8. SLE patients also taking immunosuppressants may be at higher risk of herpes zoster infections. In controlled-clinical trials serious and sometimes fatal infections (including pneumonia) occurred, including in patients receiving anifrolumab.
Due to the mechanism of action, anifrolumab should be used with caution in patients with a chronic infection, a history of recurrent infections, or known risk factors for infection. Treatment with anifrolumab should not be initiated in patients with any clinically significant active infection until the infection resolves or is adequately treated.
Patients should be instructed to seek medical advice if signs or symptoms of clinically significant infection occur. If a patient develops an infection, or is not responding to standard therapy, they should be closely monitored and careful consideration given to interrupting anifrolumab therapy until the infection resolves.
Studies in patients with a history of primary immunodeficiency have not been conducted. The placebo-controlled clinical trials excluded patients with a history of active TB or latent TB in whom an adequate course of treatment could not be confirmed.
Anti- tuberculosis (anti-TB) therapy should be considered prior to initiation of anifrolumab in patients with untreated latent TB. Anifrolumab should not be administered to patients with active TB. Immunisations No data are available on the immune response to vaccines.
Prior to initiating therapy, completion of all appropriate immunisations should be considered according to current immunisation guidelines. Concurrent use of live or attenuated vaccines should be avoided in patients treated with anifrolumab.
Malignancy The impact of treatment with anifrolumab on the potential development of malignancies is not known. Studies in patients with a history of malignancy have not been conducted; however, patients with squamous or basal cell skin cancers and uterine cervical cancer that had been fully excised or adequately treated were eligible for enrolment in the SLE clinical trials.
7 events per 100 patient years (PY), respectively). 6% of patients receiving anifrolumab and placebo, respectively. In patients receiving anifrolumab, breast and squamous cell carcinoma were the malignancies observed in more than one patient.
Individual benefit-risk should be considered in patients with known risk factors for the development or reoccurrence of malignancy. Caution should be exercised when considering continuing therapy for patients who develop malignancy.
5 Interaction with other medicinal products and other forms of interaction No interaction studies have been performed. Anifrolumab is not expected to undergo metabolism by hepatic enzymes or renal elimination. The formation of some CYP450 enzymes is suppressed by increased levels of certain cytokines during chronic inflammation.
Anifrolumab modestly suppresses the levels of some cytokines; the impact on CYP450 activity is unknown. , warfarin), therapeutic monitoring is recommended. 4). 6 Fertility, pregnancy and lactation Pregnancy There are limited data (less than 300 pregnancy outcomes) from the use of Saphnelo in pregnant women.
3). Saphnelo is not recommended during pregnancy and in women of childbearing potential not using contraception, unless the possible benefit justifies the potential risk. Breast-feeding It is not known whether anifrolumab is excreted in human milk.
3). A risk to the suckling child cannot be excluded. A decision must be made whether to discontinue breast-feeding or to discontinue from Saphnelo therapy, taking into account the benefit of breast-feeding for the child and the benefit of therapy for the woman.
Fertility There are no fertility data in humans. 3). 7 Effects on ability to drive and use machines Saphnelo has no or negligible influence on the ability to drive and use machines. 1%). 4%). Tabulated list of adverse reactions Adverse reactions reported from controlled clinical trials are classified by MedDRA System Organ Class (SOC), see Table 1.
Within each SOC, preferred terms are arranged by decreasing frequency and then by decreasing seriousness. Frequencies of occurrence of adverse reactions are defined as: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1 000 to <1/100); rare (≥1/10 000 to <1/1 000); very rare (<1/10 000) and not known (cannot be estimated from available data).
Table 1 Adverse reactions MedDRA SOC MedDRA Preferred Term Frequency Upper respiratory tract infection* Very common Bronchitis* Very common Herpes Zoster Common Infections and infestations Respiratory tract infection* Common Hypersensitivity CommonImmune system disorders Anaphylactic reaction Uncommon§ Table 1 Adverse reactions MedDRA SOC MedDRA Preferred Term Frequency Injury, poisoning and procedural […]