Treatment Overview

Living with Autoimmune Hemolytic Anemia (AIHA) can feel like an exhausting rollercoaster. One day you may feel relatively normal, and the next, you might experience profound fatigue, shortness of breath, or dizziness as your red blood cell count drops. It is a condition where the body’s immune system mistakenly identifies its own red blood cells as foreign invaders and destroys them faster than the bone marrow can replace them. This internal conflict can be confusing and isolating, but effective treatments are available to bring the immune system back into balance.

Treatment is essential to stop the destruction of red blood cells (hemolysis) and restore healthy oxygen levels in the body. Without intervention, severe anemia can strain the heart and other organs. Because AIHA comes in different forms primarily “warm” antibody types and “cold” antibody types, treatment is not one-size-fits-all. A hematologist will tailor the medication plan based on the specific type of antibodies involved and the severity of the symptoms (National Heart, Lung, and Blood Institute, 2022).

Overview of treatment options for Autoimmune Hemolytic Anemia

The primary goal of treating AIHA is to halt the immune attack on red blood cells and manage the anemia. For many patients, especially those with the warm antibody type, the condition is treated as a chronic autoimmune disorder requiring long-term management.

The initial approach almost always relies on medication to suppress the overactive immune response. While blood transfusions may be used in emergencies to stabilize a patient, they provide only temporary relief and can be technically difficult due to the antibodies present in the blood. In cases where medications are ineffective, doctors may consider a splenectomy (surgical removal of the spleen), as this is where many red blood cells are destroyed. However, medication remains the cornerstone of first-line therapy.

Medications used for Autoimmune Hemolytic Anemia

For “warm” AIHA, corticosteroids are the standard first-line treatment. Drugs like prednisone or dexamethasone are prescribed to rapidly suppress the immune system. Clinical experience suggests that a majority of patients with warm AIHA respond well to high-dose steroids within a few weeks. Once the red blood cell count stabilizes, the dose is slowly tapered down over months to avoid relapses.

If steroids are ineffective, or if the side effects are too severe, doctors often prescribe rituximab. This is a monoclonal antibody administered via intravenous infusion. It is increasingly used as a second-line option and is also a primary treatment for “cold” agglutinin disease, which typically does not respond well to steroids.

For patients who do not respond to these therapies, other immunosuppressive drugs may be introduced. These include azathioprine, cyclophosphamide, or cyclosporine. Recently, the FDA approved sutimlimab, a specialized therapy specifically for treating hemolysis in adults with cold agglutinin disease. This drug targets a different part of the immune system to prevent cell destruction (FDA, 2022).

How these medications work

Corticosteroids work by broadly dampening the immune system. They reduce the production of the antibodies that “tag” red blood cells for destruction and interfere with the macrophages (immune cells) that eat these tagged cells. This gives the red blood cells a chance to survive longer in circulation.

Rituximab works more precisely by targeting B-cells, which are the white blood cells responsible for manufacturing antibodies. By reducing the number of B-cells, the production of the harmful autoantibodies decreases.

Sutimlimab works by inhibiting the “complement” system, a specific cascade of proteins that destroys cells in cold agglutinin disease. By blocking this specific pathway, it prevents the red blood cells from rupturing, even if the cold antibodies are still present (MedlinePlus, 2021).

Side effects and safety considerations

Long-term corticosteroid use has significant side effects, including weight gain, high blood sugar, mood swings, fluid retention, and increased infection risk. Doctors therefore aim to lower the dose safely and quickly.

Rituximab and other immunosuppressants decrease infection-fighting ability. Patients may need pre-treatment vaccinations (e.g., for pneumonia or meningitis) and must monitor closely for fever. Infusion reactions, such as chills or low blood pressure, can occur with rituximab. Seek immediate medical attention for signs of severe anemia (fainting, chest pain, rapid heartbeat).

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

  1. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov
  2. Food and Drug Administration. https://www.fda.gov
  3. MedlinePlus. https://medlineplus.gov
  4. Mayo Clinic. https://www.mayoclinic.org

Medications for Autoimmune Hemolytic Anemia

These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Autoimmune Hemolytic Anemia.

