Provider Procedures Manual January 2019 Provider Handbooks
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Fig. L COMPOSITIONS and METHODS to INHIBIT STEM CELL and PROGENITOR CELL BINDING to LYMPHOID TISSUE and for REGENERATING GERMINAL CENTERS in LYMPHATIC TISSUES
(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 Χ 23 February 2012 (23.02.2012) WO 2U12/U24519ft ft A2 (51) International Patent Classification: AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, A61K 31/00 (2006.01) CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (21) International Application Number: HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, PCT/US201 1/048297 KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, (22) International Filing Date: ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, 18 August 201 1 (18.08.201 1) NO, NZ, OM, PE, PG, PH, PL, PT, QA, RO, RS, RU, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, (25) Filing Language: English TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, (26) Publication Language: English ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every 61/374,943 18 August 2010 (18.08.2010) US kind of regional protection available): ARIPO (BW, GH, 61/441,485 10 February 201 1 (10.02.201 1) US GM, KE, LR, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, 61/449,372 4 March 201 1 (04.03.201 1) US ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, (72) Inventor; and EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, ΓΓ, LT, LU, (71) Applicant : DEISHER, Theresa [US/US]; 1420 Fifth LV, MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK, Avenue, Seattle, WA 98101 (US). -
Pharmacologic Considerations in the Disposition of Antibodies and Antibody-Drug Conjugates in Preclinical Models and in Patients
antibodies Review Pharmacologic Considerations in the Disposition of Antibodies and Antibody-Drug Conjugates in Preclinical Models and in Patients Andrew T. Lucas 1,2,3,*, Ryan Robinson 3, Allison N. Schorzman 2, Joseph A. Piscitelli 1, Juan F. Razo 1 and William C. Zamboni 1,2,3 1 University of North Carolina (UNC), Eshelman School of Pharmacy, Chapel Hill, NC 27599, USA; [email protected] (J.A.P.); [email protected] (J.F.R.); [email protected] (W.C.Z.) 2 Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; [email protected] 3 Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; [email protected] * Correspondence: [email protected]; Tel.: +1-919-966-5242; Fax: +1-919-966-5863 Received: 30 November 2018; Accepted: 22 December 2018; Published: 1 January 2019 Abstract: The rapid advancement in the development of therapeutic proteins, including monoclonal antibodies (mAbs) and antibody-drug conjugates (ADCs), has created a novel mechanism to selectively deliver highly potent cytotoxic agents in the treatment of cancer. These agents provide numerous benefits compared to traditional small molecule drugs, though their clinical use still requires optimization. The pharmacology of mAbs/ADCs is complex and because ADCs are comprised of multiple components, individual agent characteristics and patient variables can affect their disposition. To further improve the clinical use and rational development of these agents, it is imperative to comprehend the complex mechanisms employed by antibody-based agents in traversing numerous biological barriers and how agent/patient factors affect tumor delivery, toxicities, efficacy, and ultimately, biodistribution. -
Where Do Novel Drugs of 2016 Fit In?
