnancy, breastfeeding and contraception
Pregnancy
Ublituximab (Briumvi) doesn’t have a licence to be used in pregnancy. UK pregnancy guidelines are now being written for this drug. We’ll update this page as soon as they’re released.
Experts say it’s likely to be safe to try to get pregnant two to three months after your last dose of ublituximab (Briumvi).
Some neurologists might be happy for you to take this drug up until you become pregnant. But because ublituximab (Briumvi) is new, others will be more cautious about using it with women who want to get pregnant.
Once you've become pregnant, you won’t normally have an infusion of this drug until after your baby has been born. To keep your risk of a relapse low, your treatment should start again soon after your baby is born.
If you want to have a child, discuss this with your neurologist. If you think you’ve become pregnant, let your medical team know at once. Never stop your DMT without first getting their advice.
Breastfeeding
Ublituximab (Briumvi) has a licence that allows it to be used during breastfeeding. But if you’re breastfeeding, you should wait a few days following the birth of your baby before having an infusion of this drug.
Contraception
If you can get pregnant, the makers of ublituximab (Briumvi) recommend that you use contraception for at least 4 months after your last infusion.
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