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WO 2018/223101 Al 06 December 2018 (06.12.2018) W !P O PCT
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2018/223101 Al 06 December 2018 (06.12.2018) W !P O PCT (51) International Patent Classification: (71) Applicant: JUNO THERAPEUTICS, INC. [US/US]; 400 A 61K 35/1 7 (20 15.0 1) A 61P 35/00 (2006 .0 1) Dexter Ave. N., Suite 1200, Seattle, WA 98109 (US). (21) International Application Number: (72) Inventor: ALBERTSON, Tina; 400 Dexter Ave. N., Suite PCT/US2018/035755 1200, Seattle, WA 98109 (US). (22) International Filing Date: (74) Agent: AHN, Sejin et al; Morrison & Foerster LLP, 1253 1 0 1 June 2018 (01 .06.2018) High Bluff Drive, Suite 100, San Diego, CA 92130-2040 (US). (25) Filing Language: English (81) Designated States (unless otherwise indicated, for every (26) Publication Language: English kind of national protection available): AE, AG, AL, AM, (30) Priority Data: AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, BZ, 62/5 14,774 02 June 2017 (02.06.2017) US CA, CH, CL, CN, CO, CR, CU, CZ, DE, DJ, DK, DM, DO, 62/5 15,530 05 June 2017 (05.06.2017) US DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, 62/521,366 16 June 2017 (16.06.2017) u s HR, HU, ID, IL, IN, IR, IS, JO, JP, KE, KG, KH, KN, KP, 62/527,000 29 June 2017 (29.06.2017) u s KR, KW, KZ, LA, LC, LK, LR, LS, LU, LY, MA, MD, ME, 62/549,938 24 August 2017 (24.08.2017) u s MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, 62/580,425 0 1 November 2017 (01 .11.2017) u s OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA, 62/593,871 0 1 December 2017 (01 .12.2017) u s SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, 62/596,764 08 December 2017 (08.12.2017) u s TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. -
Charcot Ankle Neuroarthropathy Pathology, Diagnosis and Management: a Review of Literature
MOJ Orthopedics & Rheumatology Charcot Ankle Neuroarthropathy Pathology, Diagnosis and Management: A Review of Literature Keywords: Ankle charcot Arthropathy; Ankle arthrodesis; Ankle external fxation arthrodesis; Total contact cast; Ankle Review Article neuroarthropathy Volume 6 Issue 2 - 2016 Key Points: Charcot ankle neuroarthropathy is a common hard to treat condition, early diagnosis and proper management is the key point of treatment. Non- surgical options are feasible in certain stages, but surgical intervention is required in advanced 1Orthopaedic surgery specialist, Nasser institute for research disease. and treatment, Egypt 2Foot and ankle surgery fellow, Schmerzklinik Basel, Introduction Switzerland 3Lecturer of Orthopaedic surgery, Ain Shams University, Egypt Charcot neuroarthropathy can be described as a non-infective, destructive process activated by an isolated or accumulative *Corresponding author: neuro-traumatic stimulus that manifests as dislocation, peri- Ahmed E Galhoum, Orthopedic articular fracture or both in patients rendered insensate by Department, Schmirzklinik, Basel, 11-15 Hirschgasslein, peripheral neuropathy [1]. 4010 Basel, Switzerland, Email: Received: October 01, 2016 | Published: November 03, The ankle has swelling, warmth, and erythema, and the 2016 The bones and joints develop fractures, ligamentous laxity, dislocations,syndrome may cartilage initially damage, be difficult bone to erosions, distinguish and from hypertrophic infection. repair [2]. The resulting bone and joint deformities may be is present in 22% to 53% of patients with Charcot Arthropathy [6,14,15]. or braces. Furthermore, ulceration may result from instability or bonyassociated prominence with instability and may and cause may chronic compromise or recurrent the fitting soft of tissueshoes Classification infection and osteomyelitis. Amputation may be required for Modified eichenholtz stages management of infection or instability [2]. -
DRUGS REQUIRING PRIOR AUTHORIZATION in the MEDICAL BENEFIT Page 1
