ELELYSO® Adverse Reactions

(taliglucerase alfa)

6 ADVERSE REACTIONS

6.1 Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Adverse Reactions from Clinical Trials of ELELYSO as Initial Therapy

Clinical Trial in Adult Patients
 
The safety of ELELYSO at dosages of either 30 units/kg (n=16) (50% of the recommended dosage) [see Dosage and Administration (2.1)] or 60 units/kg (n=16) administered intravenously every other week was assessed in 32 adult treatment-naïve patients (aged 19 to 74 years) with Type 1 Gaucher disease in a 9-month double-blind, randomized clinical trial (Trial 1) [see Clinical Studies (14)]. Table 1 presents the adverse reactions that occurred in these ELELYSO-treated patients.
Table 1: Adverse Reactions in ≥5% of Treatment-Naïve Adult Patients Treated with ELELYSO
Preferred TermTreatment-Naïve Adults (N=32)
n (%)

Headache

6 (19)

Arthralgia

4 (13)

Fatigue

3 (9)

Nausea

3 (9)

Dizziness

3 (9)

Abdominal pain

2 (6)

Pruritus

2 (6)

Flushing

2 (6)

Vomiting

2 (6)

Urticaria

2 (6)

Clinical Trial in Pediatric Patients 16 Years of Age and Younger
 
The safety of ELELYSO at dosages of either 30 units/kg (n=4) (50% of the recommended dosage) [see Dosage and Administration (2.1)] or 60 units/kg (n=5) administered intravenously every other week was assessed in 9 pediatric treatment-naïve patients (aged 2 to 13 years) with Type 1 Gaucher disease in a 12-month randomized clinical trial (Trial 2) [see Clinical Studies (14)].
 

The most common adverse reaction (≥10%) was vomiting, which occurred in 4 of 9 patients. Two patients developed hypersensitivity reactions; one patient experienced severe vomiting and gastrointestinal inflammation, and 1 experienced mild throat irritation and chest discomfort. Both patients responded to treatment with antihistamines and continued ELELYSO treatment.

Adverse Reactions in a Clinical Trial in Patients Who Switched from Imiglucerase to ELELYSO

The safety of ELELYSO was assessed in 31 patients (26 adult and 5 pediatric patients), ages 6 to 66 years old, with Type 1 Gaucher disease who had previously been receiving imiglucerase treatment for a minimum of 2 years (Trial 3). ELELYSO was administered intravenously every other week for 9 months at the same number of units as each patient's previous imiglucerase dose. Table 2 presents the adverse reactions in these ELELYSO-treated patients.

Table 2: Adverse Reactions in ≥10% of ELELYSO-Treated Patients Who Switched from Imiglucerase to ELELYSO (after 9 months on treatment)
Preferred TermAdult and Pediatric Patients Switched from Imiglucerase
(N=31)
n (%)

Arthralgia

4 (13)

Headache

4 (13)

Pain in extremity

3 (10)

Immunogenicity: Anti-Drug Antibody-Associated Adverse Reactions

Trials 1, 2, and 3 evaluated ELELYSO enzyme replacement therapy (ERT)-naïve and ERT-experienced adult and pediatric patients with Gaucher disease [see Clinical Studies (14.1,14.2)]. In patients with Type 1 Gaucher disease, hypersensitivity reactions occurred in 36% (9/25) of ELELYSO-treated patients who developed ADA during the treatment period and in 15% (6/41) of ELELYSO-treated patients who did not develop ADA during the treatment period [see Warnings and Precautions (5.1) and Clinical Pharmacology (12.6)]. Of the 9 ELELYSO-treated patients who tested positive for ADA and who developed hypersensitivity reactions, 2 patients had anaphylaxis and 1 additional patient discontinued ELELYSO due to hypersensitivity reactions.

