New Release: Alpha testing version has been released.

Satralizumab

L04A - Immunosuppressants ATC L04AC19 Antibody approved 2020 Parenteral First-in-class Orphan

JFDA label: Enspryng solution for injection 120mg/1ml (prefilled syringe)

Mechanism of Action

Antagonist of IL6Ralpha/GP130 — IL6Ralpha/GP130 antagonist

TargetActionGene / class
IL6Ralpha/GP130 efficacy ANTAGONIST

Indications

Approved

  • Immune System Diseases — immune system disease
  • Neuromyelitis Optica — neuromyelitis optica

Off-label

  • Encephalitis, Japanese
  • Graves Ophthalmopathy
  • Hypertension, Pulmonary
  • Muscular Dystrophy, Duchenne
  • Myasthenia Gravis

Contraindications

Source: openFDA

  • is contraindicated in patients with: A known hypersensitivity to satralizumab or any of the inactive ingredients [see Warnings and Precautions (5.4) ] Active Hepatitis B infection [see Warnings and Precautions (5.1) ] Active or untreated latent tuberculosis [see Warnings and Precautions (5.1) ] Known hypersensitivity to satralizumab or any of the inactive ingredients ( 4 ) Active Hepatitis B infection ( 4 ) Active or untreated latent tuberculosis ( 4 ) Absolute

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Nervous system disorders (1)

Not Known Headache

Skin and subcutaneous tissue disorders (1)

Not Known Rash

Musculoskeletal and connective tissue disorders (1)

Not Known Arthralgia

General disorders and administration site conditions (5)

Not Known Controlled Period · Extremity Pain · Fatigue · Gastritis · Upper Respira

Dosing

Source: openFDA

Hepatitis B virus, tuberculosis, and liver transaminase screening is required before the first dose. ( 2.1 ) Prior to every use, determine if there is an active infection. ( 2.2 ) The recommended loading dosage of ENSPRYNG for the first three administrations is 120 mg by subcutaneous injection at Weeks 0, 2, and 4, followed by a maintenance dosage of 120 mg every 4 weeks. ( 2.2 ) See Full Prescribing Information for important preparation and administration instructions. ( 2.3 ) 2.1 Assessments Prior to the First Dose of ENSPRYNG Hepatitis B Virus Screening Prior to initiating ENSPRYNG, perform Hepatitis B virus (HBV) screening. ENSPRYNG is contraindicated in patients with active HBV confirmed by positive results for surface antigen [HBsAg] and anti-HBV tests. For patients who are negative for HBsAg and positive for HB core antibody [HBcAb+] or are carriers of HBV [HBsAg+], consult liver disease experts before starting and during treatment with ENSPRYNG [see Contraindications (4) and Warnings and Precautions (5.1) ] . Tuberculosis Screening Prior to initiating ENSPRYNG, evaluate for active tuberculosis and test for latent infection. For patients with active tuberculosis or positive tuberculosis screening without a history of appropriate treatment, consult infectious disease experts before initiating treatment with ENSPRYNG [see Contraindications (4) and Warnings and Precautions (5.1) ] . Liver Transaminase Screening Liver transaminases and serum bilirubin should be assessed prior to initiation of treatment with ENSPRYNG [see Warnings and Precautions (5.2) ] . Caution should be exercised when considering initiation of ENSPRYNG treatment in patients whose aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels are greater than 1.5 times the upper limit of normal (ULN). Vaccinations Because vaccination with live-attenuated or live vaccines is not recommended during treatment with ENSPRYNG, administer all immunizations according to immunization guidelines at least 4 weeks prior to initiation of ENSPRYNG for live or live-attenuated vaccines and, whenever possible, at least 2 weeks prior to initiation of ENSPRYNG for non-live vaccines [see Warnings and Precautions (5.1) ]. 2.2 Recommended Dosage For subcutaneous use only. Prior to every use of ENSPRYNG, advise patients to consult with their healthcare professional (HCP) if they suspect an active infection, including localized infections. In case of active infection, delay use of ENSPRYNG until the infection is resolved [see Warnings and Precautions (5.1) ] . The recommended loading dosage of ENSPRYNG for the first three administrations is 120 mg by subcutaneous injection at Weeks 0, 2, and 4, followed by a maintenance dosage of 120 mg every 4 weeks. Missed Dose If a dose of ENSPRYNG is missed for any reason other than increases in liver enzymes [see Dosage and Administration (2.4) ] , administer as described in Table 1 . Table 1 Recommended Dosage for Delayed or Missed Doses Last Dose Administered Recommended Dosage for Delayed or Missed Doses Less than 8 weeks during the maintenance period or missed a loading dose Administer 120 mg by subcutaneous injection as soon as possible, and do not wait until the next planned dose. Maintenance period After the delayed or missed dose is administered, reset the dose schedule to every 4 weeks. Loading period If the second loading dose is delayed or missed, administer as soon as possible and administer the 3 rd and final loading dose 2 weeks later. If the third loading dose is delayed or missed, administer as soon as possible and administer the 1 st maintenance dose 4 weeks later. 8 weeks to less than 12 weeks 120 mg by subcutaneous injection at 0 "0 weeks" refers to time of the first administration after the missed dose. and 2 weeks, followed by 120 mg every 4 weeks. 12 weeks or longer 120 mg by subcutaneous injection at 0 , 2, and 4 weeks followed by 120 mg every 4 weeks. 2.3 Important Administration Instructions ENSPRYNG is i

