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Answers to frequently asked questions

Find information about ENSPRYNG, neuromyelitis optica spectrum disorder (NMOSD), support options, and more

About ENSPRYNG

ENSPRYNG is a prescription medication approved for NMOSD in AQP4-IgG(+) adults that has been proven to reduce the risk of relapse. It is also the only self-administered subcutaneous injection given under the skin for NMOSD. If your healthcare provider determines it is appropriate and after proper training, you or your caregiver have the ability to give it in the comfort of your own home.

ENSPRYNG is for AQP4-IgG(+) adult patients with NMOSD. Your healthcare provider will determine the most appropriate way to use ENSPRYNG, as it has been evaluated alone or with certain immunosupressive therapies (azathioprine, mycophenolate mofetil, or oral corticosteroids).

Do not take ENSPRYNG if you:

  • are allergic to ENSPRYNG or any of the ingredients in ENSPRYNG
  • have an active hepatitis B infection
  • have active or untreated inactive (latent) tuberculosis

The specific way ENSPRYNG works is not completely understood, but it is thought to affect the protein interleukin 6 (IL-6). ENSPRYNG is the first treatment for NMOSD designed to block IL-6, a protein made by immune cells in our bodies that may play a key role in the inflammation that occurs in people with NMOSD.

Every patient is unique. So your healthcare provider will determine the most appropriate way to use ENSPRYNG, as it has been evaluated alone or with immunosupressive therapy (IST), such as azathioprine, mycophenolate mofetil, or oral corticosteroids. Talk to your healthcare provider about all your medicines before starting treatment.

ENSPRYNG might be different from other medicines you’ve taken. First, talk to your healthcare provider to see if ENSPRYNG is right for you. If you’re prescribed ENSPRYNG, you won’t pick it up from your local drugstore; instead, a Specialty Pharmacy will deliver ENSPRYNG to your home.

In 2 clinical studies, ENSPRYNG was proven to reduce the risk for relapse when used by itself or with certain immunosuppressive therapy. In both studies, more patients were relapse-free with ENSPRYNG than with placebo.

Get more details about ENSPRYNG study results by visiting the About ENSPRYNG page.

ENSPRYNG may cause serious side effects including: infections, increased liver enzymes, and low neutrophil counts. All required vaccinations should be completed before starting ENSPRYNG. Do not take ENSPRYNG if you are allergic to satralizumab-mwge or any of the ingredients in ENSPRYNG, have an active hepatitis B infection, or have active or untreated inactive (latent) TB.

These are not all the possible serious side effects with ENSPRYNG. Talk to your healthcare provider if you experience side effects while taking ENSPRYNG.

The most common side effects of ENSPRYNG include:

  • sore throat/runny nose (nasopharyngitis)
  • rash
  • fatigue
  • extremity pain
  • headache
  • upper respiratory tract infection
  • nausea
  • inflammation of the stomach lining (gastritis)
  • joint pain (arthralgia)

These are not all the possible side effects of ENSPRYNG. Talk to your healthcare provider if you experience side effects while taking ENSPRYNG.

Taking ENSPRYNG

ENSPRYNG is taken as a subcutaneous injection under the skin. During the first 4 weeks, you will have 3 starting doses (injections) of ENSPRYNG. You will receive 1 prefilled syringe (120 mg of ENSPRYNG) 2 weeks apart for each dose. After the starting doses, ongoing doses will be taken every 4 weeks.

Your healthcare provider should train you on the proper technique for subcutaneous injection, which is an injection into the tissue under the skin. You can also set up a free one-on-one supplemental injection training visit with an ENSPRYNG Clinical Education Manager. Once trained and if your healthcare provider determines it is appropriate, you or a caregiver can administer your injections.

Talk with your healthcare provider if you want to adjust your dosing schedule. They can help you find a solution that safely meets your needs.

