Receiving Complement Inhibitors Increases Your Risk for Meningococcal Disease
Seek Medical Care Quickly
If you take a complement inhibitor and think you have any meningococcal disease symptoms, get medical care right away. Make sure to tell your clinician you are taking a complement inhibitor. You should seek quick medical care even if you are up to date with meningococcal vaccination or taking antibiotic prophylaxis.
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. UltomirisTM (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.
- For clinicians: Managing the risk of meningococcal disease among patients who receive complement inhibitor therapy
- Atypical hemolytic uremic syndrome (aHUS)
- Paroxysmal nocturnal hemoglobinuria (PNH)
- Recommended immunizations for children from birth through 6 years old
- Recommended immunizations for children 7—18 years old
- Recommended adult immunization schedule