FDA Approves Rhophylac(R) for the Treatment of Immune Thrombocytopenic Purpura
KING OF PRUSSIA, Pa., April 2 -- CSL Behring announced today that the U.S. Food and Drug Administration (FDA) has granted marketing approval for an additional indication for Rhophylac Rh(0)(D) (Immune Globulin Intravenous [Human]), an anti-D Rh immunoglobulin (Ig). The additional indication is for the treatment of immune thrombocytopenic purpura (ITP). Administered intravenously, Rhophylac is indicated to raise platelet counts in Rh(0)(D)-positive, non-splenectomized adult patients with chronic ITP. Having established efficacy and safety in over 10 years of use for other indications, Rhophylac offers high value pricing to help healthcare practitioners manage costs.
"Through the years, CSL Behring has made a significant commitment to patients with rare and serious disorders," said Paul Perreault, Executive Vice President of Worldwide Commercial Operations, CSL Behring, which manufactures and markets Rhophylac. "In an environment of rising health care costs, Rhophylac provides the right balance of value and cost, while continuing the company's long tradition of providing patients with safe and effective therapies."
Clinical Trial
In an open-label, single-arm, multi-center trial, Rhophylac proved safe and effective in the treatment for ITP. In the trial, 98 Rh(0)(D)-positive adult chronic ITP patients with platelet counts of Other secondary endpoints included: response rate, defined by an increase in platelet counts by Day 15, as well as regression of hemorrhage. Response rates for an increase in platelet counts ranged from 26 to 100 percent in the subsets of the ITT population. The overall regression of hemorrhage achieved was 88 percent in 50 patients with bleeding at baseline.
Highly Advanced Manufacturing Process
Rhophylac is manufactured using CSL Behring's unique ChromaPlus(TM) process, yielding a safe, highly pure, and stable product. The process includes: solvent/detergent treatment to inactivate enveloped viruses (e.g., HIV, HCV, HBV); nanofiltration using a 15- nanometer virus filter to effectively remove enveloped and non-enveloped viruses (including models for HAV and human parvovirus B19); and ion-exchange chromatography to purify the final product by separating unwanted proteins.
Coupled with careful donor selection and screening, the ChromaPlus process significantly reduces the risk of viral transmission. In clinical studies, there was no evidence of viral transmission with Rhophylac.
Rhophylac Experience
Over the past 11 years, more than 1.5 million doses of Rhophylac have been administered worldwide to prevent Hemolytic Disease of the Newborn (HDN)-a condition that can affect a newborn from an Rh-incompatible pregnancy-and to treat Rh-negative individuals in the event of an incompatible blood transfusion. In 2004, Rhophylac received approval from the FDA for the suppression of Rh isoimmunization in pregnancy and obstetric conditions and following an incompatible transfusion.
"Our vast experience in preventing HDN has firmly established Rhophylac as a safe and effective product that physicians have come to rely on," said Robert Lefebvre, Vice President and General Manager, U.S. Commercial Operations, CSL Behring.
Important Safety Information
Rhophylac is indicated to raise platelet counts in Rh(0)(D)-positive, non- splenectomized adult patients with chronic immune thrombocytopenic purpura (ITP). For the treatment of ITP, Rhophylac must be administered IV.
Rhophylac is indicated for suppression of rhesus (Rh) isoimmunization in: -- Pregnancy and obstetric conditions in non-sensitized, Rh(0)(D)-negative women with an Rh-incompatible pregnancy, including routine antepartum and postpartum Rh prophylaxis and Rh prophylaxis in cases of obstetric complications, invasive procedures during pregnancy, or obstetric manipulative procedures. -- Incompatible transfusions in Rh(0)(D)-negative individuals transfused with blood components containing Rh(0)(D)-positive red blood cells. For suppression of Rh isommunization, Rhophylac can be administered IM or IV.
Rhophylac is contraindicated in individuals with known anaphylactic or severe systemic reaction to human immune globulin products.
Allergic or hypersensitivity reactions may occur with Rhophylac; early signs of hypersensitivity include generalized urticaria, chest tightness, wheezing, hypotension, and anaphylaxis. Individuals with selective IgA deficiency can develop antibodies to IgA and may develop severe hypersensitivity and anaphylactic reactions. For these individuals, weigh the expected benefits of treatment against potential risks.
Rhophylac is derived from human plasma. As with all plasma-derived products, the risk of transmission of infectious agents, including viruses and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent, cannot be completely eliminated.
Immune Thrombocytopenic Purpura: ITP patients being treated with Rhophylac should be monitored for signs and symptoms of intravascular hemolysis, including back pain, shaking chills, fever, and hemoglobinuria. Potentially serious complications of intravascular hemolysis include clinically compromising anemia, acute renal insufficiency, and, very rarely, disseminated intravascular coagulation, and death.
In patients with preexisting anemia, weigh the benefits of Rhophylac vs the potential risk of increasing the severity of the anemia.
The most common adverse reactions in ITP treatment with Rhophylac are chills, fever, increased bilirubin, and headache.
Suppression of Rh Isoimmunization: For postpartum use following an Rh- incompatible pregnancy, Rhophylac should not be given to the newborn infant.
The most common adverse reactions in suppression of Rh isoimmunization with Rhophylac are nausea, dizziness, headache, injection-site pain, and malaise.
About ITP
Immune Thrombocytopenic Purpura, or ITP, is an autoimmune disease in which the immune system attacks and destroys the body's own platelets, the cells that prevent bleeding in blood vessels and facilitate clotting. There are two forms of ITP: acute ITP, which resolves within six months, and chronic ITP, which most often occurs in adults and by definition lasts six months or longer. The annual incidence of ITP is 100 to115 in every one million people. In the U.S., approximately 200,000 people have the disorder.
ITP is characterized by a low number of platelets (