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etranacogene dezaparvovec-drlb (Hemgenix)

Indications: - Congenital hemophilia B - defects in the gene encoding factor IX Dosage: - 2 x 10E13 genome copies/kg body weight - 2 x patient weight in Kg = dose in mL - dose in vials = dose in mL/10 rounded up - for 72 kg patient 144 mL, 15 vials - administer as anintravenous infusion after dilution with 0.9% normal saline - maintain constant infusion rate of 8 mL/min * Hemgenix can be administered only once [2] provided in kits containing 10 to 48 single-use vials, each kit constituting a dosage unit based on the patient's weight 10 mL etranacogene dezaparvovec-drlb 10E13 VECTOR-GENOMES/mL Injection Monitor: - serum ALT* & serum AST* once per week for 3 months after administration - annual liver ultrasound & serum alpha-fetoprotein testing for patients with pre-exsiting risk factors for hepatocellular carcinoma * condider glucocorticoid for elevated serum ALT [2] Adverse effects: - hepatotoxicity - hepatocellular carcinoma for patients with pre-exsiting risk factors - elevated serum ALT (24%), serum AST (42%), serum creatine kinase (42%) - headache (18%), flu-like symptoms (14%), fatigue (12%), malaise (12%), nausea (7%) - infusion-related reactions (13%) - hypersensitivity (4%) [2] Mechanism of action: - adeno-associated virus vector-based gene therapy [2]

General

gene therapy

References

  1. Shah J, Kim h, Sivamurthy K et al Comprehensive analysis and prediction of long-term durability of factor IX activity following etranacogene dezaparvovec gene therapy in the treatment of hemophilia B. Curr Med Res Opin. 2023 Feb;39(2):227-237. PMID: 36285399 https://www.tandfonline.com/doi/full/10.1080/03007995.2022.2133492
  2. HIGHLIGHTS OF PRESCRIBING INFORMATION Hemgenix (etranacogene dezaparvovec-drlb) suspension, for intravenous infusion https://labeling.cslbehring.com/PI/US/Hemgenix/EN/Hemgenix-Prescribing-Information.pdf