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Clinical Policy: Baricitinib (Olumiant) Reference Number: ERX.SPA.291 Effective Date: 07.24.18 Last Review Date: 11.18 Revision Log
Clinical Policy: Baricitinib (Olumiant) Reference Number: ERX.SPA.291 Effective Date: 07.24.18 Last Review Date: 11.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description Baricitinib (Olumiant®) is Janus kinase (JAK) inhibitor. FDA Approved Indication(s) Olumiant is indicated for the treatment of adult patients with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response to one or more tumor necrosis factor (TNF) antagonist therapies. Limitation(s) of use: Use of Olumiant in combination with other JAK inhibitors, biologic disease-modifying antirheumatic drugs (DMARDs), or with potent immunosuppressants such as azathioprine and cyclosporine is not recommended. Policy/Criteria Provider must submit documentation (such as office chart notes, lab results or other clinical information) supporting that member has met all approval criteria. It is the policy of health plans affiliated with Envolve Pharmacy Solutions™ that Olumiant is medically necessary when the following criteria are met: I. Initial Approval Criteria A. Rheumatoid Arthritis (must meet all): 1. Diagnosis of RA; 2. Prescribed by or in consultation with a rheumatologist; 3. Age ≥ 18 years; 4. Member meets one of the following (a or b): a. Failure of a ≥ 3 consecutive month trial of methotrexate (MTX) at up to maximally indicated doses, unless contraindicated or clinically significant adverse effects are experienced; b. If intolerance or contraindication to MTX (see Appendix D), failure of a ≥ 3 consecutive month trial of at least ONE conventional DMARD (e.g., sulfasalazine, leflunomide, hydroxychloroquine) at up to maximally indicated doses, unless contraindicated or clinically significant adverse effects are experienced; 5. -
Immunosuppressant Drugs Therapy with COVID-19
Immunosuppressant Drugs Therapy with COVID-19: Associated Risks, Drug-Drug Interactions & Contraindications Debjyoti Talukdar1, Diane Ignacio2, and Madan Mohan Gupta2 1Teerthanker Mahaveer University 2The University of the West Indies at St Augustine September 24, 2020 Abstract Immunosuppressant drugs like Etanercept, Mycophenolate mofetil, Sirolimus, Cyclosporine and Rituximab can weaken the immune system and make patients susceptible to SARS nCoV-2 virus. These drugs make immunocompromised persons more vulnerable to complications associated with COVID-19. Moreover, it can also increase the mortality and morbidity, as a weakened immune system can lead to longer duration of infection. This study discusses the guidelines on immunosuppressant drugs and its associated risk factors with COVID-19, issued by the U.S CDC (Centers for Disease Control and Prevention), WHO (World Health Organisation), U.S FDA (Food and Drug Administration) and other accredited global health organisa- tions. Moreover, it also includes information about pharmaceutical properties, mechanism of action, COVID-19 associated risk factors, adverse drug reactions, contraindications and drug-drug interactions. Our study will help government partners and international health organisations to better understand COVID-19 health risks associated with immunosuppressants. Increased public awareness about effective drug therapy for autoimmune diseases, cancer treatment, immunocompromised and organ transplant patients will help lower the mortality and morbidity associated with the disease amid COVID-19 pandemic. 1. INTRODUCTION As per the U.S Department of Health and Human Services and U.S FDA, immunosuppressant drugs can cause susceptibility to viruses leading to infection with increase in morbidity of the disease. It can cause severe risk of illness from COVID-19 due to a weakened immune system. -
Us 8530498 B1 3