FORMULARY JEOPARDY: WHERE DO NOVEL DRUGS OF 2016 FIT IN? Maabo Kludze, PharmD, MBA, CDE, BCPS, Associate Director Elizabeth A. Shlom, PharmD, BCPS, SVP & Director Clinical Pharmacy Program Acurity, Inc. Privileged and Confidential August 15, 2017 Privileged and Confidential Program Objectives By the end of the presentation, the pharmacist or pharmacy technician participant will be able to: ◆ Identify orphan drugs and first-in-class medications approved by the FDA in 2016. ◆ Describe the role of new agents approved for use in oncology patients. ◆ Identify and discuss the role of novel monoclonal antibodies. ◆ Discuss at least two new medications that address public health concerns. Neither Dr. Kludze nor Dr. Shlom have any conflicts of interest in regards to this presentation. Privileged and Confidential 2016 NDA Approvals (NMEs/BLAs) ◆ Nuplazid (primavanserin) P ◆ Adlyxin (lixisenatide) ◆ Ocaliva (obeticholic acid) P, O ◆ Anthim (obitoxaximab) O ◆ Rubraca (rucaparib camsylate) P, O ◆ Axumin (fluciclovive F18) P ◆ Spinraza (nusinersen sodium) P, O ◆ Briviact (brivaracetam) ◆ Taltz (ixekizumab) ◆ Cinqair (reslizumab) ◆ Tecentriq (atezolizumab) P ◆ Defitelio (defibrotide sodium) P, O ◆ Venclexta (venetoclax) P, O ◆ Epclusa (sofosburvir and velpatasvir) P ◆ Xiidra (lifitigrast) P ◆ Eucrisa (crisaborole) ◆ Zepatier (elbasvir and grazoprevir) P ◆ Exondys 51 (eteplirsen) P, O ◆ Zinbyrta (daclizumab) ◆ Lartruvo (olaratumab) P, O ◆ Zinplava (bezlotoxumab) P ◆ NETSTPOT (gallium Ga 68 dotatate) P, O O = Orphan; P = Priority Review; Red = BLA Privileged and Confidential History of FDA Approvals Privileged and Confidential Orphan Drugs ◆FDA Office of Orphan Products Development • Orphan Drug Act (1983) – drugs and biologics . “intended for safe and effective treatment, diagnosis or prevention of rare diseases/disorders that affect fewer than 200,000 people in the U.S. -
Interleukins in Therapeutics
67 ISSN: 2347 - 7881 Review Article Interleukins in Therapeutics Anjan Khadka Department of Pharmacology, AFMC, Pune, India [email protected] ABSTRACT Interleukins are a subset of a larger group of cellular messenger molecules called cytokines, which are modulators of cellular behaviour. On the basis of their respective cytokine profiles, responses to chemokines, and interactions with other cells, these T-cell subsets can promote different types of inflammatory responses. During the development of allergic disease, effector TH2 cells produce IL-4, IL- 5, IL-9, and IL-32. IL-25, IL- 31, and IL-33 contributes to TH2 responses and inflammation. These cytokines have roles in production of allergen-specific IgE, eosinophilia, and mucus. ILs have role in therapeutics as well as diagnosis and prognosis as biomarker in various conditions. Therapeutic targeting of the IL considered to be rational treatment strategy and promising biologic therapy. Keywords: Interleukins, cytokines, Interleukin Inhibitors, Advances INTRODUCTION meaning ‘hormones’. It was Stanley Cohen in Interleukins are group of cytokines that were 1974 who for the first time introduced the term first seen to be expressed by leucocytes and ‘‘cytokine’’. It includes lymphokines, they interact between cells of the immune monokines, interleukins, and colony stimulating systems. It is termed by Dr. Vern Paetkau factors (CSFs), interferons (IFNs), tumor (University of Victoria) in1979.Interleukins (IL) necrosis factor (TNF) and chemokines. The are able to promote cell growth, differentiation, majority of interleukins are synthesized by and functional activation. The question of how helper CD4 T lymphocytes as well as through diverse cell types communicate with each monocytes, macrophages, and endothelial cells. -
Challenges and Approaches for the Development of Safer Immunomodulatory Biologics
REVIEWS Challenges and approaches for the development of safer immunomodulatory biologics Jean G. Sathish1*, Swaminathan Sethu1*, Marie-Christine Bielsky2, Lolke de Haan3, Neil S. French1, Karthik Govindappa1, James Green4, Christopher E. M. Griffiths5, Stephen Holgate6, David Jones2, Ian Kimber7, Jonathan Moggs8, Dean J. Naisbitt1, Munir Pirmohamed1, Gabriele Reichmann9, Jennifer Sims10, Meena Subramanyam11, Marque D. Todd12, Jan Willem Van Der Laan13, Richard J. Weaver14 and B. Kevin Park1 Abstract | Immunomodulatory biologics, which render their therapeutic effects by modulating or harnessing immune responses, have proven their therapeutic utility in several complex conditions including cancer and autoimmune diseases. However, unwanted adverse reactions — including serious infections, malignancy, cytokine release syndrome, anaphylaxis