Found 6 Approved Drugs for Autoimmune Hemolytic Anemia

MethylPREDNISolone

Brand Names
Solu-Medrol MethylPREDNISolone, Solu-Medrol, Medrol

MethylPREDNISolone

Brand Names
Solu-Medrol MethylPREDNISolone, Solu-Medrol, Medrol
Form: Injection, Tablet
Method of administration: Oral, Intravenous, Intramuscular
FDA approval date: October 24, 1957
Classification: Corticosteroid
When oral therapy is not feasible, and the strength, dosage form, and route of administration of the drug reasonably lend the preparation to the treatment of the condition, the intravenous or intramuscular use of Methylprednisolone Sodium Succinate for Injection, USP, is indicated as follows: Allergic states Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions. Dermatologic diseases Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome). Endocrine disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis. Gastrointestinal diseases To tide the patient over a critical period of the disease in regional enteritis (systemic therapy) and ulcerative colitis. Hematologic disorders Acquired (autoimmune) hemolytic anemia, congenital (erythroid) hypoplastic anemia (Diamond-Blackfan anemia), idiopathic thrombocytopenic purpura in adults (intravenous administration only; intramuscular administration is contraindicated), pure red cell aplasia, selected cases of secondary thrombocytopenia. Miscellaneous Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy. Neoplastic diseases For the palliative management of leukemias and lymphomas. Nervous System Acute exacerbations of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor, or craniotomy. Ophthalmic diseases Sympathetic ophthalmia, uveitis and ocular inflammatory conditions unresponsive to topical corticosteroids. Renal diseases To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome or that due to lupus erythematosus. Respiratory diseases Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis. Rheumatic disorders As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, temporal arteritis, polymyositis, and systemic lupus erythematosus.

Solu-Cortef

Generic Name
Solu-Cortef

Solu-Cortef

Generic Name
Solu-Cortef
Form: Injection
Method of administration: Intravenous, Intramuscular
FDA approval date: April 27, 1955
Classification: Corticosteroid
When oral therapy is not feasible, and the strength, dosage form, and route of administration of the drug reasonably lend the preparation to the treatment of the condition, the intravenous or intramuscular use of hydrocortisone sodium succinate for injection is indicated as follows: Allergic states: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, serum sickness, transfusion reactions. Dermatologic diseases: Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome). Endocrine disorders: Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis. Gastrointestinal diseases: To tide the patient over a critical period of the disease in regional enteritis (systemic therapy) and ulcerative colitis. Hematologic disorders: Acquired (autoimmune) hemolytic anemia, congenital (erythroid) hypoplastic anemia (Diamond Blackfan anemia), idiopathic thrombocytopenic purpura in adults (intravenous administration only; intramuscular administration is contraindicated), pure red cell aplasia, select cases of secondary thrombocytopenia. Miscellaneous: Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy. Neoplastic diseases: For the palliative management of leukemias and lymphomas. Nervous System: Cerebral edema associated with primary or metastatic brain tumor, or craniotomy. Ophthalmic diseases: Sympathetic ophthalmia, uveitis and ocular inflammatory conditions unresponsive to topical corticosteroids. Renal diseases: To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome, or that due to lupus erythematosus. Respiratory diseases: Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis. Rheumatic disorders: As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, temporal arteritis, polymyositis, and systemic lupus erythematosus.

Enjaymo

Generic Name
Sutimlimab-Jome

Enjaymo

Generic Name
Sutimlimab-Jome
Form: Injection
Method of administration: Intravenous
FDA approval date: February 04, 2022
Classification: Classical Complement Pathway Inhibitor
ENJAYMO is a classical complement inhibitor indicated for the treatment of hemolysis in adults with cold agglutinin disease (CAD). ( 1 ) Cold Agglutinin Disease ENJAYMO (sutimlimab-jome) is indicated for the treatment of hemolysis in adults with cold agglutinin disease (CAD).

