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Aldurazyme 100 U/ml concentrate for solution for infusionPat
2014-06-20 16:47:00 来源: 作者: 【 】 浏览:422次 评论:0

For doctors

 

What is it and how is it used?

Aldurazyme is used to treat patients with MPS I disease (Mucopolysaccharidosis I). It is given to treat the non-neurological manifestations of the disease.

People with MPS I disease have either a low level or no level of an enzyme called α-L-iduronidase, which breaks down specific substances (glycosaminoglycans) in the body. As a result, these substances do not get broken down and processed by the body as they should. They accumulate in many tissues in the body, which causes the symptoms of MPS I.

Aldurazyme is an artificial enzyme called laronidase. This can replace the natural enzyme which is lacking in MPS I disease.

What do you have to consider before using it?

Do not use Aldurazyme
If you are allergic (hypersensitive) to any of the ingredients of Aldurazyme or if you have experienced a severe allergic reaction to laronidase.

Take special care with Aldurazyme
If you are treated with Aldurazyme, you may develop infusion-associated reactions. An infusion-associated reaction is any side effect occurring during the infusion or until the end of the infusion day (see 4 “Possible Side Effects”). Some of these reactions may be severe. When you experience such a reaction, you should immediately contact your doctor.

If these reactions occur, the Aldurazyme infusion should be stopped immediately and appropriate treatment will be started by your doctor.
These reactions may be particularly severe if you have a pre-existing MPS I-related upper airway obstruction.
You may be given additional medication such as antihistamines and paracetamol to help prevent allergic-type reactions.

Using other medicines
Please inform your doctor if you use medicines containing chloroquine or procaine, due to a possible risk of decreasing the action of Aldurazyme.

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Pregnancy and breast-feeding
There is not enough experience of the use of Aldurazyme in pregnant women. Aldurazyme should not be used during pregnancy unless clearly necessary. Ask your doctor or pharmacist for advice before taking any medicine.

It is not known whether Aldurazyme appears in breast milk. It is recommended to stop breast-feeding during treatment with Aldurazyme. Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines
The effects on the ability to drive and to use machines have not been studied.

Important information about some of the ingredients of Aldurazyme
This medicinal product contains 1.29 mmol sodium per vial. To be taken into consideration by patients on a controlled sodium diet.

How is it used?

Instruction for use - dilution and administration
The concentrate for solution for infusion has to be diluted before administration and is for intravenous use (see information for health care professionals).
Administration of Aldurazyme should be carried out in an appropriate clinical setting where resuscitation equipment to manage medical emergencies would be readily available.

Dosage
The recommended dosage regimen of Aldurazyme is 100 U/kg body weight given once every week as an intravenous infusion. The initial infusion rate of 2 U/kg/h may be gradually increased every fifteen minutes, if tolerated, to a maximum of 43 U/kg/h. The total volume of the administration should be delivered in approximately 3-4 hours.

If you forget to use Aldurazyme
If you have missed an Aldurazyme infusion, please contact your doctor.

If you use more Aldurazyme than you should
No case of overdose of Aldurazyme has been reported.

What are possible side effects?

Like all medicines, Aldurazyme can cause side effects, although not everybody gets them.

Side effects were mainly seen while patients were being given the medicine or shortly after (infusion-associated reactions). If you experience any reaction like this, please tell your doctor immediately. The number of these reactions decreased the longer that patients were on Aldurazyme. The majority of these reactions were mild or moderate in intensity. However, a few patients who had a prior history of severe MPS I related upper airway and pulmonary involvement, experienced severe reactions including bronchospasm, respiratory arrest, and swelling of the face.

The following side effects have been reported:

Very common (occurring in more than 1 in 10 patients)

Common (occurring in more than 1 in 100 patients and less than 1 in 10 patients)

Unknown frequency

If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.

How should it be stored?

Keep out of the reach and sight of children.

Do not use Aldurazyme after the expiry date which is stated on the label after the letters EXP.

Unopened vials:
Store in a refrigerator (2°C – 8°C).

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

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For doctors

What is it?

Aldurazyme is a solution for infusion (drip into a vein) that contains the active substance laronidase.

What is it used for?

Aldurazyme is used in patients with a confirmed diagnosis of mucopolysaccharidosis I (MPS I; α-L-iduronidase deficiency) to treat the non-neurological symptoms of the disease (symptoms that are not connected with the brain or nerves). MPS I is a rare, inherited disease, in which the level of α-L-iduronidase enzyme activity is much lower than normal. This means that substances called glycosaminoglycans (GAGs) are not broken down, so they build up in most of the organs in the body and damage them. The non-neurological symptoms of MPS I can be an enlarged liver, stiff joints that make moving more difficult, reduced lung volume, heart disease and eye disease.
Because the number of patients with MPS I is low, the disease is considered ‘rare’, and Aldurazyme was designated an ‘orphan medicine’ (a medicine used in rare diseases) on 14 February 2001. The medicine can only be obtained with a prescription.