and hypersensitivity as well as immunogenicity — pose a challenge to the development of new (and safer) immunomodulatory biologics. In this article, we assess the safety issues associated with immunomodulatory biologics and discuss the current approaches for predicting and mitigating adverse reactions associated with their use. We also outline how these approaches can inform the development of safer immunomodulatory biologics. Immunomodulatory Biologics currently represent more than 30% of licensed The high specificity of the interactions of immu- biologics pharmaceutical products and have expanded the thera- nomodulatory biologics with their relevant immune Biotechnology-derived peutic options available -
Simulect® (Basiliximab)
UnitedHealthcare® Value & Balance Exchange Medical Benefit Drug Policy Simulect® (Basiliximab) Policy Number: IEXD0219.02 Effective Date: July 1, 2021 Instructions for Use Table of Contents Page Related Policies Applicable States ........................................................................... 1 None Coverage Rationale ....................................................................... 1 Applicable Codes .......................................................................... 1 Background.................................................................................... 2 Clinical Evidence ........................................................................... 2 U.S. Food and Drug Administration ............................................. 2 References ..................................................................................... 2 Policy History/Revision Information ............................................. 2 Instructions for Use ....................................................................... 3 Applicable States This Medical Benefit Drug Policy only applies to the states of Arizona, Maryland, North Carolina, Oklahoma, Tennessee, Virginia, and Washington. Coverage Rationale Simulect is proven and medically necessary for the treatment of prophylaxis of acute organ rejection when all of the following criteria are met: Patient has received a kidney transplant; and Physician provided documentation that patient’s prophylaxis therapy includes cyclosporine modified and corticosteroids; and Simulect -
September 2017 ~ Resource #330909
−This Clinical Resource gives subscribers additional insight related to the Recommendations published in− September 2017 ~ Resource #330909 Medications Stored in the Refrigerator (Information below comes from current U.S. and Canadian product labeling and is current as of date of publication) Proper medication storage is important to ensure medication shelf life until the manufacturer expiration date and to reduce waste. Many meds are recommended to be stored at controlled-room temperature. However, several meds require storage in the refrigerator or freezer to ensure stability. See our toolbox, Medication Storage: Maintaining the Cold Chain, for helpful storage tips and other resources. Though most meds requiring storage at temperatures colder than room temperature should be stored in the refrigerator, expect to see a few meds require storage in the freezer. Some examples of medications requiring frozen storage conditions include: anthrax immune globulin (Anthrasil [U.S. only]), carmustine wafer (Gliadel [U.S. only]), cholera (live) vaccine (Vaxchora), dinoprostone vaginal insert (Cervidil), dinoprostone vaginal suppository (Prostin E2 [U.S.]), varicella vaccine (Varivax [U.S.]; Varivax III [Canada] can be stored in the refrigerator or freezer), zoster vaccine (Zostavax [U.S.]; Zostavax II [Canada] can be stored in the refrigerator or freezer). Use the list below to help identify medications requiring refrigerator storage and become familiar with acceptable temperature excursions from recommended storage conditions. Abbreviations: RT = room temperature Abaloparatide (Tymlos [U.S.]) Aflibercept (Eylea) Amphotericin B (Abelcet, Fungizone) • Once open, may store at RT (68°F to 77°F • May store at RT (77°F [25°C]) for up to Anakinra (Kineret) [20°C to 25°C]) for up to 30 days. -
B Cell Immunity in Solid Organ Transplantation