USOO853 0498B1 (12) UnitedO States Patent (10) Patent No.: US 8,530,498 B1 Zeldis (45) Date of Patent: *Sep. 10, 2013 (54) METHODS FORTREATING MULTIPLE 5,639,476 A 6/1997 OShlack et al. MYELOMAWITH 5,674,533 A 10, 1997 Santus et al. 3-(4-AMINO-1-OXO-1,3-DIHYDROISOINDOL- 395 A 22 N. 2-YL)PIPERIDINE-2,6-DIONE 5,731,325 A 3/1998 Andrulis, Jr. et al. 5,733,566 A 3, 1998 Lewis (71) Applicant: Celgene Corporation, Summit, NJ (US) 5,798.368 A 8, 1998 Muller et al. 5,874.448 A 2f1999 Muller et al. (72) Inventor: Jerome B. Zeldis, Princeton, NJ (US) 5,877,200 A 3, 1999 Muller 5,929,117 A 7/1999 Muller et al. 5,955,476 A 9, 1999 Muller et al. (73) Assignee: Celgene Corporation, Summit, NJ (US) 6,020,358 A 2/2000 Muller et al. - 6,071,948 A 6/2000 D'Amato (*) Notice: Subject to any disclaimer, the term of this 6,114,355 A 9, 2000 D'Amato patent is extended or adjusted under 35 SS f 1939. All et al. U.S.C. 154(b) by 0 days. 6,235,756 B1 5/2001 D'Amatoreen et al. This patent is Subject to a terminal dis- 6,281.230 B1 8/2001 Muller et al. claimer 6,316,471 B1 1 1/2001 Muller et al. 6,326,388 B1 12/2001 Man et al. 6,335,349 B1 1/2002 Muller et al. (21) Appl. No.: 13/858,708 6,380.239 B1 4/2002 Muller et al. -
Leflunomide-Arava-Fact-Sheet
Leflunomide PATIENT FACT SHEET (Arava) Leflunomide (Arava) is a drug approved to treat combination with other DMARDs. Leflunomide blocks the adults with moderate to severe rheumatoid arthritis. formation of DNA, which is important for replicating cells, It belongs to a class of medications called disease such as those in the immune system. It suppresses the modifying antirheumatic drugs (DMARDs). Leflunomide immune system to reduce inflammation that causes pain is often used to treat rheumatoid arthritis alone or in and swelling in rheumatoid arthritis. WHAT IS IT? Leflunomide is usually given as a 20 mg tablet once a the first 3 days after starting leflunomide. It may take day. Doctors will often prescribe a “loading dose” to be several weeks after starting leflunomide to experience an taken when the medicine is first prescribed. The loading improvement in joint pain or swelling. Complete benefits dose of leflunomide is usually 100 mg (or five 20 mg may not be experienced until 6 to 12 weeks after starting HOW TO tablets) once weekly for 3 weeks or 100 mg a day for the medication. TAKE IT The most common side effect of leflunomide is stomach pain, indigestion, rash, and hair loss. In fewer diarrhea, which occurs in approximately 20 percent than 10 percent of patients, leflunomide can cause of patients. This symptom frequently improves with abnormal liver function tests or decreased blood cell time or by taking a medication to prevent diarrhea. If or platelet counts. Rarely, this drug may cause lung diarrhea persists, the dose of leflunomide may need to problems, such as cough, shortness of breath or be reduced. -
2017 American College of Rheumatology/American Association
Arthritis Care & Research Vol. 69, No. 8, August 2017, pp 1111–1124 DOI 10.1002/acr.23274 VC 2017, American College of Rheumatology SPECIAL ARTICLE 2017 American College of Rheumatology/ American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty SUSAN M. GOODMAN,1 BRYAN SPRINGER,2 GORDON GUYATT,3 MATTHEW P. ABDEL,4 VINOD DASA,5 MICHAEL GEORGE,6 ORA GEWURZ-SINGER,7 JON T. GILES,8 BEVERLY JOHNSON,9 STEVE LEE,10 LISA A. MANDL,1 MICHAEL A. MONT,11 PETER SCULCO,1 SCOTT SPORER,12 LOUIS STRYKER,13 MARAT TURGUNBAEV,14 BARRY BRAUSE,1 ANTONIA F. CHEN,15 JEREMY GILILLAND,16 MARK GOODMAN,17 ARLENE HURLEY-ROSENBLATT,18 KYRIAKOS KIROU,1 ELENA LOSINA,19 RONALD MacKENZIE,1 KALEB MICHAUD,20 TED MIKULS,21 LINDA RUSSELL,1 22 14 23 17 ALEXANDER SAH, AMY S. MILLER, JASVINDER A. SINGH, AND ADOLPH YATES Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to the recommendations within this guideline to be volun- tary, with the ultimate determination regarding their application to be made by the physician in light of each patient’s individual circumstances. Guidelines and recommendations are intended to promote benefi- cial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed and endorsed by the ACR are subject to periodic revision as warranted by the evolution of medi- cal knowledge, technology, and practice. -
Multinational Evaluation of Mycophenolic Acid, Tacrolimus
