Receiving Complement Inhibitors Increases Your Risk for Meningococcal Disease

If you receive a complement inhibitor you are at 1,000 to 2,000 times greater risk for getting meningococcal disease compared to otherwise healthy people in the United States. Complement inhibitors include eculizumab (Soliris^®) and ravulizumab (Ultomiris™).

Doctors prescribe complement inhibitors for four rare medical conditions:

• Atypical hemolytic uremic syndrome (aHUS), a blood disorder
• Paroxysmal nocturnal hemoglobinuria (PNH), a blood disorder
• Generalized myasthenia gravis (MG), a disorder that leads to muscle weakness
• Neuromyelitis optica spectrum disorder (NMOSD), a disorder of the brain and spinal cord

If you receive a complement inhibitor, you are at high risk for meningococcal disease even if vaccinated

Recent data suggest that meningococcal vaccines provide incomplete protection against invasive meningococcal disease in people receiving eculizumab. Experts believe this increased risk likely also applies to people receiving ravulizumab. Even if you received meningococcal vaccines, you could still get meningococcal disease if you receive a complement inhibitor.

If you are receiving a complement inhibitor, watch for symptoms of meningococcal disease. If you have any of these symptoms, get medical care right away and tell your doctor you are receiving a complement inhibitor.

CDC recommends meningococcal vaccination even if you receive a complement inhibitor

CDC recommends 2 meningococcal vaccines, including regular booster shots, for people receiving complement inhibitors. Even though meningococcal vaccination may not prevent all cases of meningococcal disease, you should continue receiving the recommended meningococcal vaccines. Talk to your doctor to make sure you are up to date on vaccination.

Antibiotics may help prevent meningococcal disease

Your doctor may give you antibiotics to help prevent meningococcal disease (this is known as prophylaxis) while you are receiving a complement inhibitor. It is important to seek quick treatment for symptoms of meningococcal disease even if you are taking antibiotics.

References

• Food and Drug Administration. Ultomiris^TM (ravulizumab) product label. Accessed 5/2019.
• Food and Drug Administration. Soliris ^® (eculizumab) product label. Accessed 6/2017.
• McNamara LA, Topaz N, Wang X, Hariri S, Fox L, MacNeil J. High risk for invasive meningococcal disease among patients receiving eculizumab (Soliris) despite receipt of meningococcal vaccine. MMWR Morb Mortal Wkly Rep. 2017;66(27):734–7.