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Inflammatory Conditions – Kevzara™ (Sarilumab for Subcutaneous Injection)
Cigna National Formulary Coverage Policy Prior Authorization Inflammatory Conditions – Kevzara® (sarilumab for subcutaneous injection) Table of Contents Product Identifier(s) National Formulary Medical Necessity ................ 1 59231 Conditions Not Covered....................................... 2 Background .......................................................... 2 References .......................................................... 3 Revision History ................................................... 3 INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD) or similar plan document] may differ significantly from the standard benefit plans upon which these Coverage Policies are based. For example, a customer’s benefit plan document may contain a specific exclusion related to a topic addressed in a Coverage Policy. In the event of a conflict, a customer’s benefit plan document always supersedes the information in the Coverage Policies. In the absence of a controlling federal or state coverage mandate, benefits are ultimately determined by the terms of the applicable benefit plan document. Coverage determinations in each specific instance require consideration of 1) the terms of the applicable benefit plan document in effect on the date of service; 2) any applicable laws/regulations; 3) any relevant collateral source materials including Coverage Policies and; 4) the specific facts of the particular situation. -
FDA Updates Highlighting the Latest Cancer Treatments
FDA Updates Highlighting the Latest Cancer Treatments Orphan Drug Designation of NUV-422 for (mCRC) or squamous cell carcinoma of the head and neck (SCCHN). Malignant Gliomas This approval provides for a biweekly dosage regimen option in The FDA has granted Orphan Drug Designation to NUV-422, a cyclin- addition to the previously approved weekly dosage regimen for the dependent kinase (CDK) 2/4/6 inhibitor, for the treatment of patients approved indications when cetuximab is used as a single agent or in with malignant gliomas. combination with chemotherapy. Patient enrollment and dosing is ongoing in the Phase I/II study The approval was based on population pharmacokinetic (PK) of NUV-422 in adult patients with recurrent or refractory high-grade modeling analyses that compared the predicted exposures of cetux- gliomas, including glioblastoma multiforme. The Phase I dose-esca- imab 500 mg Q2W to observed cetuximab exposures in patients who lation part of the study is designed to evaluate safety and tolerability, received cetuximab 250 mg weekly. The application was also supported as well as determine a recommended Phase II dose based on the toler- by pooled analyses of overall response rates, progression-free survival, ability profile and pharmacokinetic properties of NUV-422. The Phase and overall survival (OS) from published literature in patients with II dose expansion part of the study is expected to initially focus on CRC and SCCHN, and OS analyses using real-world data in patients patients with high-grade gliomas, and it is designed to evaluate overall with mCRC who received either the weekly cetuximab or Q2W regi- response rate, duration of response, and survival. -
New Drug Updates Brendan Mangan, Pharmd Clinical Pharmacy Specialist Hospital of the University of Pennsylvania
11/9/2020 Disclosures • There are no relevant financial interests to disclose for myself or my spouse/partner from within the last 12 months New Drug Updates Brendan Mangan, PharmD Clinical Pharmacy Specialist Hospital of the University of Pennsylvania 1 2 Objectives New Drugs Explain the pharmacology of each new medication Malignant Hematology Medical Oncology Define indications, adverse effects and pertinent drug interactions Outline supportive care measures and clinical pearls Selinexor Tazemotostat Isatuximab-irfc Avapritinib Discuss the results of clinical trials and place in therapy Belantamab mafodotin-blmf Pexidartinib Fedratinib Entrectinib Polatuzumab vedotin-piiq Tafasitamab-cxix Zanubrutinib 3 4 Selinexor (XPOVIO®) Approval: July 3, 2019 Novel agent Exportin 1 inhibitor ▫ Reversibly inhibits nuclear export of tumor suppressor proteins, growth regulators, and mRNAs of oncogenic proteins XPOVI™ [Prescribing Information] Newton, MA. Karyopharm Therapeutics. 2019. Picture: xpovio.com 5 6 1 11/9/2020 Selinexor Selinexor Indication Adverse Effects Clinical Pearls • In combination with dexamethasone for relapse refractory multiple myeloma after failing 4 prior therapies Thrombocytopenia (74%) GCSF and prophylactic antimicrobials Recommended Neutropenia (34%) Prophylactic anti-emetics First Reduction Second Reduction Third Reduction Starting Dosage Nausea (72%)/Vomiting (41%) IV fluids and electrolyte repletion may be Diarrhea (44%) warranted monitor closely 80 mg Discontinue Days 1 and 3 of each Anorexia (53%)/Weight loss (47%) Correct sodium levels for concurrent 100 mg once weekly 80 mg once weekly 60 mg once weekly week (160 mg weekly Hyponatremia (39%) hyperglycemia (>150 mg/dL) total) Infections (52%) TPO agonist may be warranted for Neurological toxicity (30%) thrombocytopenia GCSF = Granulocyte colony-stimulating factor XPOVI™ [Prescribing Information] Newton, MA. -