REVIEW published: 10 January 2017 doi: 10.3389/fimmu.2016.00686 B Cell Immunity in Solid Organ Transplantation Gonca E. Karahan, Frans H. J. Claas and Sebastiaan Heidt* Department of Immunohaematology and Blood Transfusion, Leiden University Medical Center, Leiden, Netherlands The contribution of B cells to alloimmune responses is gradually being understood in more detail. We now know that B cells can perpetuate alloimmune responses in multiple ways: (i) differentiation into antibody-producing plasma cells; (ii) sustaining long-term humoral immune memory; (iii) serving as antigen-presenting cells; (iv) organizing the formation of tertiary lymphoid organs; and (v) secreting pro- as well as anti-inflammatory cytokines. The cross-talk between B cells and T cells in the course of immune responses forms the basis of these diverse functions. In the setting of organ transplantation, focus has gradually shifted from T cells to B cells, with an increased notion that B cells are more than mere precursors of antibody-producing plasma cells. In this review, we discuss the various roles of B cells in the generation of alloimmune responses beyond antibody production, as well as possibilities to specifically interfere with B cell activation. Keywords: HLA, donor-specific antibodies, antigen presentation, cognate T–B interactions, memory B cells, rejection Edited by: Narinder K. Mehra, INTRODUCTION All India Institute of Medical Sciences, India In the setting of organ transplantation, B cells are primarily known for their ability to differentiate Reviewed by: into long-lived plasma cells producing high affinity, class-switched alloantibodies. The detrimental Anat R. Tambur, role of pre-existing donor-reactive antibodies at time of transplantation was already described in Northwestern University, USA the 60s of the previous century in the form of hyperacute rejection (1). -
Asthma Agents
APPROVED PA Criteria Initial Approval Date: July 10, 2019 Revised Date: January 20, 2021 CRITERIA FOR PRIOR AUTHORIZATION Asthma Agents BILLING CODE TYPE For drug coverage and provider type information, see the KMAP Reference Codes webpage. MANUAL GUIDELINES Prior authorization will be required for all current and future dose forms available. All medication-specific criteria, including drug-specific indication, age, and dose for each agent is defined in Table 1 below. Benralizumab (Fasenra®) Dupilumab (Dupixent®) Mepolizumab (Nucala®) Omalizumab (Xolair®) Reslizumab (Cinqair®) GENERAL CRITERIA FOR INITIAL PRIOR AUTHORIZATION: (must meet all of the following) • Must be approved for the indication, age, and not exceed dosing limits listed in Table 1. • Must be prescribed by or in consultation with a pulmonologist, allergist, or immunologist.1,2 • For all agents listed, the preferred PDL drug, which treats the PA indication, is required unless the patient meets the non-preferred PDL PA criteria. • Must have experienced ≥ 2 exacerbations within the last 12 months despite meeting all of the following (exacerbation is defined as requiring the use of oral/systemic corticosteroids, urgent care/hospital admission, or intubation: o Patient adherence to two long-term controller medications, including a high-dose inhaled corticosteroid 1,2 (ICS) and a long-acting beta2-agonist (LABA) listed in Table 2. ▪ Combination ICS/LABA and ICS/LABA/LAMA products meet the requirement of two controller medications. o Patient must have had an adequate trial (at least 90 consecutive days) of a leukotriene modifier or a long-acting muscarinic antagonist (LAMA) as a third long-term controller medication listed in Table 2. -
Novel Therapies for Eosinophilic Disorders
Novel Therapies for Eosinophilic Disorders Bruce S. Bochner, MD KEYWORDS Eosinophil Therapies Antibodies Targets Pharmacology Biomarkers KEY POINTS A sizable unmet need exists for new, safe, selective, and effective treatments for eosinophil-associated diseases, such as hypereosinophilic syndrome, eosinophilic gastrointestinal disorders, nasal polyposis, and severe asthma. An improved panel of biomarkers to help guide diagnosis, treatment, and assessment of disease activity is also needed. An impressive array of novel therapeutic agents, including small molecules and biologics, that directly or indirectly target eosinophils and eosinophilic inflammation are undergoing controlled clinical trials, with many already showing promising results. A large list of additional eosinophil-related potential therapeutic targets remains to be pursued, including cell surface structures, soluble proteins that influence eosinophil biology, and eosinophil-derived mediators that have the potential to contribute adversely to disease pathophysiology. INTRODUCTION Eosinophilic disorders, also referred to as eosinophil-associated diseases, consist of a range of infrequent conditions affecting virtually any body compartment and organ.1 The most commonly affected areas include the bone marrow, blood, mucosal sur- faces, and skin, often with immense disease- and treatment-related morbidity, Disclosure Statement: Dr Bochner’s research efforts are supported by grants AI072265, AI097073 and HL107151 from the National Institutes of Health. He has current or recent consul- ting or scientific advisory board arrangements with, or has received honoraria from, Sanofi-A- ventis, Pfizer, Svelte Medical Systems, Biogen Idec, TEVA, and Allakos, Inc. and owns stock in Allakos, Inc. and Glycomimetics, Inc. He receives publication-related royalty payments from Elsevier and UpToDate and is a coinventor on existing and pending Siglec-8-related patents and, thus, may be entitled to a share of future royalties received by Johns Hopkins University on the potential sales of such products. -
