Rystiggo®

What is Rystiggo®?

Rystiggo® (rozanolixizumab-noli) treats generalized myasthenia gravis, often shortened to gMG, in adults who test positive for AChR or MuSK antibodies. Your doctor can tell you which type you have from a blood test.

Rystiggo goes under the skin of your lower belly, not into a vein. A small pump pushes it in slowly, and a nurse does this for you here at the clinic.

Rystiggo is given in rounds, not on an endless schedule. One round is 6 weekly treatments. Then you take a break.

Here is what a round looks like:

• Your dose: Based on your weight

• How often: Once a week for 6 weeks, then a break

• Total appointment time: About 1 to 2 hours, depending on your weight and how fast the pump can run

• Your next round: Based on how you are feeling, not on a set calendar date

A nurse will watch you for about 15 minutes afterward. Most people end up needing about four rounds a year, but this varies a lot from person to person. Keep track of how you feel between rounds — that is what helps your neurologist decide when to start the next one.

How does Rystiggo work?

Your muscles move when your nerves send them a signal. In myasthenia gravis, your immune system makes proteins called antibodies that block those signals. Your muscles never get the message, so they feel weak and tired.

Your body normally recycles antibodies so they can keep working for a long time. A receptor called FcRn does that recycling job.

The problem is that FcRn recycles the harmful antibodies too. It keeps them in your blood instead of clearing them out.

Here is what it does:

• Rystiggo blocks FcRn. It stops the recycling process.

• Harmful antibodies get cleared out. Your body breaks them down instead of keeping them.

• Nerve signals get through again. Your muscles start receiving the messages they were missing.

• It works for both antibody types. Rystiggo is approved for people who are AChR positive and for people who are MuSK positive.

Benefit builds across the six weeks of a round. After the round ends, you will have a stretch of time where you keep feeling the effect, and then it slowly wears off.

Because of this pattern, paying attention to your own symptoms really matters with Rystiggo. You will know before your doctor does when the benefit is fading.

Common side effects:

• Headache

• Infections

• Diarrhea

• Fever

• Upset stomach

• Sore joints

• Soreness where you got your treatment, usually a day or three afterward

Serious side effects — get medical help right away:

• Swelling around the brain. This can cause a bad headache, a stiff neck, fever, and trouble with bright light. If this happens, call your doctor right away — it needs to be checked quickly.

• Infections. If you are sick, your treatment will be put off until you are better.

• Allergic reactions. These can include a rash or swelling of the face, lips, or throat. They have shown up anywhere from a day to two weeks after treatment.

• Live vaccines. You should not get live vaccines while on Rystiggo. Talk with your care team about your shots before you start.