Inebilizumab-cdon (Uplizna®) Injection
EVICORE-MEDICAL_DRUG-5F0EC5AF
Uplizna (inebilizumab‑cdon) is covered for adults (≥18) with anti‑aquaporin‑4 antibody–positive NMOSD and is not covered for seronegative patients or those under 18. Initial 12‑month approval requires documented seropositivity, neurologist prescribing/consultation, relapse history (≥1 in past 12 months or ≥2 in past 2 years), prior therapy with Soliris or Enspryng or prior/current use of two of azathioprine, corticosteroid, mycophenolate mofetil, or rituximab, with reauthorization requiring documented clinical benefit and dosing per label (300 mg IV x2 two weeks apart, then 300 mg IV every 6 months).
"Treatment of neuromyelitis optica spectrum disorder (NMOSD) in adult patients who are anti-aquaporin-4 antibody positive."
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