Effective Date: 08/01/2021 DRUGS REQUIRING PRIOR AUTHORIZATION IN THE MEDICAL BENEFIT Page 1 Therapeutic Category Drug Class Trade Name Generic Name HCPCS Procedure Code HCPCS Procedure Code Description Anti-infectives Antiretrovirals, HIV CABENUVA cabotegravir-rilpivirine C9077 Injection, cabotegravir and rilpivirine, 2mg/3mg Antithrombotic Agents von Willebrand Factor-Directed Antibody CABLIVI caplacizumab-yhdp C9047 Injection, caplacizumab-yhdp, 1 mg Cardiology Antilipemic EVKEEZA evinacumab-dgnb C9079 Injection, evinacumab-dgnb, 5 mg Cardiology Hemostatic Agent BERINERT c1 esterase J0597 Injection, C1 esterase inhibitor (human), Berinert, 10 units Cardiology Hemostatic Agent CINRYZE c1 esterase J0598 Injection, C1 esterase inhibitor (human), Cinryze, 10 units Cardiology Hemostatic Agent FIRAZYR icatibant J1744 Injection, icatibant, 1 mg Cardiology Hemostatic Agent HAEGARDA c1 esterase J0599 Injection, C1 esterase inhibitor (human), (Haegarda), 10 units Cardiology Hemostatic Agent ICATIBANT (generic) icatibant J1744 Injection, icatibant, 1 mg Cardiology Hemostatic Agent KALBITOR ecallantide J1290 Injection, ecallantide, 1 mg Cardiology Hemostatic Agent RUCONEST c1 esterase J0596 Injection, C1 esterase inhibitor (recombinant), Ruconest, 10 units Injection, lanadelumab-flyo, 1 mg (code may be used for Medicare when drug administered under Cardiology Hemostatic Agent TAKHZYRO lanadelumab-flyo J0593 direct supervision of a physician, not for use when drug is self-administered) Cardiology Pulmonary Arterial Hypertension EPOPROSTENOL (generic) -
ICD-10 Code Descriptions
ICD-10 Code Descriptions TYPE 1 DIABETES MELLITUS WITH... (E10) TYPE 2 DIABETES MELLITUS WITH... (E11) E10.10 Ketoacidosis without coma E11.00 Hyperosmolarity w/o nonket hyprgly-hypros coma (NKHHC) E10.11 Ketoacidosis with coma Hyperosmolarity without nonketotic hyperglycemic- E11.00 E10.21 Diabetic nephropathy hyperosmolar coma (NKHHC) E10.22 Diabetic chronic kidney disease E11.01 Hyperosmolarity with coma E10.29 Other diabetic kidney complication E11.21 Diabetic nephropathy E10.311 Unspecified diabetic retinopathy with macular edema E11.22 Diabetic chronic kidney disease E11.29 Other diabetic kidney complication E10.319 Unspecified diabetic retinopathy without macular edema E11.311 Unspecified diabetic retinopathy with macular edema Mild nonproliferative diabetic retinopathy without macular E10.329 edema E11.319 Unspecified diabetic retinopathy without macular edema Moderate nonproliferative diabetic retinopathy with E11.321 Mild nonproliferative diabetic retinopathy with macular edema E10.331 macular edema Mild nonproliferative diabetic retinopathy without macular E11.329 edema Moderate nonproliferative diabetic retinopathy without E10.339 Moderate nonproliferative diabetic retinopathy with macular macular edema E11.331 edema Mellitus with severe nonproliferative diabetic retinopathy E10.341 Moderate nonproliferative diabetic retinopathy without macular with macular edema E11.339 edema Severe nonproliferative diabetic retinopathy without E10.349 Severe nonproliferative diabetic retinopathy with macular macular edema E11.341 edema E10.351 -
Outcome After Protected Full Weightbearing Treatment in an Orthopedic Device in Diabetic Neuropathic Arthropathy
Renner et al. BMC Musculoskeletal Disorders (2016) 17:504 DOI 10.1186/s12891-016-1357-4 RESEARCH ARTICLE Open Access Outcome after protected full weightbearing treatment in an orthopedic device in diabetic neuropathic arthropathy (Charcot arthropathy): a comparison of unilaterally and bilaterally affected patients Niklas Renner1*, Stephan Hermann Wirth2, Georg Osterhoff3, Thomas Böni2 and Martin Berli2 Abstract Background: Charcot neuropathic arthropathy (CN) is a chronic, progressive, destructive, non-infectious process that most frequently affects the bone architecture of the foot in patients with sensory neuropathy. We evaluated the outcome of protected weightbearing treatment of CN in unilaterally and bilaterally affected patients and secondarily compared outcomes in protected versus unprotected weightbearing treatment. Methods: Patient records and radiographs from 2002 to 2012 were retrospectively analyzed. Patients with Type 1 or Type 2 diabetes with peripheral neuropathy were included. Exclusion criteria included immunosuppressive or osteoactive medication and the presence of bone tumors. Ninety patients (101 ft), mean age 60.7 ± 10.6 years at first diagnosis of CN, were identified. Protected weightbearing treatment was achieved by total contact cast or custom-made orthosis. Ulcer, infection, CN recurrence, and amputation rates were recorded. Mean follow-up was 48 (range 1–208) months. Results: Per the Eichenholtz classification, 9 ft were prodromal, 61 in stage 1 (development), 21 in stage 2 (coalescence) and 10 in stage 3 (reconstruction). Duration of protected weightbearing was 20 ± 21 weeks and 22 ± 29 weeks in patients with unilateral and bilateral CN, respectively. In bilaterally affected patients, new ulcers developed in 9/22 (41%) feet. In unilaterally affected patients, new ulcers developed in 5/66 (8%) protected weightbearing feet and 4/13 (31%) unprotected, full weightbearing feet (p = 0.036). -