6.2 Postmarketing Experience

The following adverse reactions have been identified during post-approval use of ELELYSO. Because these reactions include those reported voluntarily from a population of uncertain size in addition to those from postmarketing studies, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure:

Gastrointestinal disorders: Vomiting, diarrhea
General disorders and administration site conditions: Fatigue
Immune system disorders: Anaphylaxis [see Warnings and Precautions (5.1)], Type III immune-mediated fixed drug eruption
Musculoskeletal and connective tissue disorders: Back pain

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Adverse Reactions

6 ADVERSE REACTIONS

6.1 Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Adverse Reactions from Clinical Trials of ELELYSO as Initial Therapy

Clinical Trial in Adult Patients
 
The safety of ELELYSO at dosages of either 30 units/kg (n=16) (50% of the recommended dosage) [see Dosage and Administration (2.1)] or 60 units/kg (n=16) administered intravenously every other week was assessed in 32 adult treatment-naïve patients (aged 19 to 74 years) with Type 1 Gaucher disease in a 9-month double-blind, randomized clinical trial (Trial 1) [see Clinical Studies (14)]. Table 1 presents the adverse reactions that occurred in these ELELYSO-treated patients.
Table 1: Adverse Reactions in ≥5% of Treatment-Naïve Adult Patients Treated with ELELYSO
Preferred TermTreatment-Naïve Adults (N=32)
n (%)

Headache

6 (19)

Arthralgia

4 (13)

Fatigue

3 (9)

Nausea

3 (9)

Dizziness

3 (9)

Abdominal pain

2 (6)

Pruritus

2 (6)

Flushing

2 (6)

Vomiting

2 (6)

Urticaria

2 (6)

Clinical Trial in Pediatric Patients 16 Years of Age and Younger
 
The safety of ELELYSO at dosages of either 30 units/kg (n=4) (50% of the recommended dosage) [see Dosage and Administration (2.1)] or 60 units/kg (n=5) administered intravenously every other week was assessed in 9 pediatric treatment-naïve patients (aged 2 to 13 years) with Type 1 Gaucher disease in a 12-month randomized clinical trial (Trial 2) [see Clinical Studies (14)].
 

The most common adverse reaction (≥10%) was vomiting, which occurred in 4 of 9 patients. Two patients developed hypersensitivity reactions; one patient experienced severe vomiting and gastrointestinal inflammation, and 1 experienced mild throat irritation and chest discomfort. Both patients responded to treatment with antihistamines and continued ELELYSO treatment.

Adverse Reactions in a Clinical Trial in Patients Who Switched from Imiglucerase to ELELYSO

The safety of ELELYSO was assessed in 31 patients (26 adult and 5 pediatric patients), ages 6 to 66 years old, with Type 1 Gaucher disease who had previously been receiving imiglucerase treatment for a minimum of 2 years (Trial 3). ELELYSO was administered intravenously every other week for 9 months at the same number of units as each patient's previous imiglucerase dose. Table 2 presents the adverse reactions in these ELELYSO-treated patients.

Table 2: Adverse Reactions in ≥10% of ELELYSO-Treated Patients Who Switched from Imiglucerase to ELELYSO (after 9 months on treatment)
Preferred TermAdult and Pediatric Patients Switched from Imiglucerase
(N=31)
n (%)

Arthralgia

4 (13)

Headache

4 (13)

Pain in extremity

3 (10)

Immunogenicity: Anti-Drug Antibody-Associated Adverse Reactions

Trials 1, 2, and 3 evaluated ELELYSO enzyme replacement therapy (ERT)-naïve and ERT-experienced adult and pediatric patients with Gaucher disease [see Clinical Studies (14.1,14.2)]. In patients with Type 1 Gaucher disease, hypersensitivity reactions occurred in 36% (9/25) of ELELYSO-treated patients who developed ADA during the treatment period and in 15% (6/41) of ELELYSO-treated patients who did not develop ADA during the treatment period [see Warnings and Precautions (5.1) and Clinical Pharmacology (12.6)]. Of the 9 ELELYSO-treated patients who tested positive for ADA and who developed hypersensitivity reactions, 2 patients had anaphylaxis and 1 additional patient discontinued ELELYSO due to hypersensitivity reactions.

6.2 Postmarketing Experience

The following adverse reactions have been identified during post-approval use of ELELYSO. Because these reactions include those reported voluntarily from a population of uncertain size in addition to those from postmarketing studies, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure:

Gastrointestinal disorders: Vomiting, diarrhea
General disorders and administration site conditions: Fatigue
Immune system disorders: Anaphylaxis [see Warnings and Precautions (5.1)], Type III immune-mediated fixed drug eruption
Musculoskeletal and connective tissue disorders: Back pain
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