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ASPARLAS® INDICATIONS AND IMPORTANT SAFETY INFORMATION
INDICATIONS AND USAGE
ASPARLAS® (calaspargase pegol-mknl) is indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) in pediatric and young adult patients aged 1 month to 21 years.
CONTRAINDICATIONS
WARNINGS and PRECAUTIONS
Hypersensitivity: Grade 3 and 4 hypersensitivity reactions, including anaphylaxis, have been reported in clinical trials with ASPARLAS with an incidence of 7% to 21%. Because of the risk of serious allergic reactions, administer ASPARLAS in a clinical setting with resuscitation equipment and other agents necessary to treat anaphylaxis. Premedicate patients 30-60 minutes prior to administration of ASPARLAS. Observe patients for 1 hour after administration. Discontinue ASPARLAS in patients with serious hypersensitivity reactions.
Pancreatitis: Cases of pancreatitis have been reported in clinical trials with ASPARLAS with an incidence of 12% to 16%. Inform patients of the signs and symptoms of pancreatitis, which, if left untreated, could be fatal. Assess serum amylase and/or lipase levels to identify early signs of pancreatic inflammation. Discontinue ASPARLAS in case of suspicion of pancreatitis. If pancreatitis is confirmed, do not resume ASPARLAS.
Thrombosis: Serious thrombotic events, including sagittal sinus thrombosis, have been reported in clinical trials with ASPARLAS with an incidence of 9% to 12%. Discontinue ASPARLAS in patients experiencing serious thrombotic events.
Hemorrhage: Hemorrhage associated with increased prothrombin time (PT), increased partial thromboplastin time (PTT), and hypofibrinogenemia has been reported. Evaluate patients with signs and symptoms of hemorrhage with coagulation parameters, including PT, PTT, and fibrinogen. Consider appropriate replacement therapy in patients with severe or symptomatic coagulopathy.
Hepatotoxicity: Hepatotoxicity, including severe, life-threatening, and potentially fatal cases of hepatic veno-occlusive disease (VOD), has been observed in patients treated with ASPARLAS in combination with standard chemotherapy, including during the induction phase of multiphase chemotherapy. Do not administer ASPARLAS to patients with severe hepatic impairment. Evaluate bilirubin and transaminases prior to each dose of ASPARLAS and at least weekly, during cycles of treatment that include ASPARLAS, through 6 weeks after the last dose of ASPARLAS. Monitor frequently for signs and symptoms of hepatic VOD, which may include rapid weight gain, fluid retention with ascites, hepatomegaly (which may be painful), and rapid increase of bilirubin. For patients who develop abnormal liver tests after ASPARLAS, more frequent monitoring for liver test abnormalities and clinical signs and symptoms of VOD is recommended. In the event of serious liver toxicity, including VOD, discontinue treatment with ASPARLAS and provide supportive care.
ADVERSE REACTIONS
The most common grade 3 and above adverse reactions (incidence ≥10%) for patients receiving
ASPARLAS with multiagent chemotherapy observed in the DFCI clinical trial are elevated transaminase
(52%), increased bilirubin (20%), pancreatitis (18%) and abnormal clotting studies (14%). There
was 1 fatal adverse reaction (multi-organ failure in the setting of chronic pancreatitis associated
with a pancreatic pseudocyst). Not all grade 1 and 2 adverse reactions were collected prospectively.
Please see the accompanying Full Prescribing Information .
ASPARLAS is a registered trademark of Servier IP UK Ltd., a wholly owned, indirect subsidiary of Les Laboratoires Servier. Servier and the Servier logo are trademarks of Les Laboratoires Servier.
INDICATIONS AND USAGE
ASPARLAS® (calaspargase pegol-mknl) is indicated as a component of a multi-agent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) in pediatric and young adult patients aged 1 month to 21 years.
CONTRAINDICATIONS
WARNINGS and PRECAUTIONS
Hypersensitivity: Grade 3 and 4 hypersensitivity reactions, including anaphylaxis, have been reported in clinical trials with ASPARLAS with an incidence of 7% to 21%. Because of the risk of serious allergic reactions, administer ASPARLAS in a clinical setting with resuscitation equipment and other agents necessary to treat anaphylaxis. Premedicate patients 30-60 minutes prior to administration of ASPARLAS. Observe patients for 1 hour after administration. Discontinue ASPARLAS in patients with serious hypersensitivity reactions.
Pancreatitis: Cases of pancreatitis have been reported in clinical trials with ASPARLAS with an incidence of 12% to 16%. Inform patients of the signs and symptoms of pancreatitis, which, if left untreated, could be fatal. Assess serum amylase and/or lipase levels to identify early signs of pancreatic inflammation. Discontinue ASPARLAS in case of suspicion of pancreatitis. If pancreatitis is confirmed, do not resume ASPARLAS.
Thrombosis: Serious thrombotic events, including sagittal sinus thrombosis, have been reported in clinical trials with ASPARLAS with an incidence of 9% to 12%. Discontinue ASPARLAS in patients experiencing serious thrombotic events.
Hemorrhage: Hemorrhage associated with increased prothrombin time (PT), increased partial thromboplastin time (PTT), and hypofibrinogenemia has been reported. Evaluate patients with signs and symptoms of hemorrhage with coagulation parameters, including PT, PTT, and fibrinogen. Consider appropriate replacement therapy in patients with severe or symptomatic coagulopathy.
Hepatotoxicity: Hepatotoxicity, including severe, life-threatening, and potentially fatal cases of hepatic veno-occlusive disease (VOD), has been observed in patients treated with ASPARLAS in combination with standard chemotherapy, including during the induction phase of multiphase chemotherapy. Do not administer ASPARLAS to patients with severe hepatic impairment. Evaluate bilirubin and transaminases prior to each dose of ASPARLAS and at least weekly, during cycles of treatment that include ASPARLAS, through 6 weeks after the last dose of ASPARLAS. Monitor frequently for signs and symptoms of hepatic VOD, which may include rapid weight gain, fluid retention with ascites, hepatomegaly (which may be painful), and rapid increase of bilirubin. For patients who develop abnormal liver tests after ASPARLAS, more frequent monitoring for liver test abnormalities and clinical signs and symptoms of VOD is recommended. In the event of serious liver toxicity, including VOD, discontinue treatment with ASPARLAS and provide supportive care.
ADVERSE REACTIONS
The most common grade 3 and above adverse reactions (incidence ≥10%) for patients receiving
ASPARLAS with multiagent chemotherapy observed in the DFCI clinical trial are elevated transaminase
(52%), increased bilirubin (20%), pancreatitis (18%) and abnormal clotting studies (14%). There
was 1 fatal adverse reaction (multi-organ failure in the setting of chronic pancreatitis associated
with a pancreatic pseudocyst). Not all grade 1 and 2 adverse reactions were collected prospectively.
Please see the accompanying Full Prescribing Information .
ASPARLAS is a registered trademark of Servier IP UK Ltd., a wholly owned, indirect subsidiary of Les Laboratoires Servier. Servier and the Servier logo are trademarks of Les Laboratoires Servier.
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