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Rystiggo Infusion Treatment for Generalized Myasthenia Gravis

TwelveStone Health Partners coordinates and provides Rystiggo treatment for eligible adults with generalized myasthenia gravis (gMG) who are anti-AChR or anti-MuSK antibody positive. Patients receive clinically supervised care in private infusion suites across 30+ locations in the Southeast.

Our clinical team simplifies the onboarding process by coordinating with your neurologist, managing treatment scheduling, and helping navigate benefits verification and prior authorization. We handle these administrative steps so you have a clearer path from referral to treatment.

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Who Qualifies for Rystiggo Treatment?

Rystiggo (rozanolixizumab-noli) is an FDA-approved neonatal Fc receptor (FcRn) blocker for adults with generalized myasthenia gravis who are anti-AChR or anti-MuSK antibody positive. By blocking FcRn, Rystiggo reduces circulating IgG levels, including the disease-causing autoantibodies involved in gMG. 

Rystiggo is administered as a subcutaneous infusion using an infusion pump rather than through an IV. The medication is prepared and administered by a healthcare professional. Once your neurologist determines that Rystiggo is appropriate and sends the treatment order, TwelveStone can begin coordinating authorization, scheduling, and treatment.

A Rystiggo treatment cycle consists of one subcutaneous infusion each week for six consecutive weeks, with the dose based on body weight. After the six-dose cycle, your neurologist determines whether and when another cycle is appropriate based on your clinical response. The safety of starting a subsequent cycle sooner than 63 days from the start of the previous cycle has not been established.

What If I Miss a Rystiggo Dose?

If you miss a scheduled Rystiggo dose, contact your neurologist or TwelveStone care team as soon as possible. Rystiggo may be administered up to four days after the scheduled dose; after that, the original weekly dosing schedule should resume until the six-dose treatment cycle is complete.

What to Expect During Rystiggo Infusion Treatment

Patient receiving Rystiggo infusion treatment for generalized myasthenia gravis in an outpatient clinic.

A typical Rystiggo visit includes check-in, medication preparation, subcutaneous administration, and a brief monitoring period.

  1. Check-in and dose confirmation. Your care team reviews your treatment order, records your vital signs, and confirms the prescribed dose.
  2. Medication preparation. The clinical team prepares Rystiggo for administration based on your prescribed weight-based dose.
  3. Subcutaneous infusion. A healthcare professional administers Rystiggo through an infusion pump in the lower abdomen below the navel. Once prepared, the infusion takes about 15 minutes for many patients, although administration time can vary by dose and provider.
  4. Post-infusion monitoring. Your care team monitors you during treatment and for at least 15 minutes after the infusion for signs of a hypersensitivity reaction.

Rystiggo treatments at TwelveStone take place in private infusion suites designed for comfort, with recliners, Wi-Fi, television, and refreshments available at many locations. Our nurses and clinical pharmacy team support you throughout treatment, and optional chaplain support is available for patients who would like spiritual care as part of their experience.

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Rystiggo Side Effects and Safety Monitoring

Rystiggo may increase the risk of infection, so your care team will review for active infections before treatment and monitor for signs of infection during your treatment cycle. Before a new cycle begins, your prescribing team should also review whether age-appropriate vaccinations are needed. Live or live-attenuated vaccines are not recommended during Rystiggo treatment.

Common Rystiggo Side Effects

The most common adverse reactions reported with Rystiggo include:

  • Headache
  • Infections
  • Diarrhea
  • Fever
  • Hypersensitivity reactions
  • Nausea

When to Contact Your Healthcare Provider

Tell your healthcare provider right away if you develop symptoms of an infection, aseptic meningitis, or a hypersensitivity reaction during or after treatment, including:

  • Signs of infection, such as fever, chills, cough, shortness of breath, or painful or frequent urination
  • Symptoms of aseptic meningitis, such as a severe headache, neck stiffness, fever, sensitivity to light, nausea, or vomiting
  • Signs of a hypersensitivity reaction, such as swelling, rash, or another unexpected reaction during or after treatment

During each visit, our nurses monitor you for treatment reactions and document your clinical response. Our team also coordinates with your referring neurologist and shares relevant treatment updates to support continuity of care.