European Medicines Agency Accepts Marketing Authorization Application for Asfotase Alfa As a Treatment for Patients with Hypophosphatasia
July 24, 2014 European Medicines Agency Accepts Marketing Authorization Application for Asfotase Alfa as a Treatment for Patients with Hypophosphatasia -- Application designated for review under accelerated assessment process -- CHESHIRE, Conn.--(BUSINESS WIRE)-- Alexion Pharmaceuticals, Inc. (NASDAQ:ALXN) today announced that the Marketing Authorization Application (MAA) for asfotase alfa, an investigational, first-in-class targeted enzyme replacement therapy for the treatment of hypophosphatasia (HPP), has been validated and granted accelerated assessment by the European Medicines Agency (EMA). The acceptance of this MAA marks the beginning of the review process in the European Union (EU) for this potential new treatment. "HPP is a devastating disease for patients and their families due to progressive deterioration of bones and muscle weakness, which can result in impaired respiratory function, severe disability and death," said Leonard Bell, M.D., Chief Executive Officer of Alexion. "If approved, asfotase alfa would be the first therapy for patients with this life-threatening disorder." The EU filing includes positive data from 68 patients with pediatric-onset HPP (ranging from newborns to 66 years of age) enrolled in three pivotal prospective studies and their extensions, as well as a retrospective natural history study in infants. In April, Alexion initiated the rolling submission of a Biologics License Application (BLA) for asfotase alfa as a treatment for patients with HPP with the U.S. Food and Drug Administration (FDA). About -
JAK-Inhibitors for the Treatment of Rheumatoid Arthritis: a Focus on the Present and an Outlook on the Future
biomolecules Review JAK-Inhibitors for the Treatment of Rheumatoid Arthritis: A Focus on the Present and an Outlook on the Future 1, 2, , 3 1,4 Jacopo Angelini y , Rossella Talotta * y , Rossana Roncato , Giulia Fornasier , Giorgia Barbiero 1, Lisa Dal Cin 1, Serena Brancati 1 and Francesco Scaglione 5 1 Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, 20133 Milan, Italy; [email protected] (J.A.); [email protected] (G.F.); [email protected] (G.B.); [email protected] (L.D.C.); [email protected] (S.B.) 2 Department of Clinical and Experimental Medicine, Rheumatology Unit, AOU “Gaetano Martino”, University of Messina, 98100 Messina, Italy 3 Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Pordenone, 33081 Aviano, Italy; [email protected] 4 Pharmacy Unit, IRCCS-Burlo Garofolo di Trieste, 34137 Trieste, Italy 5 Head of Clinical Pharmacology and Toxicology Unit, Grande Ospedale Metropolitano Niguarda, Department of Oncology and Onco-Hematology, Director of Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, 20162 Milan, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-090-2111; Fax: +39-090-293-5162 Co-first authors. y Received: 16 May 2020; Accepted: 1 July 2020; Published: 5 July 2020 Abstract: Janus kinase inhibitors (JAKi) belong to a new class of oral targeted disease-modifying drugs which have recently revolutionized the therapeutic panorama of rheumatoid arthritis (RA) and other immune-mediated diseases, placing alongside or even replacing conventional and biological drugs. -
Oregon Medicaid Pharmaceutical Services Prior Authorization Criteria
