Think Fabrazyme first, think a potential reduction of clinically significant events for your patients1
The rate of clinically significant events in Fabrazyme-treated patients vs. placebo-treated patients1
Adapted from Banikazemi M et al. 2007.1
*Clinical event defined as renal, cardiac, or cerebrovascular event or death.2
**HR 0.57, 95% CI: 0.27, 1.22, p=0.14.1.1,2
α-GAL A, α-galactosidase A; CI, confidence interval; EOW, every other week; HR, hazard ratio; ITT, intent-to-treat; IV, intravenous.
experienced clinical events*2
43%
relative risk reduction of renal, cardiac and cerebrovascular clinical events and death in the unadjusted ITT population of Fabrazyme®-treated patients vs. placebo**2
Study 2: A multicenter, randomized, double-blind, placebo-controlled study in which 82 patients (72 males and 10 females) were randomized 2:1 to receive either agalsidase beta (1 mg/kg, n=51) or placebo (n=31) EOW for up to 35 months. The study included patients aged 20 to 72 years (median age: 45), with a baseline median plasma α-GAL A level of 1.5 nmol/hour/mL (range: 0 to 1.5). The primary endpoint was time to first clinical event (renal, cardiac, or cerebrovascular event or death). Secondary analysis of protocol-adherent patients with mild-to-moderate kidney dysfunction at baseline who were adjusted for baseline proteinuria.1
Think Fabrazyme first, think decreased incidence of severe clinical events over time3
Registry data: Incidence of combined severe clinical events in patients on ERT for up to 5 years*3
Adapted from Ortiz A et al. 2016.3
*Information on the Fabry Registry is voluntary. The Fabry Registry includes patients with a variable range of disease status and management.
†Compared with patients aged <40 years at first ERT, patients aged >40 years at first ERT had a significantly higher risk (based on a Cox proportional hazards regression analysis) of having an event during 0-0.5 year (Model 1: HR 4.4, 95% Cl 2.2 to 8.7, p<0.01), but this decreased during the period >0.5-5 years (Model 2: HR 2.5, 95% Cl 1.7 to 3.8, p<0.01).3
‡Model 1: HR 1.1, 95% Cl 0.6 to 2.0, p=0.81.3
§Model 2: HR 1.8, 95% Cl 1.2 to 2.7, p<0.01.3
Cl, confidence interval; EOW, every other week; ERT, enzyme replacement therapy; HR, hazard ratio.
- After 6 months of Fabrazyme, the rate of severe clinical events decreased from 111 to 40-58 events per 1000 patient-years and remained stable for the remainder of the follow-up period3
- The largest decrease in incidence rates was among male patients and those aged ≥40 years when Fabrazyme was initiated†3
- Among patients with pre-ERT clinical events, the risk of developing an event after starting Fabrazyme was not significantly different during 0-0.5 year compared with those who had no previous clinical events,‡ but increased thereafter§3
- Retrospective, observational study analyzing the incidence of combined severe clinical events (renal events, cardiovascular events, cerebrovascular events) in 1044 adult patients (641 men, 403 women) enrolled in the Fabry Registry who received Fabrazyme (1 mg/kg every 2 weeks) for up to 5 years3
- Models were run to assess if the incidence of events according to factors associated with severe clinical events were time-dependent3
- Model 1 examined risk factors within the first 6 months (0-0.5 years of Fabrazyme treatment)
- Model 2 examined risk factors within 6 months to 5 years (0.5-5 years of Fabrazyme treatment)
IMPORTANT SAFETY INFORMATION
IMPORTANT SAFETY INFORMATION
WARNING: HYPERSENSITIVITY REACTIONS INCLUDING ANAPHYLAXIS Patients treated with enzyme replacement therapies have experienced life-threatening hypersensitivity reactions, including anaphylaxis. Anaphylaxis has occurred during the early course of enzyme replacement therapy and after extended duration of therapy. Initiate FABRAZYME in a healthcare setting with appropriate medical monitoring and support measures, including access to cardiopulmonary resuscitation equipment. If a severe hypersensitivity reaction (e.g. anaphylaxis) occurs, discontinue FABRAZYME and immediately initiate appropriate medical treatment, including use of epinephrine. Inform patients of the symptoms of life-threatening hypersensitivity reactions, including anaphylaxis and to seek immediate medical care should symptoms occur [see Warnings and Precautions (5.1)]. |
WARNINGS AND PRECAUTIONS
Hypersensitivity Reactions Including Anaphylaxis
In clinical trials and post-marketing experience, approximately 1% of patients developed anaphylactic or severe hypersensitivity reactions, some life-threatening, during Fabrazyme infusion. Reactions have included localized angioedema (including swelling of the face, mouth, and throat), bronchospasm, hypotension, generalized urticaria, dysphagia, rash, dyspnea, flushing, chest discomfort, pruritus, and nasal congestion. Consider pretreating with antihistamines, antipyretics, and/or corticosteroids; however, reactions may still occur.
In Fabrazyme clinical trials, some patients developed IgE antibodies or skin test reactivity specific to Fabrazyme.
- Higher incidences of hypersensitivity reactions were observed in adult patients with persistent anti-Fabrazyme antibodies, and in those with high antibody titers compared with antibody negative adult patients.
