Uplizna (inebilizumab)

What it is

Uplizna (inebilizumab) is a biologic medicine that removes B cells — the white blood cells that produce antibodies. It is the first treatment approved for IgG4-related disease, an uncommon condition in which immune cells cause swelling and scarring in glands and organs such as the pancreas, the salivary glands (which make saliva), the tear glands, and the kidneys. Uplizna is also approved for neuromyelitis optica spectrum disorder (NMOSD), a related antibody-driven condition. By removing the B cells driving the disease, it helps calm swelling and reduce flares.

Before starting

Before starting, we screen for hepatitis B and tuberculosis (TB). These checks matter because B-cell removal can allow hidden infections to reactivate — hepatitis B in particular can flare when B cells are removed — so if there is any sign of past infection, preventive steps are taken first. We also check your immunoglobulin (antibody) levels, because removing B cells lowers antibody levels over time and those numbers tell us how your infection defences are holding up. Vaccines work best before B cells are removed, so we review your vaccination record first; live vaccines are avoided during treatment. Uplizna is not started during an active infection and is not used in pregnancy.

How it’s given

It is given as an IV infusion — medicine dripped slowly into a vein — in our infusion suite. Two starter infusions are given 2 weeks apart; after that, one infusion every 6 months keeps the treatment going, so most of the year there is nothing to take at home. Before each infusion you are given medicines (typically a steroid, an antihistamine, and a fever reducer) to help prevent infusion reactions, and the team monitors you during and after the drip.

What to expect

The goal is fewer flares and gradual shrinking or stabilising of swollen glands and organs, judged over months with your symptoms, exams, and scans or labs rather than day to day. Infusion reactions — headache, nausea, flushing, or fever during the drip — are the most common side effect, usually around the first infusions; the pre-medicines help prevent them. Urinary tract infections and joint aches are also reported. Because your B cells are lowered, infections may be more likely and vaccine responses weaker — call us promptly for fever, painful urination, or any infection that is not improving.

Everyday guidance

Keep the twice-yearly infusion appointments on your calendar; the protection is long-lasting but depends on the next dose arriving on time. Keep lab appointments too, even when you feel well — antibody levels and organ labs are how we confirm the treatment is doing its job safely. Tell every clinician treating you that you receive B-cell therapy, since it affects infections and vaccines for months after each dose. If you are planning a pregnancy, talk with your provider well in advance. Questions or signs of infection: call (361) 400-7700.