taliglucerase alfa

taliglucerase alfa

(tali-gloo-ser-ase al-fa) ,

Elelyso

(trade name)

Classification

Therapeutic: orphan drugs
Pharmacologic: enzymes
Pregnancy Category: B

Indications

Long-term replacement therapy in adults with confirmed Type 1 Gaucher disease.

Action

Prevents the accumulation of glucocerebrosides in cells. Replaces glucocerebrosidases that are deficient in type 1 Gaucher’s disease.

Therapeutic effects

Improvement in symptoms of Gaucher disease (anemia, thrombocytopenia, bone disease, splenomegaly, and hepatomegaly)

Pharmacokinetics

Absorption: IV administration results in complete bioavailability
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: 18.9–28.7 min

Time/action profile

ROUTEONSETPEAKDURATION
IVunknownend of infusion2 wk

Contraindications/Precautions

Contraindicated in: None noted.
Use Cautiously in: Obstetric: Use during pregnancy only if clearly needed Lactation: Use cautiously in nursing women Pediatric: Safe and effective use in children has not been established

Adverse Reactions/Side Effects

Miscellaneous

  • allergic reactions including anaphylaxis
  • infusion reactions

Interactions

Drug-Drug interaction

None noted.

Route/Dosage

Intravenous (Adults) 60 Units/kg every other week (range 11–73 Units/kg)

Availability

Lyophilized powder for IV injection (requires reconstitution): 200 Units/vial

Nursing implications

Nursing assessment

  • Monitor for an improvement in symptoms including hepatomegaly, splenomegaly, anemia, thrombocytopenia, bone demineralization, and increased appetite and energy level periodically throughout therapy. Assess liver and spleen size every 6 mo to determine effectiveness of therapy.
  • Assess for signs and symptoms of anaphylaxis (angioedema, dyspnea, wheezing, coughing, cyanosis, hypotension). Stop infusion immediately and treat symptomatically.
  • Monitor for signs and symptoms of infusion reactions (headache, chest pain, asthenia, fatigue, urticaria, erythema, increased BP, back pain, flushing). Treat by slowing infusion or with antihistamines or antipyretics. Pretreatment with antihistamines and/or corticosteroids may be used.

Potential Nursing Diagnoses

Fatigue (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)

Implementation

  • Patients treated with imiglucerase can be switched to taliglucerase at the same dose.
  • Remove required vials from refrigerator; do not leave at room temperature for longer than 24 hr. Reconstitute each vial with 5.1 mL of Sterile Water for Injection for a volume of 5.3 mL. Mix gently; do not shake. Solution is clear and colorless; do not administer solutions that are discolored or contain particulate matter. Vials are for single use; discard solution.Diluent: Withdraw 5 mL from each vial and dilute with 100–200 mL 0.9% NaCl.Mix gently; do not shake.
  • Rate: Initial infusion rate should be 1.3 mL/min; if tolerated, may increase to 2.3 mL/min. Infuse over 60–120 min; total infusion should be administered over at least 1 hr.

Patient/Family Teaching

  • Inform patient of the purpose of this medication and the importance of treatment every 2wk. taliglucerase helps control the symptoms but does not cure Gaucher’s disease. Lifelong therapy may be required.
  • Instruct patient to notify health care professional if signs and symptoms of anaphylaxis or infusion reactions occur.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
  • Emphasize the importance of follow-up examinations and lab tests.

Evaluation/Desired Outcomes

  • Increasing hemoglobin and platelet counts and decreasing acid phosphatase levels, hepatomegaly, and splenomegaly. In pediatric patients, cachexia and wasting should diminish.
References in periodicals archive ?
The three endocrine/metabolic agents are ivacaftor (Kalydeco; cystic fibrosis), taliglucerase alfa (Elelyso; Gaucher disease), and pasireotide (Signifor; Cushing's disease).
Marketing applications for taliglucerase alfa have been filed in additional territories as well.
Pfizer and Protalix inked a deal on November 30, 2009, to develop and commercialize taliglucerase alfa, an enzyme replacement therapy to treat Gaucher disease.
By joining our advances in biologics manufacturing and protein development with Pfizer's global strengths in patient services and reimbursement, we expect to help make taliglucerase alfa an important and cost-effective treatment choice for Gaucher's patients throughout the world.
The deal also gives Pfizer worldwide rights, except in Israel, to sell a genetically engineered drug called taliglucerase alfa to treat a rare inherited condition known as Gaucher's disease.
declared that the European Commission (EC) refused marketing authorization for taliglucerase alfa (Elylyso), an enzyme replacement therapy for the treatment of Gaucher disease.
The audit was performed as part of the Ministry of Health's evaluation of the company's manufacturing process of taliglucerase alfa for the treatment of Gaucher disease.
M2 PHARMA-February 9, 2012-Protalix to present new clinical data on taliglucerase alfa at WORLD Lysosonal Disease Network Symposium(C)2012 M2 COMMUNICATIONS
M2 PHARMA-December 6, 2011-FDA extends taliglucerase alfa NDA review date by three months(C)2011 M2 COMMUNICATIONS
M2 EQUITYBITES-November 30, 2010-Pfizer and Protalix BioTherapeutics submit taliglucerase alfa for MAA to European Medicine Agency(C)2010 M2 COMMUNICATIONS http://www.
Food and Drug Administration (FDA) for taliglucerase alfa, a plant-cell expressed form of glucocerebrosidase (GCD) for the potential treatment of Gaucher's disease.