What to expect at a gMG infusion center

Last updated Jan. 2, 2025, by Mary Chapman
Fact-checked by Patrícia Silva, PhD

 

Myasthenia gravis (MG) is a neuromuscular condition that, depending on the prescribed therapy, may be treated in an infusion center.

In MG, self-reactive antibodies mistakenly target bodily proteins required for communication between nerve and muscle cells. It can cause fatigue and weakness in any muscle that is involved in the body’s voluntary movements, especially those that control eye and eyelid movements.

The most common type of MG is generalized myasthenia gravis (gMG), which is also the most severe. Muscle weakness can be widespread — not restricted to a particular muscle group — and affect the face, neck, throat, limbs, or those necessary for breathing. Often early symptoms involve the eyes.

There are treatments that can help control and relieve MG symptoms, including issues with vision, speech, mobility, and breathing. One option for medications that are given intravenously, by infusion into the bloodstream, is getting them at MG infusion centers.

What are MG infusion centers?

MG infusion centers are certified to provide a person who has MG with outpatient therapy.

The centers usually administer the infusion therapy for MG through a catheter inserted into a vein, delivering the medication directly into the bloodstream.

Infusion centers may be standalone or located in a hospital.

Available treatments

Generally, MG treatments try to restore nerve-muscle communication or to suppress the immune system’s harmful effects on the body.

The MG treatment prescribed will be determined by factors including MG type, symptom severity, and cause. The dosage and frequency of infusion therapies will depend on the therapy and the needs of the person’s disease.

There are a number of therapies approved in the U.S. that may be given as an MG infusion.

They are categorized into classes including acetylcholinesterase inhibitors or anticholinesterases. These treatments try to block the destruction of acetylcholine, which serves as a chemical messenger between muscle and nerve cells. They can enhance muscle strength.

Another class of therapies, complement inhibitors, try to control the immune activity that results in muscle weakness in adults with gMG who are positive for anti-acetylcholine receptor antibodies.

An additional option for some adults with gMG may be FcRn blockers, which can relieve symptoms by inhibiting the neonatal Fc receptor (FcRn) protein.

The receptor helps to stabilize antibodies that are ultimately responsible for MG muscle weakness and fatigue. When FcRn is inhibited, it increases the rate of elimination of self-reactive antibodies.

Intravenous immunoglobulin (IVIG) infusions can also help slow the autoimmune process. An IVIG infusion for MG is usually a treatment for when symptoms are severe or worsening quickly.

Infusion center care team

Because MG is a complex disorder, a multi-disciplinary approach is key to managing an infusion for MG. Each infusion center may have its own procedures and protocols for administering MG medications.

Your infusion center care team will include a number of healthcare professionals such as:

•     infusion nurses
•     a nurse practitioner
•     a physician assistant
•     a pharmacist.

Hospitals versus dedicated infusion centers

Traditionally, infusion therapies were only administered in hospitals, but dedicated infusion centers are now more common. These centers usually have the latest equipment as well as staff who specialize in administering infusions.

People with a chronic disorder such as MG usually spend a great deal of time in clinical environments, which can feel impersonal or even unwelcoming. Some people find hospital settings extra stressful due to experiences connected to their diagnosis or past treatments.

For some, infusion centers can be more convenient and time efficient than hospitals and easier to navigate. They’re commonly in smaller buildings and are more manageable. Care team members are more likely to get to know each person with MG.

Dedicated infusion centers commonly offer flexible hours. Some standalone centers have amenities such as private suites, recliners, high-speed internet, televisions, music, and complimentary beverages and snacks.

Some people with MG may feel more comfortable being treated in a hospital, a fully equipped and staffed medical facility that can handle any medical needs or treatment reactions.

How to find the right MG infusion center

To find the best MG infusion center for you, consider these factors:

•     available treatment options
•     comfort and amenities
•     accessibility and scheduling flexibility
•     location.

For recommendations, ask your doctor or contact support organizations such as the Myasthenia Gravis Foundation of America.

Some pharmaceutical companies may have online tools to help you find infusion centers.

You should always contact your insurance provider to know which centers are in your care network and whether there are pre-authorization requirements for treatment.

Preparing for your stay

To prepare for your infusion, call the center ahead of time to see if there is anything special you need to do.

In general, drink plenty of fluids in the days leading up to your appointment to make sure you’re well hydrated. To maintain energy levels during the infusion, eat a light meal beforehand.

Wear comfortable clothing that makes it easy to access the intravenous site. Since infusions can temporarily affect some people’s body temperature, consider wearing layers that you can remove or put back on as needed. If you feel cold during the IVIG infusions, request a blanket.

Make a list of all medications you are taking, including supplements and over-the-counter medicines. Consider bringing a book or tablet, or music to keep you occupied during your infusion, which can last a few hours.

While severe infusion side effects are rare, they can occur. Ask your doctor about the potential side effects of your infusion medications.

A healthcare professional will watch for any reactions during the procedure and monitor your vital signs during and after infusion therapy.

Additional services

Beyond infusions and a comfortable environment, some centers offer consultations with specialists about treatment options and to discuss specific concerns.

They also may offer pre-infusion evaluations to assess your status and post-infusion follow-up to monitor therapy effectiveness and address any issues.

Some centers can give you information about MG as well as have resources and support groups.

The cost of treatment

MG infusion cost can vary widely depending on the therapy dosage, administration frequency, and the site of care.

Out-of-pocket costs depend on your insurance coverage and whether the treatment center is in your plan’s network.

Survey data presented at the MDA Engage Virtual MG Symposium, held in October 2022, indicated the financial toll of MG for out-of-pocket expenses was, on average, almost $16,000 per year with medications and treatments accounting for nearly one-third of those costs.

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