Oregon Medicaid Pharmaceutical Services Prior Authorization Criteria HEALTH SYSTEMS DIVISION Prior authorization (PA) criteria for fee-for-service prescriptions for Oregon Health Plan clients March 1, 2021 Contents Contents ................................................................................................................................................................ 2 Introduction........................................................................................................................................................... 7 About this guide ......................................................................................................................................... 7 How to use this guide ................................................................................................................................. 7 Administrative rules and supplemental information .................................................................................. 7 Update information............................................................................................................................................... 8 Effective March 1, 2021 ............................................................................................................................ 8 Substantive updates and new criteria ............................................................................................. 8 Clerical changes ............................................................................................................................ -
Asfotase Alfa for Infants and Young Children with Hypophosphatasia: 7 Year Outcomes of a Single-Arm, Open-Label, Phase 2 Extension Trial
Articles Asfotase alfa for infants and young children with hypophosphatasia: 7 year outcomes of a single-arm, open-label, phase 2 extension trial Michael P Whyte, Jill H Simmons, Scott Moseley, Kenji P Fujita, Nicholas Bishop, Nada J Salman, John Taylor, Dawn Phillips, Mairead McGinn, William H McAlister Summary Background Our previous phase 2, open-label study of 11 infants and young children with life-threatening perinatal or Lancet Diabetes Endocrinol infantile hypophosphatasia showed 1 year safety and efficacy of asfotase alfa, an enzyme replacement therapy. We 2019; 7: 93–105 aimed to report the long-term outcomes over approximately 7 years of treatment. Published Online December 14, 2018 http://dx.doi.org/10.1016/ Methods We did a prespecified, end of study, 7 year follow-up of our single-arm, open-label, phase 2 trial in which S2213-8587(18)30307-3 children aged 3 years or younger with life-threatening perinatal or infantile hypophosphatasia were recruited from This online publication has been ten hospitals (six in the USA, two in the UK, one in Canada, and one in the United Arab Emirates). Patients received corrected. The corrected version asfotase alfa (1 mg/kg three times per week subcutaneously, adjusted to 3 mg/kg three times per week if required) for first appeared at thelancet. up to 7 years (primary treatment period plus extension phase) or until the product became commercially available; com/diabetes-endocrinology on January 22, 2019 dosage adjustments were made at each visit according to changes in the patient’s weight. The primary objectives of See Comment page 76 this extension study were to assess the long-term tolerability of asfotase alfa, defined as the number of patients with Center for Metabolic Bone one or more treatment-emergent adverse events, and skeletal manifestations associated with hypophosphatasia, Disease and Molecular evaluated using the Radiographic Global Impression of Change (RGI-C) scale (−3 indicating severe worsening, and Research, Shriners Hospital for +3 complete or near-complete healing). -
Pathogenesis and Potential Relative Risk Factors of Diabetic Neuropathic
Zhao et al. Journal of Orthopaedic Surgery and Research (2017) 12:142 DOI 10.1186/s13018-017-0634-8 REVIEW Open Access Pathogenesis and potential relative risk factors of diabetic neuropathic osteoarthropathy Hong-Mou Zhao1, Jia-Yu Diao2, Xiao-Jun Liang1, Feng Zhang3* and Ding-Jun Hao4* Abstract Diabetic neuropathic osteoarthropathy (DNOAP) is an uncommon, but with considerable morbidity and mortality rates, complication of diabetes. The real pathogenesis is still unclear. The two popular theories are the neuro-vascular theory and neuro-traumatic theory. Most theories and pathways focused on the uncontrolled inflammations that resulted in the final common pathway, receptor activator of nuclear factor κβ ligand (RANKL)/osteoprotegerin (OPG) axis, for the decreased bone density in DNOAP with an osteoclast and osteoblast imbalance. However, the RANKL/OPG pathway does not explain all the