Immunotherapies Shape the Treatment Landscape for Hematologic Malignancies Jane De Lartigue, Phd
Feature Immunotherapies shape the treatment landscape for hematologic malignancies Jane de Lartigue, PhD he treatment landscape for hematologic of TIL therapy has been predominantly limited to malignancies is evolving faster than ever melanoma.1,3,4 before, with a range of available therapeutic Most recently, there has been a substantial buzz Toptions that is now almost as diverse as this group around the idea of genetically engineering T cells of tumors. Immunotherapy in particular is front and before they are reintroduced into the patient, to center in the battle to control these diseases. Here, increase their anti-tumor efficacy and minimize we describe the latest promising developments. damage to healthy tissue. This is achieved either by manipulating the antigen binding portion of the Exploiting T cells T-cell receptor to alter its specificity (TCR T cells) The treatment landscape for hematologic malig- or by generating artificial fusion receptors known as nancies is diverse, but one particular type of therapy chimeric antigen receptors (CAR T cells; Figure 1). has led the charge in improving patient outcomes. The former is limited by the need for the TCR to be Several features of hematologic malignancies may genetically matched to the patient’s immune type, make them particularly amenable to immunother- whereas the latter is more flexible in this regard and apy, including the fact that they are derived from has proved most successful. corrupt immune cells and come into constant con- CARs are formed by fusing part of the single- tact with other immune cells within the hemato- chain variable fragment of a monoclonal antibody poietic environment in which they reside. -
Antibodies to Watch in 2021 Hélène Kaplona and Janice M
MABS 2021, VOL. 13, NO. 1, e1860476 (34 pages) https://doi.org/10.1080/19420862.2020.1860476 PERSPECTIVE Antibodies to watch in 2021 Hélène Kaplona and Janice M. Reichert b aInstitut De Recherches Internationales Servier, Translational Medicine Department, Suresnes, France; bThe Antibody Society, Inc., Framingham, MA, USA ABSTRACT ARTICLE HISTORY In this 12th annual installment of the Antibodies to Watch article series, we discuss key events in antibody Received 1 December 2020 therapeutics development that occurred in 2020 and forecast events that might occur in 2021. The Accepted 1 December 2020 coronavirus disease 2019 (COVID-19) pandemic posed an array of challenges and opportunities to the KEYWORDS healthcare system in 2020, and it will continue to do so in 2021. Remarkably, by late November 2020, two Antibody therapeutics; anti-SARS-CoV antibody products, bamlanivimab and the casirivimab and imdevimab cocktail, were cancer; COVID-19; Food and authorized for emergency use by the US Food and Drug Administration (FDA) and the repurposed Drug Administration; antibodies levilimab and itolizumab had been registered for emergency use as treatments for COVID-19 European Medicines Agency; in Russia and India, respectively. Despite the pandemic, 10 antibody therapeutics had been granted the immune-mediated disorders; first approval in the US or EU in 2020, as of November, and 2 more (tanezumab and margetuximab) may Sars-CoV-2 be granted approvals in December 2020.* In addition, prolgolimab and olokizumab had been granted first approvals in Russia and cetuximab saratolacan sodium was first approved in Japan. The number of approvals in 2021 may set a record, as marketing applications for 16 investigational antibody therapeutics are already undergoing regulatory review by either the FDA or the European Medicines Agency. -
Sarclisa, INN-Isatuximab
ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 1 This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions. See section 4.8 for how to report adverse reactions. 1. NAME OF THE MEDICINAL PRODUCT SARCLISA 20mg/mL concentrate for solution for infusion. 2. QUALITATIVE AND QUANTITATIVE COMPOSITION One ml of concentrate for solution for infusion contains 20 mg of isatuximab. Each vial contains 100 mg of isatuximab in 5 mL of concentrate (100 mg/5mL). Each vial contains 500 mg of isatuximab in 25 mL of concentrate (500 mg/25mL). Isatuximab is an immunoglobulin G1 (IgG1) monoclonal antibody (mAb) produced from a mammalian cell line (Chinese Hamster Ovary, CHO). For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Concentrate for solution for infusion. Colourless to slightly yellow solution, essentially free of visible particulates. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications SARCLISA is indicated: - in combination with pomalidomide and dexamethasone, for the treatment of adult patients with relapsed and refractory multiple myeloma who have received at least two prior therapies including lenalidomide and a proteasome inhibitor and have demonstrated disease progression on the last therapy. - in combination with carfilzomib and dexamethasone, for the treatment of adult patients with multiple myeloma who have received at least one prior therapy (see section 5.1). 4.2 Posology and method -