View metadata, citation and similar papers at core.ac.uk brought to you by CORE providedORIGINAL by University of QueenslandPAPER eSpace ISSN 1425-9524 © Ann Transplant, 2016; 21: 1-11 DOI: 10.12659/AOT.895664 Received: 2015.08.15 Accepted: 2015.09.01 Multinational Evaluation of Mycophenolic Published: 2016.01.05 Acid, Tacrolimus, Cyclosporin, Sirolimus, and Everolimus Utilization Authors’ Contribution: ABCDEF Kyle M. Gardiner School of Pharmacy, University of Queensland, Brisbane, QLD, Australia Study Design A ACDEF Susan E. Tett Data Collection B Statistical Analysis C ACDEF Christine E. Staatz Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G Corresponding Author: Christine E. Staatz, e-mail: [email protected] Source of support: Departmental funding only Background: Increasing immunosuppressant utilization and expenditure is a worldwide challenge as more people success- fully live with transplanted organs. Our aims were to characterize utilization of mycophenolate, tacrolimus, cy- closporin, sirolimus, and everolimus in Australian transplant recipients from 2007 to 2013; to identify specific patterns of usage; and to compare Australian utilization with Norwegian, Danish, Swedish, and the Netherlands use. Material/Methods: Australian utilization and expenditure data were captured through national Pharmaceutical Benefits Scheme and Highly Specialized Drug administrative databases. Norwegian, Danish, Swedish, and the Netherlands uti- lization were retrieved from their healthcare databases. Utilization was compared as defined daily dose per 1000 population per day (DDD/1000 population/day). Data on kidney transplant recipients, the predominant patient group prescribed these medicines, were obtained from international transplant registries. Results: From 2007–2013 Australian utilization of mycophenolic acid, tacrolimus and everolimus increased 2.7-fold, 2.2- fold, and 2.3-fold, respectively. -
(12) Patent Application Publication (10) Pub. No.: US 2017/0209462 A1 Bilotti Et Al
US 20170209462A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2017/0209462 A1 Bilotti et al. (43) Pub. Date: Jul. 27, 2017 (54) BTK INHIBITOR COMBINATIONS FOR Publication Classification TREATING MULTIPLE MYELOMA (51) Int. Cl. (71) Applicant: Pharmacyclics LLC, Sunnyvale, CA A 6LX 3/573 (2006.01) A69/20 (2006.01) (US) A6IR 9/00 (2006.01) (72) Inventors: Elizabeth Bilotti, Sunnyvale, CA (US); A69/48 (2006.01) Thorsten Graef, Los Altos Hills, CA A 6LX 3/59 (2006.01) (US) A63L/454 (2006.01) (52) U.S. Cl. CPC .......... A61 K3I/573 (2013.01); A61K 3 1/519 (21) Appl. No.: 15/252,385 (2013.01); A61 K3I/454 (2013.01); A61 K 9/0053 (2013.01); A61K 9/48 (2013.01); A61 K (22) Filed: Aug. 31, 2016 9/20 (2013.01) (57) ABSTRACT Disclosed herein are pharmaceutical combinations, dosing Related U.S. Application Data regimen, and methods of administering a combination of a (60) Provisional application No. 62/212.518, filed on Aug. BTK inhibitor (e.g., ibrutinib), an immunomodulatory agent, 31, 2015. and a steroid for the treatment of a hematologic malignancy. US 2017/0209462 A1 Jul. 27, 2017 BTK INHIBITOR COMBINATIONS FOR Subject in need thereof comprising administering pomalido TREATING MULTIPLE MYELOMA mide, ibrutinib, and dexamethasone, wherein pomalido mide, ibrutinib, and dexamethasone are administered con CROSS-REFERENCE TO RELATED currently, simulataneously, and/or co-administered. APPLICATION 0008. In some aspects, provided herein is a method of treating a hematologic malignancy in a subject in need 0001. This application claims the benefit of U.S. -
Benlysta® (Belimumab)