Study Protocol with Amendment 04
Clinical Study Protocol with Amendment 04 A 52-Week Double-Blind, Placebo-Controlled, Parallel-Group Efficacy and Safety Study of Reslizumab 110 mg Fixed, Subcutaneous Dosing in Patients with Uncontrolled Asthma and Elevated Blood Eosinophils Study Number C38072-AS-30025 NCT02452190 Protocol with Amendment 04 Approval Date: 24 October 2016 Placebo-Controlled Study–Asthma Clinical Study Protocol with Amendment 04 C38072-AS-30025 Clinical Study Protocol with Amendment 04 Study Number C38072-AS-30025 A 52-Week Double-Blind, Placebo-Controlled, Parallel-Group Efficacy and Safety Study of Reslizumab 110 mg Fixed, Subcutaneous Dosing in Patients with Uncontrolled Asthma and Elevated Blood Eosinophils Phase 3 IND number: 101,399 EudraCT number: 2015-000865-29 Protocol Approval Date: 24 October 2016 Sponsor Monitor Teva Branded Pharmaceutical Products R&D, Inc. 41 Moores Road Frazer, Pennsylvania 19355 United States Authorized Representative Teva Branded Pharmaceutical Products R&D, Inc. Sponsor’s Medical Expert Sponsor’s Safety Representative Teva Global R&D Teva Branded Pharmaceutical Products R&D, Inc Confidentiality Statement This clinical study will be conducted in accordance with current Good Clinical Practice (GCP) as directed by the provisions of the International Conference on Harmonisation (ICH); United States Code of Federal Regulations (CFR) and European Union Directives (as applicable in the region of the study); local country regulations; and the sponsor’s Standard Operating Procedures (SOPs). This document contains confidential and proprietary information (including confidential commercial information pursuant to 21CFR§20.61) and is a confidential communication of Teva Pharmaceuticals. The recipient agrees that no information contained herein may be published or disclosed without written approval from the sponsor. -
Novel Biologics for Asthma: Steps on the Long Road to Therapies for Uncontrolled Asthma
Trialtrove Pharmaprojects Pharma intelligence | Pharma intelligence | Novel Biologics for Asthma: Steps on the Long Road to Therapies for Uncontrolled Asthma LAURA RUNKEL, PHD Associate Director, CNS, Autoimmune/Inflammation Introduction Asthma is one of the most prevalent respiratory diseases worldwide, and prevalence is projected to increase over the coming decades, particularly in the US as the population continues to grow (1). This chronic disease is associated with increased morbidity, detrimental impacts on quality of life, and high health care costs especially in the severe asthma population. Asthma management utilizes a stepwise approach to control symptoms while minimizing risks (2). Inhaled corticosteroids (ICS) remain the standard of care for mild asthma, while more severe disease is treated with combination therapies of ICS plus a long-acting beta agonist (LABA) and may require a third, add-on controller medication for the most severe asthma population. However, symptoms for an estimated 5-10% of asthma sufferers remain uncontrolled by available treatment options (3). In recent years, uncontrolled asthma has emerged as an area of high unmet need, and has also been recognized to be a heterogeneous syndrome with different underlying pathophysiological features (4). Efforts to define key drivers for asthma “phenotypes” have focused on the role of eosinophilic inflammation and Th2 type immunological pathways, and led to the clinical development of biologics that antagonize IL-5, IL-14 and IL-13 pathways. After many years of research, the first two novel biologics have been filed for approval for uncontrolled, eosinophilic asthma treatment. Will the hope for truly targeted therapies for uncontrolled asthma now be realized? 2 Trialtrove Pharmaprojects 2 Pharma intelligence | Pharma intelligence | Table 1 provides an overview of sponsors, molecular targets and current status of novel biologics targeting IL-5, IL-4 or IL-13 with development programs for asthma.