Briumvi (ublituximab)
Drug Overview
Briumvi (ublituximab) is a CD20 monoclonal antibody approved for treating relapsing forms of multiple sclerosis (MS) in adults, including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease. It works by depleting B cells, which play a role in MS-related nerve damage.
Patient Education Before Administration
Screening & Premedication:
Confirm no active infections (delay infusion if present)
Pregnancy test required for females of reproductive potential
Administer premedication 30–60 minutes before infusion:
Methylprednisolone 100 mg IV (or equivalent corticosteroid)
Antihistamine (e.g., diphenhydramine).
Optional antipyretic (e.g., acetaminophen)
Verify vaccination status: Live vaccines must be given ≥4 weeks before starting Briumvi.
Patient Counseling:
Report signs of infection (fever, chills)
Avoid live vaccines during and after treatment
Use contraception during and for ≥6 months post-treatment
Administration Guidelines
Preparation:
Dilute in 250 mL 0.9% sodium chloride
Do not shake the vial; inspect for particulates
Infusion Protocol:
Infusion | Dose | Rate | Duration | Monitoring |
First | 150 mg | Slow titration | 4 hours | ≥1 hour post-infusion |
Second (Week 2) | 450 mg | Fixed rate | 1 hour | ≥1 hour post-infusion |
Subsequent (Q24W) | 450 mg | Fixed rate | 1 hour | Per physician discretion |
Key Steps:
Use in-line filter (0.2 µm)
Monitor for infusion reactions (e.g., fever, chills, hypotension)
Observe the patient for at least one hour after the completion of the first two infusions.
Managing Infusion Reactions & Side Effects
Common Reactions:
Infusion-related: Fever, chills, headache, nausea
Infections: Increased risk of URI, UTI, herpes zoster
Hepatitis B Reactivation: Screen before initiation
Interventions:
For mild reactions: Slow infusion rate, administer antihistamines/steroids
For severe reactions: Stop infusion, initiate emergency protocols
Post-infusion observation: Mandatory for first two doses
Post-Administration Monitoring & Education
Lab Monitoring:
B-cell counts (repletion may take months)
LFTs (if signs of hepatitis)
Patient Follow-Up:
Report delayed reactions (e.g., rash, fatigue)
Avoid live vaccines until immune recovery
References:
[1] https://ec.europa.eu/health/documents/community-register/2023/20231009160716/anx_160716_en.pdf
[2] https://www.drugs.com/dosage/briumvi.html
[3] https://www.youtube.com/watch?v=bctTKygOj6o
[4] https://www.drugs.com/briumvi.html
[5] https://www.briumvi.com/wp-content/uploads/2023/02/BRIUMVI-Day-1-Med-Guide-Patient-Brochure-Digital-3-002.pdf
[6] https://quizlet.com/841982726/class-6-chapter-30-medications-flash-cards/
[7] https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/761238s000lbl.pdf
[8] https://ivxhealth.com/therapies/briumvi/
[9] https://www.tgtherapeutics.com/label-prescribing-info/uspi-briumvi.pdf
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