Provider Newsletter April 2021
Medicaid Managed Care Dual Advantage Provider Newsletter April 2021 https://providers.healthybluela.com Provider Services: Medicaid — 1-844-521-6942, Medicare — reference the back of your patient’s member ID card Table of Contents COVID-19 information from Page 2 Healthy Blue Medicaid: MCG Care Guidelines Page 2 24th edition customization Dual Advantage: Medical drug benefit Page 3 Clinical Criteria updates In-Office Assessment Page 4 program Oncology Dose Reduction Program beginning Page 6 July 1, 2021 Want to receive the Provider Newsletter via email? Click here to provide/update your email address. BLA-NL-0301-21 Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross and Blue Shield Association. COVID-19 information from Healthy Blue Healthy Blue is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. Our clinical team is actively monitoring external queries and reports from the Centers for Disease Control and Prevention (CDC) and the Louisiana Department of Health (LDH) to help us determine what action is necessary on our part. Healthy Blue will continue to follow LDH guidance policies. For additional information, reference the COVID-19 News and Updates section of our website. BLAPEC-1682-20/BLACARE-0163-20 Medicaid MCG Care Guidelines 24th edition customization Effective March 12, 2021, the following new customizations will be implemented: • Gastrointestinal Bleeding, Upper (W0170, previously ORG M-180) — Customized the Clinical Indications for admission to inpatient care by revising the hemoglobin, systolic blood pressure, pulse, melena, orthostatic hypotension and BUN criteria. -
Northwest Medical Benefit Formulary (List of Covered Drugs) Please Read
Northwest Medical Benefit Formulary (List of Covered Drugs) Please Read: This document contains information about the drugs we cover when they are administered to you in a Participating Medical Office. What is the Kaiser Permanente Northwest Medical Benefit Formulary? A formulary is a list of covered drugs chosen by a group of Kaiser Permanente physicians and pharmacists known as the Formulary and Therapeutics Committee. This committee meets regularly to evaluate and select the safest, most effective medications for our members. Kaiser Permanente Formulary The formulary list that begins on the next page provides information about some of the drugs covered by our plan when they are administered to you in a Participating Medical Office. Depending on your medical benefits, you may pay a cost share for the drug itself. The first column of the chart lists the drug’s generic name. The second column lists the brand name. Most administered medications and vaccines are only available as brand name drugs. Contraceptive Drugs and Devices Your provider may prescribe as medically necessary any FDA-approved contraceptive drug or device, including those on this formulary, which you will receive at no cost share. Last Updated 09/01/2021 Generic Name Brand Name Clinic Administered Medications (ADMD) ABATACEPT ORENCIA ABOBOTULINUM TOXIN A DYSPORT ADALIMUMAB HUMIRA ADO-TRASTUZUMAB EMTANSINE KADCYLA AFAMELANOTIDE ACETATE SCENESSE AFLIBERCEPT EYLEA AGALSIDASE BETA FABRAZYME ALDESLEUKIN PROLEUKIN ALEMTUZUMAB LEMTRADA ALGLUCOSIDASE ALFA LUMIZYME ARALAST, GLASSIA, -
Tocilizumab and Sarilumab Alone Or in Combination with Corticosteroids For
medRxiv preprint doi: https://doi.org/10.1101/2021.07.05.21259867; this version posted July 7, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . 1 Tocilizumab and sarilumab alone or in combination with 2 corticosteroids for COVID-19: A systematic review and network meta- 3 analysis 4 Dena Zeraatkar, methodologist 5 Department of Biomedical Informatics, Harvard Medical School 6 Department of Health Research Methods, Evidence, and Impact, McMaster University 7 8 Ellen Cusano, internist 9 Cumming School of Medicine, University of Calgary 10 11 Juan Pablo Díaz Martinez, methodologist 12 Department of Health Research Methods, Evidence, and Impact, McMaster University 13 14 Anila Qasim, methodologist 15 Department of Health Research Methods, Evidence, and Impact, McMaster University 16 17 Sophia O. Mangala, methodologist 18 Department of Health Research Methods, Evidence, and Impact, McMaster University 19 20 Elena Kum, methodologist 21 Department of Health Research Methods, Evidence, and Impact, McMaster University 22 23 Jessica J. Bartoszko, methodologist 24 Department of Health Research Methods, Evidence, and Impact, McMaster University 25 26 Tahira Devji, methodologist 27 Department of Health Research Methods, Evidence, and Impact, McMaster University 28 29 Thomas Agoritsas, internist, methodologist 30 Department of Health Research Methods, -
Antibodies for the Treatment of Brain Metastases, a Dream Or a Reality?