UnitedHealthcare Pharmacy Clinical Pharmacy Programs Program Number 2021 P 1227-6 Program Prior Authorization/Notification Medication Benlysta® (belimumab)* *This program applies to the subcutaneous formulation of belimumab P&T Approval Date 9/2017, 9/2018, 9/2019, 9/2020, 2/2021, 7/2021 Effective Date 10/1/2021; Oxford only: 10/1/2021 1. Background: Benlysta® is a B-lymphocyte stimulator (BLyS)-specific inhibitor indicated for the treatment of patients aged 5 years and older with active, autoantibody-positive, systemic lupus erythematosus (SLE) who are receiving standard therapy and adult patients with active lupus nephritis who are receiving standard therapy. Limitations of Use: The efficacy of Benlysta has not been evaluated in patients with severe active central nervous system lupus. Benlysta has not been studied in combination with other biologics. Use of Benlysta is not recommended in these situations. 2. Coverage Criteria: A. Systemic Lupus Erythematosus 1. Initial Authorization a. Benlysta will be approved based on all of the following criteria: (1) Diagnosis of systemic lupus erythematosus -AND- (2) Laboratory testing has documented the presence of autoantibodies [e.g., ANA, Anti-dsDNA, Anti-Sm, Anti-Ro/SSA, Anti-La/SSB] -AND- (3) Patient is currently receiving standard immunosuppressive therapy [e.g., hydroxychloroquine, chloroquine, prednisone, azathioprine, methotrexate] -AND- (4) Patient does not have severe active central nervous system lupus -AND- (5) Patient is not receiving Benlysta in combination with either of the following: (a) Biologic DMARD [e.g., Enbrel (etanercept), Humira (adalimumab), Cimzia (certolizumab), Kineret (anakinra)] © 2021 UnitedHealthcare Services, Inc. 1 (b) Lupkynis (voclosporin) Authorization will be issued for 12 months. -
Attachment: Extract from Clinical Evaluation: Etanercept
AusPAR Attachment 2 Extract from the Clinical Evaluation Report for etanercept Proprietary Product Name: Erelzi Sponsor: Novartis Pharmaceuticals Australia Pty Ltd First round report: June 2017 Second round report: August 2017 Therapeutic Goods Administration About the Therapeutic Goods Administration (TGA) · The Therapeutic Goods Administration (TGA) is part of the Australian Government Department of Health and is responsible for regulating medicines and medical devices. · The TGA administers the Therapeutic Goods Act 1989 (the Act), applying a risk management approach designed to ensure therapeutic goods supplied in Australia meet acceptable standards of quality, safety and efficacy (performance) when necessary. · The work of the TGA is based on applying scientific and clinical expertise to decision- making, to ensure that the benefits to consumers outweigh any risks associated with the use of medicines and medical devices. · The TGA relies on the public, healthcare professionals and industry to report problems with medicines or medical devices. TGA investigates reports received by it to determine any necessary regulatory action. · To report a problem with a medicine or medical device, please see the information on the TGA website <https://www.tga.gov.au>. About AusPARs · An Australian Public Assessment Report (AusPAR) provides information about the evaluation of a prescription medicine and the considerations that led the TGA to approve or not approve a prescription medicine submission. · AusPARs are prepared and published by the TGA. · An AusPAR is prepared for submissions that relate to new chemical entities, generic medicines, major variations and extensions of indications. · An AusPAR is a static document; it provides information that relates to a submission at a particular point in time. -
Inner 24 India Pharma & Healthcare Fund Low
Tata India Pharma & Healthcare Fund (An open ended equity scheme investing in Pharma and Healthcare Services Sector) As on 30th June 2020 PORTFOLIO INVESTMENT STYLE Company name No. of Market Value % of Company name No. of Market Value % of Primarily focuses on investment in at least 80% of its net Shares Rs. Lakhs Assets Shares Rs. Lakhs Assets assets in equity/equity related instruments of the Equity & Equity Related Total 23733.48 98.49 companies in the Pharma & Healthcare sectors in India. Healthcare Services Other Equities^ 380.78 1.58 INVESTMENT OBJECTIVE Narayana Hrudayalaya Ltd. 382720 1025.69 4.26 Repo 871.61 3.62 The investment objective of the scheme is to seek long Healthcare Global Enterprises Ltd. term capital appreciation by investing atleast 80% of its 410000 503.48 2.09 Portfolio Total 24605.09 102.11 net assets in equity/equity related