Imbruvica and Beyond: 4 Chronic Graft-vs.-Host Disease Medications Worth Considering
Learn what medications are FDA approved for chronic graft-vs.-host disease, plus other treatment options that are available.
Niktimvo
Used for Chronic Graft Versus-Host Disease
Used for Chronic Graft Versus-Host Disease
Niktimvo (axatilimab-csfr or axatilimab) is a type of medication called a CSF-1R-blocking antibody. It's used to treat chronic graft-versus-host disease (cGVHD) in adults and children who weigh at least 88 lbs (40 kg). cGVHD can happen after a stem cell or bone marrow transplant. Niktimvo (axatilimab) is used when 2 or more other treatments haven't worked well enough. Niktimvo (axatilimab) is given by a healthcare professional as an infusion into the vein once every 2 weeks. Common side effects include infections, muscle or joint pain, and low energy.
What is Niktimvo (axatilimab)?
What is Niktimvo (axatilimab) used for?
- Chronic graft-versus-host disease (cGVHD) in people weighing at least 88 lbs after 2 other treatments
How Niktimvo (axatilimab) works
Niktimvo (axatilimab) is a colony stimulating factor-1 receptor (CSF-1R)-blocking antibody. CSF-1R is a protein found on some immune cells. In chronic graft-versus-host disease (cGVHD), these cells can stay too active and cause inflammation and scarring.
Niktimvo (axatilimab) works by blocking CSF-1R. This helps calm these immune cells and can improve symptoms over time.
Drug facts
| Common Brands | Niktimvo |
|---|---|
| Drug Class | CSF-1R-blocking antibody |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Niktimvo (axatilimab)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Higher liver enzyme levels (up to 61%)
- Infection (57%)
- Lower phosphate levels (51%)
- Lower hemoglobin levels (48%)
- Viral infection (43%)
- Muscle, bone, or joint pain (35%)
- Higher lipase levels (34%)
- Low energy (32%)
- Higher amylase levels (31%)
- Higher calcium levels (31%)
- Higher creatinine phosphokinase levels (25%)
- Nausea (23%)
- Headache (20%)
- Diarrhea (18%)
- Cough (18%)
- Bacterial infection (15%)
- Fever (15%)
- Shortness of breath (15%)
Less Common Side Effects
- Dizziness
- Lower appetite
- Swelling
- Swelling around the eyes
- Itching
- Rash
- Bleeding (e.g., nosebleed, bruising)
- High blood pressure
Niktimvo (axatilimab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic reaction: rash; hives; swelling of the face, lips, tongue, or throat; trouble breathing
- Infusion-related reaction: fever, chills, rash, flushing, shortness of breath, trouble breathing, nausea, chest pain, headache
Pros and cons of Niktimvo (axatilimab)
Pros
- An option when other cGVHD treatments haven't worked well enough
- Given once every 2 weeks
- Infusion itself usually lasts about 30 minutes
Cons
- Must be given as an intravenous (IV) infusion at a treatment center
- Can cause infusion-related reactions
- Needs regular blood tests
Pharmacist tips for Niktimvo (axatilimab)
- Keep your Niktimvo (axatilimab) infusion visits on schedule every 2 weeks. Staying on time helps keep your treatment working as intended. Also, delaying infusions can make it harder to control your cGVHD symptoms.
- If you miss a Niktimvo (axatilimab) appointment, call your treatment team as soon as you can. Your care team can help you reschedule your infusion to keep your treatment on track.
- Plan ahead for your Niktimvo (axatilimab) appointments. The infusion usually takes about 30 minutes. But your visit might last longer because of check-in, preparation, and monitoring. You can bring something with you to help pass the time.
- Tell your care team right away if you notice any new symptoms during your Niktimvo (axatilimab) infusion. Fever, chills, rash, flushing, trouble breathing, nausea, chest pain, or a headache can be signs of an infusion reaction. Your care team can slow or stop the infusion and give you medication if needed.
- Tell your care team if you've had an infusion reaction with Niktimvo (axatilimab) before. Before your next infusion, they might give you diphenhydramine (Benadryl) and acetaminophen (Tylenol). These medications can help lower the chance of another reaction.
- Get your blood tests on schedule while you're taking Niktimvo (axatilimab). They're usually done every 2 weeks for the first month, then every 1 to 2 months. These tests help your prescriber check your liver, muscles, and pancreas. It helps them keep you safe during treatment.
- Infections are a common side effect of Niktimvo (axatilimab). Tell your care team right away if you have a fever, chills, cough, or shortness of breath.
- If you can become pregnant: Use effective birth control while you're taking Niktimvo (axatilimab) and for 30 days after your last dose. This medication might harm an unborn baby. If you become pregnant during this time, let your prescriber know right away.
- If you plan to breastfeed: Don't breastfeed while taking Niktimvo (axatilimab) and for 30 days after your last dose. It's not known if the medication passes into breast milk. Avoiding breastfeeding during this time can help protect your baby. Talk to your prescriber or a lactation consultant if you have questions.
Risks and warnings for Niktimvo (axatilimab)
Niktimvo (axatilimab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Infusion-related reactions
Niktimvo (axatilimab) can cause infusion-related reactions. These reactions usually happen while the medication is going into your vein or shortly after. Rarely, they can be serious. Your care team will watch you closely during the infusion so they can help relieve symptoms fast.
Watch for infusion reactions during your Niktimvo (axatilimab) infusion. This can include a fever, chills, rash, flushing, nausea, trouble breathing, chest pain, or headache. Some people might also have signs of a severe allergic reaction, such as hives or swelling. If symptoms start during the infusion, tell your nurse right away. They can slow or stop the infusion and give you treatment if needed.
If you have an infusion reaction, your care team might give you medication before your next Niktimvo (axatilimab) infusions. This helps lower the chance of another reaction. If you have a severe reaction, your prescriber might decide that Niktimvo (axatilimab) isn't right for you.
Harm to an unborn baby
- Risk factors: Currently pregnant
Based on how Niktimvo (axatilimab) works, it can harm an unborn baby. If you can become pregnant, your care team should have you take a pregnancy test before you start treatment.
Use effective birth control while taking Niktimvo (axatilimab) and for 30 days after your last dose. Even if you don't plan to become pregnant, an unexpected pregnancy can still happen. Your care team can help you choose a birth control method that's right for you. If become pregnant during treatment, tell your prescriber right away.
Niktimvo (axatilimab) dosage
Typical dosage for Niktimvo (axatilimab)
Your prescriber will choose the dose based on your body weight. A healthcare professional will give Niktimvo (axatilimab) as an infusion into a vein at a medical center or infusion center.
The typical dose is 0.3 mg/kg once every 2 weeks. The maximum dose is 35 mg.
Your prescriber might adjust the dose if you have side effects.
What are alternatives to Niktimvo (axatilimab)?
There are a number of medications that your doctor can prescribe in place of Niktimvo (axatilimab). Compare a few possible alternatives below.
News about Niktimvo (axatilimab)