pharmaceutics Review Antibodies for the Treatment of Brain Metastases, a Dream or a Reality? Marco Cavaco, Diana Gaspar, Miguel ARB Castanho * and Vera Neves * Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal * Correspondence: [email protected] (M.A.R.B.C.); [email protected] (V.N.) Received: 19 November 2019; Accepted: 28 December 2019; Published: 13 January 2020 Abstract: The incidence of brain metastases (BM) in cancer patients is increasing. After diagnosis, overall survival (OS) is poor, elicited by the lack of an effective treatment. Monoclonal antibody (mAb)-based therapy has achieved remarkable success in treating both hematologic and non-central-nervous system (CNS) tumors due to their inherent targeting specificity. However, the use of mAbs in the treatment of CNS tumors is restricted by the blood–brain barrier (BBB) that hinders the delivery of either small-molecules drugs (sMDs) or therapeutic proteins (TPs). To overcome this limitation, active research is focused on the development of strategies to deliver TPs and increase their concentration in the brain. Yet, their molecular weight and hydrophilic nature turn this task into a challenge. The use of BBB peptide shuttles is an elegant strategy. They explore either receptor-mediated transcytosis (RMT) or adsorptive-mediated transcytosis (AMT) to cross the BBB. The latter is preferable since it avoids enzymatic degradation, receptor saturation, and competition with natural receptor substrates, which reduces adverse events. Therefore, the combination of mAbs properties (e.g., selectivity and long half-life) with BBB peptide shuttles (e.g., BBB translocation and delivery into the brain) turns the therapeutic conjugate in a valid approach to safely overcome the BBB and efficiently eliminate metastatic brain cells. -
Sarilumab-Kevzara-Fact-Sheet.Pdf
Sarilumab PATIENT FACT SHEET (Kevzara) Sarilumab (Kevzara) is a biologic medication that affect the immune system. Sarilumab blocks currently approved to treat adults with moderate a messenger of inflammation called the interleukin-6 to severe active rheumatoid arthritis (RA). Biologic receptor (IL-6R). This improves joint pain and swelling from medications are proteins designed by humans arthritis and other symptoms caused by inflammation. WHAT IS IT? For adults with RA, sarilumab is given as a several months to take full effect. Sarilumab may be subcutaneous (beneath the skin) injection every 2 taken alone or with methotrexate or other non-biologic weeks at a dose between 150 mg to 200 mg. The drugs. Sarilumab should not be given in combination medicine can be injected into the thigh or abdomen. with another biologic drug. Blood tests will be used to The site of injection should be rotated so the same site monitor for changes to liver enzymes, cholesterol, and for HOW TO is not used multiple times. Some patients will start to reductions in blood cell counts while taking sarilumab. see improvement within a few weeks, but it may take TAKE IT Sarilumab can lower the ability of your immune system complication seen with sarilumab use in clinical trials to fight infections. If you develop symptoms of an was bowel perforation, or a hole in the bowel wall. If you infection while using this medication, you should stop it have a history or diverticulitis or develop abdominal pain and contact your doctor. All patients should be tested for or bloody bowel movements while taking sarilumab, you tuberculosis before starting on sarilumab, although these should notify your doctor immediately. -
“Drug Lag” Analysis of Monoclonal Antibodies in the United States and Europe
“Drug Lag” Analysis of Monoclonal Antibodies in the United States and Europe by Vibha Sharma Submitted to the College of Health and Human Services Eastern Michigan University In partial fulfillment of the requirements for the degree of MASTER OF SCIENCE in Clinical Research Administration April, 2019 Ypsilanti, Michigan Drug Lag Analysis of Monoclonal Antibodies Acknowledgments I would like to thank Dr. Irwin Martin for providing me with the support and guidance throughout the project. He has always been available to help whenever I needed help in writing or research. I would also like to help Dr. Jean Rowan and Dr. Stephen Sonstein for guidance throughout my master’s program. ii Drug Lag Analysis of Monoclonal Antibodies Abstract The review time of new drug applications (NDA) in the United States (US) and market authorization applications (MAA) in European Union (EU) were compared for monoclonal antibodies (mAbs). The Food and Drug Administration (FDA) had been criticized in the past for longer review times to approve drugs than the European Medicines Agency (EMA). The main objective of this study was to see how the FDA compared to the EMA in approving “cutting edge products”. The FDA review time for mutually approved mAbs was calculated by searching the NDA submission dates and approval dates from Drugs@FDA. In a similar manner, MAA submission and approval dates were searched from European public assessment reports (EPAR) from the EMA website, and the review time were calculated. The review times for mAbs approved in both the US and EU were compared using descriptive statistics. The results revealed that FDA review time mean (in days) was 269, while the EMA review time mean (in days) was 427.