If a starting dose is missed, you should take it immediately, then maintain the 2-week dosing interval from your new starting date until the first 3 doses are complete, and then continue with ongoing doses every 4 weeks.

If an ongoing dose is missed, you should take it immediately, wait the 4-week interval from your new starting date, and continue with ongoing doses every 4 weeks.

Speak with your healthcare provider if you have any questions about how to restart treatment or if it has been more than 8 weeks since your last dose of ENSPRYNG.

If the seal is broken, your medication has expired, or there are any other issues with your medication, contact your healthcare provider immediately. Do not use the medication.

If you have experienced this, we encourage everyone to report any side effects related to ENSPRYNG or other Genentech prescription drugs to Genentech, Inc. at 1-888-835-2555 and the FDA at 1-800-FDA-1088.

Yes. Because you may be able to administer ENSPRYNG yourself, you can take it with you when you travel. Be sure to stick to your regular schedule and keep ENSPRYNG in a travel cooler whenever possible. ENSPRYNG should not be unrefrigerated for more than 8 days.

It's important to stay on track with your ENSPRYNG injections. Keep track of the date of each dose and where it was given (left abdomen, right abdomen, left thigh, or right thigh), as you'll need to rotate injection sites. Make note of any reactions and how you felt, so you can discuss with your doctor. It can help to set reminders of your upcoming injection days in your phone or calendar.

About NMOSD

NMOSD stands for neuromyelitis optica spectrum disorder and is sometimes called neuromyelitis optica or NMO for short. It is a rare, chronic autoimmune disease marked by inflammation of the optic nerves and spinal cord. NMOSD can cause relapses that result in new or worsening symptoms.

NMOSD symptoms can be different from person to person, so it's important to discuss any you experience with your healthcare provider. Common symptoms include:

  • blurred vision
  • inability to see colors
  • complete vision loss
  • pain
  • weakness
  • paralysis in the legs
  • loss of sensation or numbness
  • bladder and bowel control issues
  • severe hiccups
  • vomiting
  • nausea

AQP4-IgG stands for aquaporin-4 immunoglobulin G. It's an antibody produced by the immune system that helps in diagnosing NMOSD. If you'd like to know your AQP4-IgG antibody status, talk to your healthcare provider.

Based on current understanding of NMOSD, damage caused by relapses is often irreversible and accumulates or adds up over time. This is what leads to NMOSD symptoms and to symptoms getting worse over time.

Anytime you experience a relapse, call your healthcare provider immediately.

Support Options

Your Patient Navigator from Genentech Access Solutions can help you understand your insurance coverage and assistance options. There may be options that may help you afford your medication, no matter what type of health insurance you have.

For more information, visit the Resources page or call 844-NSPRYNG (844-677-7964).

Yes. Along with the Injection Training Video and Administration Pocket Guide, 1:1 injection training is available with a Clinical Education Manager. If you're interested, talk with a Patient Navigator at 1-844-NSPRYNG (844-677-7964).

In addition to the ENSPRYNG website, there are several organizations that are dedicated to providing support for those who have been diagnosed with NMOSD, as well as providing valuable disease and resource information. Check out Resources and Support for more information.

NMOSD advocacy organizations provide resources dedicated to NMOSD care, support, and research. Check out Resources and Support for more information.

 ENSPRYNG patient Kila said "The best plan of action is to educate yourself. You have to be your own advocate."

Sign up to learn more about NMOSD and ENSPRYNG

LEARN FROM OTHERS WITH NMOSD

Hear real people answer key questions about NMOSD and ENSPRYNG

ENSPRYNG patient Donna, diagnosed with NMOSD in 2013

What is ENSPRYNG?

ENSPRYNG is a prescription medicine used to treat neuromyelitis optica spectrum disorder (NMOSD) in adults who are aquaporin-4 (AQP4) antibody positive. It is not known if ENSPRYNG is safe and effective in children.

Who should not receive ENSPRYNG?

