6 Briumvi Side Effects and How to Manage Them

When choosing a treatment for multiple sclerosis (MS), there are several factors to consider. How well it works and the dosage form or route - such as pills, injections, or infusions - are a few examples. Potential side effects may be another consideration.

Briumvi (ublituximab) is an MS treatment that's given as an intravenous (IV) infusion. Along with infusion reactions, trouble sleeping and fatigue are possible side effects. And while rare, serious infections can also develop during treatment.

If you or a loved one has been prescribed Briumvi, it can help to know which side effects to expect when starting the medication.

Briumvi side effects at a glance

Briumvi side effects range from mild to severe. You may be able to manage milder side effects at home or with some help from your care team. Others may require medical treatment.

Common Briumvi side effects include:

• Mild infusion reactions

• Mild infections, such as respiratory infections

• Lower levels of white blood cells

• Pain in the extremities (arms/hands and legs/feet)

• Trouble sleeping (insomnia)

• Feeling tired or fatigued

Less common Briumvi side effects include:

• Severe infusion reactions, including anaphylaxis

• Severe infections such as reactivation of the hepatitis B virus

• Progressive multifocal leukoencephalopathy (PML)

Your prescriber or pharmacist can help you better understand your risk for certain side effects. In this article, we'll cover six notable Briumvi side effects in more detail.

1. Infusion reactions

Infusion reactions are a common Briumvi side effect. In fact, nearly half (48%) of people who received Briumvi in clinical trials had an infusion reaction.

The symptoms are typically mild but can be severe. Infusion reactions are most likely to happen within 24 hours of your first infusion of Briumvi.

You'll likely receive "pre-medication" before your Briumvi infusion to lower the chance of an infusion reaction. This might include a steroid and antihistamines. Your healthcare team will also have you stay at the infusion center for at least an hour after your first two infusions. This is a safety precaution in case you develop a reaction.

Symptoms of an infusion reaction from Briumvi can include:

• Fever

• Chills

• Headache

• Flu-like symptoms

• Nausea

• Throat irritation

• Anaphylaxis (a severe allergic reaction)

If you develop an infusion reaction during or after your Briumvi infusion, your healthcare team will know what to do. You may need your infusion slowed or stopped. You may also need other treatments depending on your symptoms. If you start experiencing symptoms after leaving the infusion center, contact your care team right away.

2. Infections

Briumvi affects your immune system. While this seems to help with MS, it can make you more likely to get an infection. In clinical trials, a little over half (56%) of people receiving Briumvi had an infection. But a few (5%) had serious infections.

Some infections, such as upper respiratory infections, are easily treatable or may go away on their own. For example, viral respiratory infections typically don't need antibiotic treatment. But a healthcare professional needs to treat more serious infections, such as reactivation of the hepatitis B virus.

Contact your care team if you notice any signs of an infection, including fever, cough, and pain while urinating. If you have an active infection, your Briumvi infusion will be delayed until the infection is gone. Your healthcare team can help treat your infection, whether you need an antibiotic, symptom relief, or both.

Good to know: Your healthcare team may recommend receiving certain vaccines before starting Briumvi. This can help lower your risk of certain infections. Talk with your prescriber about which vaccines you should receive and when to get them.

3. Pain in the extremities

Another possible Briumvi side effect is pain in the "extremities," or in your arms/hands and legs/feet. However, pain is also common for people living with MS. This can include pain that feels like burning, tingling, or stabbing.

Tell your healthcare team if you have pain that's getting worse, isn't going away, or is affecting your quality of life. They can determine potential treatment options.

4. Insomnia

Some people experience insomnia, or trouble sleeping, while receiving Briumvi. While this was reported more frequently with Briumvi during clinical trials, insomnia is also common in people with MS. Certain MS symptoms, such as restless legs and pain, can make it difficult to sleep.

If you're having sleeping problems after starting Briumvi, there are a few things you can try to improve your sleep hygiene. Sleep hygiene helps your body prepare for sleep and get into a consistent sleep routine. A few tips include:

• Keeping your room quiet

• Turning off electronics before bed

• Going to sleep at the same time each night

• Avoiding caffeine late in the day

• Avoiding naps during the day, especially close to bedtime

• Getting regular exercise

If you're still having trouble sleeping, talk to your healthcare team. They can help pinpoint the cause and next steps. If needed, they may recommend an over-the-counter or prescription sleep medication to help. Or they might suggest other changes to your medication regimen.

5. Fatigue

Fatigue, or feeling tired or weak, is another reported Briumvi side effect. However, fatigue is one of the most common symptoms of MS. So if you're feeling fatigued while receiving Briumvi, it could also be related to MS. Pain, sleeping problems, and depression or anxiety from MS can all contribute to fatigue.

There are a few things that can help boost your energy levels if you're feeling tired or weak. Eating energy-boosting foods and gradually increasing physical activity can help you feel more energized. It's also a good idea to work on your sleep hygiene, as detailed above.

Your healthcare team may have other suggestions that can help with energy levels. Or they can narrow down what might be the most effective way to reduce your fatigue based on your health history and medications.

6. Progressive multifocal leukoencephalopathy

PML is a serious, life-threatening viral infection of the brain. It can happen when a person's immune system becomes weakened. PML hasn't been reported in people receiving Briumvi. But it has been seen in people receiving medications that work in a similar way, such as Tysabri (natalizumab).

Symptoms of PML tend to progress over days to weeks. They include weakness on one side of the body, vision problems, and changes in thinking or memory. Tell your healthcare team right away if you notice these symptoms. They can determine if PML is the cause. If it is, they'll have you stop receiving Briumvi.