Rystiggo Insurance, Prior Authorization, and Scheduling

Getting started with Rystiggo at TwelveStone begins after your prescribing neurologist sends the treatment order and required clinical documentation. Insurance requirements vary by plan, so our care coordinators and financial specialists help manage the steps needed before your first treatment, which may include:

  • Benefits verification to confirm your plan requirements and anticipated patient responsibility
  • Prior authorization support, including required clinical documentation when authorization is needed
  • Financial assistance screening, including applicable manufacturer support programs for eligible patients
  • Treatment scheduling for your six-dose Rystiggo cycle at an appropriate TwelveStone location

Out-of-pocket costs vary based on your insurance plan, deductible, coinsurance, and coverage requirements. Before treatment begins, our financial specialists review your benefits and explain your anticipated patient responsibility. 

Once authorization requirements are complete, our team coordinates scheduling across our infusion treatments network of 30+ locations in the Southeast. 

Start Your Rystiggo Intake

Frequently Asked Questions About Rystiggo Treatment

No. Rystiggo is not administered intravenously. It is given as a subcutaneous infusion through an infusion pump, with the medication delivered under the skin of the lower abdomen below the navel. A healthcare professional administers the medication and monitors you during treatment and for 15 minutes after the infusion is complete.

Once Rystiggo has been prepared, the subcutaneous infusion takes about 15 minutes for many patients. Your appointment will be longer because it also includes check-in, medication preparation, and at least 15 minutes of monitoring after the infusion. Total visit time can vary based on your prescribed dose and the clinical preparation required, so your TwelveStone care team can tell you how much time to allow when scheduling.

The most common side effects reported with Rystiggo include headache, infections, diarrhea, fever, hypersensitivity reactions, and nausea. Contact your healthcare provider right away if you develop signs of an infection, symptoms of aseptic meningitis such as a severe headache with neck stiffness or fever, or signs of a hypersensitivity reaction such as swelling or rash.

Rystiggo requires a prescription from an appropriate healthcare provider. To begin treatment at TwelveStone, your prescribing neurologist sends the treatment order or referral along with the clinical documentation needed for intake and insurance review. Our team then coordinates any applicable authorization requirements and scheduling.

Insurance coverage for Rystiggo varies by health plan and may be subject to prior authorization or other coverage requirements. Before treatment, TwelveStone verifies your benefits, determines whether authorization is required, and helps you understand your anticipated financial responsibility. Our team can also review manufacturer or other financial assistance options when you meet the applicable eligibility requirements.

Rystiggo, Vyvgart, and Vyvgart Hytrulo all target the neonatal Fc receptor (FcRn), but they use different medications and administration methods. Rystiggo is a weight-based subcutaneous infusion delivered by pump once weekly for six weeks. 

Vyvgart is administered as an IV infusion once weekly for four weeks, while Vyvgart Hytrulo is a subcutaneous injection given once weekly for four weeks. Rystiggo is FDA-approved for adults with gMG who are anti-AChR or anti-MuSK antibody positive, while Vyvgart and Vyvgart Hytrulo are approved for adults with gMG regardless of antibody subtype. 

Your neurologist will consider your diagnosis, treatment history, clinical needs, and preferences when determining which option is appropriate.

Before your Rystiggo appointment, follow any instructions provided by your neurologist and TwelveStone care team. Wear comfortable clothing that allows access to the lower abdomen, where the medication is administered. Make sure your care team has an up-to-date list of your prescription and over-the-counter medications, vitamins, and supplements, and tell them about any current infection, recent or planned vaccinations, or other changes in your health before treatment. 

chronic condition patient discussing managing care with nurse

If your neurologist has prescribed Rystiggo or you need help understanding the next steps, TwelveStone Health Partners can guide you through intake, benefits verification, applicable prior authorization requirements, and treatment scheduling. Contact our coordination team to begin the process at a TwelveStone infusion center near you.

Contact Our Coordination Team