Do not take ENSPRYNG if you:

  • are allergic to ENSPRYNG or any of the ingredients in ENSPRYNG.
  • have an active hepatitis B infection.
  • have active or untreated inactive (latent) tuberculosis.

What is the most important information I should know about ENSPRYNG?

ENSPRYNG may cause serious side effects including:

  • Infections. ENSPRYNG can increase your risk of serious infections some of which can be life-threatening. Talk to your healthcare provider if you are being treated for an infection or call them right away if you think you have signs of an infection, with or without a fever, such as:
    • chills, feeling tired, muscle aches, cough that will not go away or a sore throat
    • skin redness, swelling, tenderness, pain or sores on your body
    • diarrhea, belly pain, or feeling sick
    • burning when you urinate or urinating more often than usual

Your healthcare provider will check if you have an infection and treat it if needed before you start or continue to take ENSPRYNG.

  • Your healthcare provider should test you for hepatitis and tuberculosis (TB) before you start taking ENSPRYNG.
  • All required vaccinations should be completed before starting ENSPRYNG. People using ENSPRYNG should not be given ‘live’ or ‘live-attenuated’ vaccines. ‘Live’ or ‘live-attenuated’ vaccines should be given at least 4 weeks before you start ENSPRYNG. Your healthcare provider may recommend that you get a ‘non-live’ (inactivated) vaccine, such as some of the seasonal flu vaccines. If you plan to get a ‘non-live’ (inactivated) vaccine it should be given, whenever possible, at least 2 weeks before you start ENSPRYNG.
  • Increased liver enzymes.
    Your healthcare provider should order blood tests to check your liver enzymes before and while you are taking ENSPRYNG. Your healthcare provider will tell you how often you will need to have these blood tests. Make sure you get all of your follow-up blood tests as ordered by your healthcare provider. Your healthcare provider will tell you if you need to wait to start ENSPRYNG if your liver enzymes are increased.
  • Low neutrophil count.
    ENSPRYNG can cause a decrease in your neutrophil counts in your blood. Neutrophils are white blood cells that help the body fight off bacterial infections. Your healthcare provider should order blood tests to check your neutrophil count while you are taking ENSPRYNG.
  • Serious allergic reactions.
    Serious allergic reactions that may be life-threatening have happened with other medicines like ENSPRYNG. Tell your healthcare provider before taking your next dose if you had hives, rash, or flushing after your injection. Seek medical attention right away if you have any symptoms of a serious allergic reaction, such as:
    • shortness of breath or trouble breathing
    • dizziness or feeling faint
    • swelling of your lips, face, or tongue
    • moderate or severe stomach (abdominal) pain or vomiting
    • chest pain

Before you take ENSPRYNG, tell your healthcare provider about all of your medical conditions, including if you:

  • have or think you have an infection. See "What is the most important information I should know about ENSPRYNG?"
  • have liver problems.
  • have ever had hepatitis B or are a carrier of the hepatitis B virus.
  • have had or have been in contact with someone with tuberculosis.
  • have had a recent vaccination or are scheduled to receive any vaccination.
  • are pregnant, think that you might be pregnant, or plan to become pregnant. It is not known if ENSPRYNG will harm your unborn baby.
  • are breastfeeding or plan to breastfeed. It is not known if ENSPRYNG passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you take ENSPRYNG.

Tell your healthcare provider about all the medicines you are taking, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the most common side effects of ENSPRYNG?
The most common side effects of ENSPRYNG include:

  • sore throat, runny nose (nasopharyngitis)
  • rash
  • fatigue
  • extremity pain
  • headache
  • upper respiratory tract infection
  • nausea
  • inflammation of the stomach lining (gastritis)
  • joint pain (arthralgia)

These are not all the possible side effects of ENSPRYNG.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects to Genentech at 1-888-835-2555.

For more information, call 1-844-NSPRYNG.

For additional safety information, please see the full Prescribing Information and Medication Guide.