instruments of the Apollo Hospitals Enterprise Ltd. 32500 438.70 1.82 Net Current Liabilities -507.01 -2.11 companies in the pharma & healthcare sectors in Pharmaceuticals India.However, there is no assurance or guarantee that Net Assets 24098.08 100.00 the investment objective of the Scheme will be Sun Pharmaceutical Industries Ltd. 870100 4115.14 17.08 achieved.The Scheme does not assure or guarantee any Dr Reddys Laboratories Ltd. 98000 3866.05 16.04 returns. Divi Laboratories Ltd. 102500 2335.87 9.69 DATE OF ALLOTMENT Lupin Ltd. 223000 2033.31 8.44 December 28, 2015 Ipca Laboratories Ltd. 95000 1590.68 6.60 Cipla Ltd. 230000 1472.58 6.11 FUND MANAGER Aurobindo Pharma Ltd. -
WHO Drug Information Vol 22, No
WHO Drug Information Vol 22, No. 1, 2008 World Health Organization WHO Drug Information Contents Challenges in Biotherapeutics Miglustat: withdrawal by manufacturer 21 Regulatory pathways for biosimilar Voluntary withdrawal of clobutinol cough products 3 syrup 22 Pharmacovigilance Focus Current Topics WHO Programme for International Drug Proposed harmonized requirements: Monitoring: annual meeting 6 licensing vaccines in the Americas 23 Sixteen types of counterfeit artesunate Safety and Efficacy Issues circulating in South-east Asia 24 Eastern Mediterranean Ministers tackle Recall of heparin products extended 10 high medicines prices 24 Contaminated heparin products recalled 10 DacartTM development terminated and LapdapTM recalled 11 ATC/DDD Classification Varenicline and suicide attempts 11 ATC/DDD Classification (temporary) 26 Norelgestromin-ethynil estradiol: infarction ATC/DDD Classification (final) 28 and thromboembolism 12 Emerging cardiovascular concerns with Consultation Document rosiglitazone 12 Disclosure of transdermal patches 13 International Pharmacopoeia Statement on safety of HPV vaccine 13 Cycloserine 30 IVIG: myocardial infarction, stroke and Cycloserine capsules 33 thrombosis 14 Erythropoietins: lower haemoglobin levels 15 Recent Publications, Erythropoietin-stimulating agents 15 Pregabalin: hypersensitivity reactions 16 Information and Events Cefepime: increased mortality? 16 Assessing the quality of herbal medicines: Mycophenolic acid: pregnancy loss and contaminants and residues 36 congenital malformation 17 Launch -
XELJANZ (Tofacitinib) XELJANZ XR (Tofacitinib Extended Release Tablets)
Reference number(s) 2011-A SPECIALTY GUIDELINE MANAGEMENT XELJANZ (tofacitinib) XELJANZ XR (tofacitinib extended release tablets) POLICY I. INDICATIONS The indications below including FDA-approved indications and compendial uses are considered a covered benefit provided that all the approval criteria are met and the member has no exclusions to the prescribed therapy. FDA-Approved Indications A. Moderately to severely active rheumatoid arthritis B. Active psoriatic arthritis C. Moderately to severely active ulcerative colitis All other indications are considered experimental/investigational and are not a covered benefit. II. CRITERIA FOR INITIAL APPROVAL A. Moderately to severely active rheumatoid arthritis (RA) 1. Authorization of 24 months may be granted to members who have previously received tofacitinib or any biologic DMARD indicated for the treatment of moderately to severely active rheumatoid arthritis. 2. Authorization of 24 months may be granted for treatment of moderately to severely active RA when any of the following criteria is met: i. Member has experienced an inadequate response to at least a 3-month trial of methotrexate despite adequate dosing (i.e., titrated to 20 mg/week). ii. Member has an intolerance or contraindication to methotrexate (see Appendix). B. Active psoriatic arthritis (PsA) 1. Authorization of 24 months may be granted to members who have previously received tofacitinib or any biologic DMARD indicated for the treatment of active psoriatic arthritis. Tofacitinib must be used in combination with a nonbiologic DMARD (e.g., methotrexate, leflunomide, sulfasalazine, etc.) 2. Authorization of 24 months may be granted for treatment of active PsA when all of the following criteria are met: i.