changes, other pathways and factors also play roles. A lot of DNOAP potential relative risk factors were evaluated and reported in the literature, including age, gender, weight, duration and type of diabetes, bone mineral density, peripheral neuropathy and arterial disease, trauma history, and some others. However, most of them are still in debates. Future studies focus on the pathogenesis of DNOAP are still needed, especially for the genetic factors. And, the relationship between DNOAP and those potential relative risk factors are still need to further clarify. Keywords: Charcot foot, Diabetic neuropathic osteoarthropathy, Pathogenesis, Risk factor, Receptor activator of nuclear factor κβ ligand (RANKL) Background DNOAP is a devastating complication for diabetes, Musgrave firstly reported neuropathic joint changes as a culminating in bone destruction and involving joints and complication of venereal disease in 1703 [1]. -
Study Protocol
(rJ GI LEAi) Galapagos CLINICAL STUDY PROTOCOL Study Title: A Phase 2, Double-Blind, Randomized, Placebo-Controlled Study Evaluating the Efficacy and Safety of Filgotinib in the Treatment of Small Bowel Crohn’s Disease (SBCD) Sponsor: Gilead Sciences, Inc. 333 Lakeside Drive Foster City, CA 94404, USA IND Number: 129646 EudraCT Number: 2016-003179-23 Clinical Trials.gov NCT03046056 Identifier: Indication: Small Bowel Crohn’s Disease Protocol ID: GS-US-419-4015 Contact Information: The medical monitor name and contact information will be provided on the Key Study Team Contact List. Protocol Original: 12 September 2016 Version/Date: Amendment 1: 16 December 2016 Amendment 2: 26 June 2017 Amendment 3: 04 February 2020 CONFIDENTIALITY STATEMENT The information contained in this document, particularly unpublished data, is the property or under control of Gilead Sciences, Inc., and is provided to you in confidence as an investigator, potential investigator, or consultant, for review by you, your staff, and an applicable Institutional Review Board or Independent Ethics Committee. The information is only to be used by you in connection with authorized clinical studies of the investigational drug described in the protocol. You will not disclose any of the information to others without written authorization from Gilead Sciences, Inc., except to the extent necessary to obtain informed consent from those persons to whom the drug may be administered. Filgotinib Protocol GS-US-419-4015 Final Gilead Sciences, lnc. Amendment3 TABLE OF CONTENTS TABLE -
Recommendations from York and Scarborough Medicines
Recommendations from York and Scarborough Medicines Commissioning Committee March 2021 Drug name Indication Recommendation, rationale and place in RAG status Potential full year cost impact therapy CCG commissioned Technology Appraisals 1. TA672: Brolucizumab for Brolucizumab is recommended as an option for treating wet Listed as RED Discussed and approved at Feb 2021 MCC meeting. treating wet age-related age-related macular degeneration in adults, only if, in the eye drug macular degeneration to be treated: the best-corrected visual acuity is between 6/12 and Commissioning: CCG, 6/96 tariff excluded there is no permanent structural damage to the central fovea the lesion size is less than or equal to 12 disc areas in greatest linear dimension and there is recent presumed disease progression (for example, blood vessel growth, as shown by fluorescein angiography, or recent visual acuity changes). It is recommended only if the company provides brolucizumab according to the commercial arrangement. If patients and their clinicians consider brolucizumab to be one of a range of suitable treatments, including aflibercept and ranibizumab, choose the least expensive (taking into account administration costs and commercial arrangements). Only continue brolucizumab in people who maintain an adequate response to therapy. Criteria for stopping should include persistent deterioration in visual acuity and identification of anatomical changes in the retina that indicate inadequate response to therapy. 2. TA675: Vernakalant for NICE is unable to make a recommendation about the Not listed No cost impact to CCGs as appraisal terminated by the rapid conversion of use in the NHS of vernakalant for the rapid conversion NICE and insufficient evidence to approve use.