- Consider testing for IgE antibodies in patients who experienced suspected hypersensitivity reactions and consider the risks and benefits of continued treatment in patients with anti-Fabrazyme IgE antibodies. Rechallenge of these patients should only occur under the direct supervision of qualified personnel, with appropriate medical support measures readily available.
Infusion-Associated Reactions
In Fabrazyme clinical trials, 59% of patients experienced infusion-associated reactions (IARs), some of which were severe. IARs are defined as those occurring on the same day as the infusion. The incidence of these reactions was higher in patients who were positive for anti-Fabrazyme antibodies than those negative for anti-Fabrazyme antibodies.
- Consider pretreatment with antipyretics, antihistamines, and/or corticosteroids to reduce the risk of IARs; however, they may still occur.
- If a mild or moderate IAR occurs, consider holding the infusion temporarily, decreasing the infusion rate, and/or reducing the Fabrazyme dosage. If a severe IAR occurs, discontinue Fabrazyme immediately and initiate appropriate medical treatment as needed. Assess the risks and benefits of readministering Fabrazyme and monitor patients closely if readministering.
- Patients with advanced Fabry disease may have compromised cardiac function, which may predispose them to a higher risk of severe complications from IARs. Closely monitor patients with compromised cardiac function receiving Fabrazyme.
Common Adverse Reactions
Adverse reactions reported (≥20%) were upper respiratory tract infection, chills, pyrexia, headache, cough, paresthesia, fatigue, peripheral edema, dizziness, and rash.
Please see full Prescribing Information, including Boxed WARNING
IMPORTANT SAFETY INFORMATION
Show moreIMPORTANT SAFETY INFORMATION
WARNING: HYPERSENSITIVITY REACTIONS INCLUDING ANAPHYLAXIS Patients treated with enzyme replacement therapies have experienced life-threatening hypersensitivity reactions, including anaphylaxis. Anaphylaxis has occurred during the early course of enzyme replacement therapy and after extended duration of therapy. Initiate FABRAZYME in a healthcare setting with appropriate medical monitoring and support measures, including access to cardiopulmonary resuscitation equipment. If a severe hypersensitivity reaction (e.g. anaphylaxis) occurs, discontinue FABRAZYME and immediately initiate appropriate medical treatment, including use of epinephrine. Inform patients of the symptoms of life-threatening hypersensitivity reactions, including anaphylaxis and to seek immediate medical care should symptoms occur [see Warnings and Precautions (5.1)]. |
WARNINGS AND PRECAUTIONS
Hypersensitivity Reactions Including Anaphylaxis
In clinical trials and post-marketing experience, approximately 1% of patients developed anaphylactic or severe hypersensitivity reactions, some life-threatening, during Fabrazyme infusion. Reactions have included localized angioedema (including swelling of the face, mouth, and throat), bronchospasm, hypotension, generalized urticaria, dysphagia, rash, dyspnea, flushing, chest discomfort, pruritus, and nasal congestion. Consider pretreating with antihistamines, antipyretics, and/or corticosteroids; however, reactions may still occur.
In Fabrazyme clinical trials, some patients developed IgE antibodies or skin test reactivity specific to Fabrazyme.
- Higher incidences of hypersensitivity reactions were observed in adult patients with persistent anti-Fabrazyme antibodies, and in those with high antibody titers compared with antibody negative adult patients.
- Consider testing for IgE antibodies in patients who experienced suspected hypersensitivity reactions and consider the risks and benefits of continued treatment in patients with anti-Fabrazyme IgE antibodies. Rechallenge of these patients should only occur under the direct supervision of qualified personnel, with appropriate medical support measures readily available.
Infusion-Associated Reactions
In Fabrazyme clinical trials, 59% of patients experienced infusion-associated reactions (IARs), some of which were severe. IARs are defined as those occurring on the same day as the infusion. The incidence of these reactions was higher in patients who were positive for anti-Fabrazyme antibodies than those negative for anti-Fabrazyme antibodies.
- Consider pretreatment with antipyretics, antihistamines, and/or corticosteroids to reduce the risk of IARs; however, they may still occur.
- If a mild or moderate IAR occurs, consider holding the infusion temporarily, decreasing the infusion rate, and/or reducing the Fabrazyme dosage. If a severe IAR occurs, discontinue Fabrazyme immediately and initiate appropriate medical treatment as needed. Assess the risks and benefits of readministering Fabrazyme and monitor patients closely if readministering.
- Patients with advanced Fabry disease may have compromised cardiac function, which may predispose them to a higher risk of severe complications from IARs. Closely monitor patients with compromised cardiac function receiving Fabrazyme.
Common Adverse Reactions
Adverse reactions reported (≥20%) were upper respiratory tract infection, chills, pyrexia, headache, cough, paresthesia, fatigue, peripheral edema, dizziness, and rash.
Please see full Prescribing Information, including Boxed WARNING
INDICATION AND USAGE
Fabrazyme® is indicated for the treatment of adult and pediatric patients 2 years of age and older with confirmed Fabry disease.
References: 1. Banikazemi M et al. Ann Intern Med 2007;146:77–86. 2. Fabrazyme® (agalsidase beta). Prescribing Information 2024. 3. Ortiz A et al. J Med Genet 2016;53(7):495-502.