Warnings & Precautions

Source: openFDA

Warnings & Precautions

Infections: Delay ENSPRYNG administration in patients with an active infection until the infection is resolved. Vaccination with live or live-attenuated vaccines is not recommended during treatment. ( 5.1 ) Elevated Liver Enzymes: Monitor ALT and AST levels during treatment; interruption of ENSPRYNG may be required. ( 5.2 ) Decreased Neutrophil Counts: Monitor neutrophils during treatment. ( 5.3 )

Infections An increased risk of infections, including serious and pote

Infections An increased risk of infections, including serious and potentially fatal infections, has been observed in patients treated with IL-6 receptor antagonists, including ENSPRYNG. The most common infections reported in a randomized clinical trial of patients treated with ENSPRYNG who were not on other chronic immunosuppressant therapies (Study 1), and that occurred more often than in patients receiving placebo, were nasopharyngitis (12%) and cellulitis (10%). The most common infections in patients who were on an additional concurrent immunosuppressant, and that occurred more often than in patients receiving placebo, were nasopharyngitis (31%), upper respiratory infection (19%), and pharyngitis (12%). Delay ENSPRYNG administration in patients with an active infection, including localized infections, until the infection is resolved. Hepatitis B Virus (HBV) Reactivation Risk of HBV reactivation has been observed with other immunosuppressant therapies. Patients with chronic HBV infection were excluded from clinical trials. Perform HBV screening in all patients before initiation of treatment with ENSPRYNG. Do not administer ENSPRYNG to patients with active hepatitis. For patients who are chronic carriers of HBV [HBsAg+] or are negative for HBsAg and positive for HB core antibody [HBcAb+], consult liver disease experts before starting and during treatment with ENSPRYNG. Tuberculosis Tuberculosis has occurred in patients treated with other interleukin-6 receptor antagonists. Patients should be evaluated for tuberculosis risk factors and tested for latent infection prior to initiating ENSPRYNG. Consider anti-tuberculosis therapy prior to initiation of ENSPRYNG in patients with a history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection. Consult infectious disease experts regarding whether initiating anti-tuberculosis therapy is appropriate before starting treatment. Patients should be monitored for the development of symptoms and signs of tuberculosis with ENSPRYNG, even if initial tuberculosis testing is negative. Vaccinations Live or live-attenuated vaccines should not be given concurrently with ENSPRYNG because clinical safety has not been established. Administer all immunizations according to immunization guidelines at least 4 weeks prior to initiation of ENSPRYNG for live or live-attenuated vaccines

Elevated Liver Enzymes Mild and moderate elevations of liver enzymes h

Elevated Liver Enzymes Mild and moderate elevations of liver enzymes have been observed in patients treated with ENSPRYNG at a higher incidence than in patients receiving placebo [see Adverse Reactions (6.1) ] . ALT and AST levels should be monitored every 4 weeks for the first 3 months of treatment, followed by every 3 months for one year, and thereafter, as clinically indicated [see Dosage and Administration (2.4) ].

Decreased Neutrophil Counts Decreases in neutrophil counts were observ

Decreased Neutrophil Counts Decreases in neutrophil counts were observed in patients treated with ENSPRYNG at a higher incidence than placebo [see Adverse Reactions (6.1) ]. Neutrophil counts should be monitored 4 to 8 weeks after initiation of therapy, and thereafter at regular clinically determined intervals [see Dosage and Administration (2.4) ].

Hypersensitivity Reactions Hypersensitivity reactions, including rash,

Hypersensitivity Reactions Hypersensitivity reactions, including rash, urticaria, and fatal anaphylaxis, have occurred with other interleukin-6 receptor antagonists.

Pregnancy & Lactation

Lactation

Caution Hale L3

Waiting for at least 2 weeks postpartum to resume therapy may minimize transfer to the infant.

Biology & Pharmacokinetics

Drug–drug interactions (78, DDInter)

Interacting drugSeverityManagement
Abatacept major
Adalimumab major
Anakinra major
Baricitinib major
Canakinumab major
Certolizumab pegol major
Cladribine major
Deferiprone major
Etanercept major
Fingolimod major
Golimumab major
Infliximab major
Leflunomide major
Natalizumab major
Ozanimod major
Rilonacept major
Rituximab major
Samarium (153Sm) lexidronam major
Siponimod major
Talimogene laherparepvec major
Teriflunomide major
Tofacitinib major
Upadacitinib major
Ustekinumab major
Alefacept moderate
Alemtuzumab moderate
Aminophylline moderate
Apixaban moderate
Asparaginase Escherichia coli moderate
Azathioprine moderate
Brentuximab vedotin moderate
Chloramphenicol moderate
Chloramphenicol (ophthalmic) moderate
Clofarabine moderate
Cyclosporine moderate
Dicoumarol moderate
Dimethyl fumarate moderate
Efalizumab moderate
Epirubicin moderate
Ethinylestradiol moderate

Showing 40 of 78.

Registered Products (1)

BrandForm / strengthPackAgentCitizen (JOD)
Enspryng solution for injection 120mg/1ml (prefilled syringe) Injection 120 mg/1 ml 1 SYR/1 BOX Shawi & Rushedat Drug Store