A biologic that blocks complement, FDA-approved for NMO to prevent relapses.
Drug Class: biologic
Eculizumab (Soliris) is a monoclonal antibody that inhibits complement, part of the immune system. It's FDA-approved for preventing relapses in neuromyelitis optica (NMO).
Key Takeaways
- FDA-approved for NMO
- Prevents relapses effectively
- IV infusion every 2 weeks
- Meningococcal vaccination required
- Very expensive medication
How It Works
- Blocks complement protein C5
- Complement contributes to nerve damage in NMO
- Reduces inflammatory attack
- Very effective at preventing relapses
Use in NMO
- For AQP4-antibody positive NMO
- Prevents future attacks
- Does not reverse existing damage
- Shown to significantly reduce relapse rate
Administration
- Loading doses initially
- Then 900 mg IV every 2 weeks
- Each infusion takes 35-45 minutes
- Lifelong treatment typically
Meningococcal Infection Risk
Increased Risk of Meningitis
- Complement needed to fight certain bacteria
- Meningococcal vaccination required before starting
- MenB and MenACWY vaccines
- May need daily antibiotics too
- Carry patient safety card
- Seek immediate care for fever, headache, stiff neck
Side Effects
- Headache
- Upper respiratory infections
- Nausea
- Back pain
- Serious infection risk (especially meningococcal)
Monitoring
- Signs of infection
- Relapse symptoms
- Regular follow-up
Cost Considerations
- One of the most expensive drugs
- Insurance coverage variable
- Patient assistance programs available
- Newer alternatives (ravulizumab) available
Medical Disclaimer: This information is for educational purposes only and does not replace professional medical advice.
Medically Reviewed Content
This article meets our editorial standards
- Written by:
- Hashemi Eye Care Medical Team
- Medically reviewed by:
- Board-Certified Neuro-Ophthalmologist (MD, Neuro-Ophthalmology)
- Last reviewed:
- January 30, 2025