MethylPREDNISolone Acetate

Brand Names
Medroloan, Medroloan SUIK, Depo-Medrol, Dyural

MethylPREDNISolone Acetate

Brand Names
Medroloan, Medroloan SUIK, Depo-Medrol, Dyural
Form: Injection, Kit
Method of administration: Intra-articular, Intramuscular, Intrasynovial, Intralesional, Soft Tissue, Infiltration, Topical, Intrameningeal, Intra-arterial
FDA approval date: May 28, 1959
Classification: Corticosteroid
A. FOR INTRAMUSCULAR ADMINISTRATION When oral therapy is not feasible and the strength, dosage form, and route of administration of the drug reasonably lend the preparation to the treatment of the condition, the intramuscular use of Methylprednisolone Acetate Injectable Suspension is indicated as follows: A llergic States : Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, serum sickness, transfusion reactions. De rmatologic Diseases : Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome). E ndocrine Disorders : Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis. G astrointestinal Diseases : To tide the patient over a critical period of the disease in regional enteritis (systemic therapy) and ulcerative colitis. Hem atologic Disorders : Acquired (autoimmune) hemolytic anemia, congenital (erythroid) hypoplastic anemia (Diamond Blackfan anemia), pure red cell aplasia, select cases of secondary thrombocytopenia. M iscellaneous : Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy. Neoplastic Diseases : For palliative management of leukemias and lymphomas. Nervous System : Cerebral edema associated with primary or metastatic brain tumor or craniotomy. O phthalmic Diseases : Sympathetic ophthalmia, temporal arteritis, uveitis and ocular inflammatory conditions unresponsive to topical corticosteroids. Re nal Diseases : To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome, or that due to lupus erythematosus. Re spiratory Diseases : Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis. R heumatic Disorders : As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, polymyositis, and systemic lupus erythematosus. B. FOR INTRA-ARTICULAR OR SOFT TISSUE ADMINISTRATION (See WARNINGS) Methylprednisolone Acetate Injectable Suspension is indicated as adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis of osteoarthritis. C. FOR INTRALESIONAL ADMINISTRATION Methylprednisolone Acetate Injectable Suspension is indicated for intralesional use in alopecia areata, discoid lupus erythematosus, keloids, localized hypertrophic, infiltrated, inflammatory lesions of granuloma annulare, lichen planus, lichen simplex chronicus (neurodermatitis), and psoriatic plaques, necrobiosis lipoidica diabeticorum. Methylprednisolone Acetate Injectable Suspension also may be useful in cystic tumors of an aponeurosis or tendon (ganglia).

Multi-Specialty

Generic Name
Depo-Medrol

Multi-Specialty

Generic Name
Depo-Medrol
Form: Kit
Method of administration: Intra-articular, Infiltration, Topical, Intramuscular, Intralesional, Soft Tissue
FDA approval date: February 06, 2014
Lidocaine Hydrochloride Injection, USP is indicated for production of local or regional anesthesia by infiltration techniques such as percutaneous injection and intravenous regional anesthesia by peripheral nerve block techniques such as brachial plexus and intercostal and by central neural techniques such as lumbar and caudal epidural blocks, when the accepted procedures for these techniques as described in standard textbooks are observed. A. For Intramuscular Administration When oral therapy is not feasible and the strength, dosage form, and route of administration of the drug reasonably lend the preparation to the treatment of the condition, the intramuscular use of DEPO-MEDROL Sterile Aqueous Suspension is indicated as follows: Allergic States : Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, seasonal or perennial allergic rhinitis, serum sickness, transfusion reactions. Dermatologic Diseases : Bullous dermatitis herpetiformis, exfoliative dermatitis, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome). Endocrine Disorders : Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsupportive thyroiditis. Gastrointestinal Diseases : To tide the patient over a critical period of the disease in regional enteritis (systemic therapy) and ulcerative colitis. Hematologic Disorders : Acquired (autoimmune) hemolytic anemia, congenital (erythroid) hypoplastic anemia (Diamond Blackfan anemia), pure red cell aplasia, select cases of secondary thrombocytopenia. Miscellaneous : Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculous chemotherapy. Neoplastic Diseases : For palliative management of: leukemias and lymphomas. Nervous System : Acute exacerbations of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor or craniotomy. Ophthalmic Diseases : Sympathetic opthalmia, temporal arteritis, uveitis, ocular inflammatory conditions unresponsive to topical corticosteroids. Renal Diseases : To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome, or that due to lupus erythematosus. Respiratory Diseases : Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis. Rheumatic Disorders : As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, polymyositis, and systemic lupus erythematosus. B. For Intra-articular Or Soft Tissue Administration (See WARNINGS ) DEPO-MEDROL is indicated as adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis of osteoarthritis. C. For Intralesional Administration DEPO-MEDROL is indicated for intralesional use in alopecia areata, discoid lupus erythematosus; keloids, localized hypertrophic, infiltrated inflammatory lesions of granuloma annulare, lichen planus, lichen simplex chronicus (neurodermatitis) and psoriatic plaques; necrobiosis lipoidica diabeticorum. DEPO-MEDROL also may be useful in cystic tumors of an aponeurosis or tendon (ganglia). For first aid to decrease germs in minor cuts scrapes burns For preparation of the skin prior to injection.
Showing 1-5 of 6
Not sure about your diagnosis?
Check Your Symptoms
Tired of the same old research?
Check Latest Advances