How is it used?

Aldurazyme treatment should be supervised by a doctor who has experience in the management of patients with MPS I or other inherited metabolic diseases. Aldurazyme should be given in a hospital or clinic where resuscitation equipment is available, and patients may need to receive some medicines before the infusion to prevent an allergic reaction. Aldurazyme is given once a week as an infusion. It is designed for long-term use.

How does it work?

The active substance in Aldurazyme, laronidase, is a copy of the human enzyme α-L-iduronidase. It is produced by a method known as ‘recombinant DNA technology’: the enzyme is made by a cell that has received a gene (DNA), which makes it able to produce laronidase. Laronidase is used as ‘enzyme replacement therapy’, which means that it replaces the enzyme that is missing in patients with MPS I. This controls the symptoms of MPS I, improving the patient’s quality of life.

How has it been studied?

Aldurazyme has been compared with placebo (a dummy treatment) in 45 patients aged five years and over with a confirmed diagnosis of MPS I. The main measure of effectiveness was the forced vital capacity (FVC, a measure of how well the lungs are working) and the distance the patients could walk over six minutes. These were measured before and after 26 weeks of treatment. After this, the study continued for up to four years and all of the patients were treated with Aldurazyme. Aldurazyme has also been studied in 20 children below the age of five years who received Aldurazyme for a year. The study was looking mainly at the safety of the medicine, but it also measured its ability to reduce the levels of GAGs in the urine and the size of the liver.

What benefits has it shown during the studies?

The study showed that Aldurazyme had improved both the FVC and the walking ability of patients at 26 weeks. This effect was maintained for up to four years.
In children under five years of age, Aldurazyme reduced the levels of GAGs in the urine by about 60%. Half of the children treated had a normal size liver at the end of the study.

What is the risk associated?

Most of the side effects seen with Aldurazyme are reactions caused by the infusion rather than the medicine itself. Some of these are severe, but the number of side effects tends to decrease with time. The most common side effects in patients over the age of five years (seen in more than 1 patient in 10) are headache, nausea (feeling sick), abdominal pain (stomach ache), rash, arthropathy (damage to the joints), arthralgia (joint pain), back pain, pain in the extremities (hands and feet), flushing, pyrexia (fever) and reactions at the site of the infusion. In patients under five years of age, the most common side effects (seen in more than 1 patient in 10) are increased blood pressure, decreased oxygen saturation (a measure of how well the lungs are working), tachycardia (rapid heart rate), pyrexia and chills. For the full list of all side effects reported with Aldurazyme, see the Package Leaflet. Almost all patients who receive Aldurazyme develop antibodies (proteins that are produced in response to Aldurazyme). The effect of these on the safety and effectiveness of the medicine is not fully known.
Aldurazyme should not be used in people who may have a severe allergic reaction (such as an anaphylactic reaction) to laronidase or any of the other ingredients.

Why has it been approved?

The Committee for Medicinal Products for Human Use (CHMP) decided that Aldurazyme gives effective control of the symptoms of MPS I. The Committee decided that Aldurazyme’s benefits are greater than its risks for long-term enzyme replacement therapy in patients with a confirmed diagnosis of MPS I. The Committee recommended that Aldurazyme be given marketing authorisation. Aldurazyme has been authorised under ‘Exceptional Circumstances’. This means that, because the disease is rare, it has not been possible to obtain complete information about Aldurazyme. Every year, the European Medicines Agency will review any new information that may become available and this summary will be updated as necessary.

How has it been studied?

The company that makes Aldurazyme will monitor patients receiving Aldurazyme, looking at reactions to the infusion and the development of antibodies.

Further information

The European Commission granted a marketing authorisation valid throughout the European Union for Aldurazyme to Genzyme Europe B.V. on 10 June 2003. The marketing authorisation was renewed on 10 June 2008.

The summary of opinion of the Committee for Orphan Medicinal Products for Aldurazyme is available here.

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Name

 

Aldurazyme 100 U/ml concentrate for solution for infusion

 

Composition

 

1 ml contains 100 U (approximately 0.58 mg) of laronidase.
Each vial of 5 ml contains 500 U of laronidase.

The activity unit (U) is defined as the hydrolysis of one micromole of substrate (4-MUI) per minute.

Laronidase is a recombinant form of human α-L-iduronidase and is produced by recombinant DNA technology using mammalian Chinese Hamster Ovary (CHO) cell culture.

Excipients

Each vial of 5 ml contains 1.29 mmol sodium.

For a full list of excipients, see section 6.1.

 

Pharmaceutical Form

 

Concentrate for solution for infusion.
A clear to slightly opalescent, and colourless to pale yellow solution.

 

Are you an Healthcare Professional? Access professional drug leaflets on Diagnosia.com!

 

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