Asfotase alfa

Generic name
Asfotase alfa
Brand name
ATC Code
A16AB13

Asfotase alfa

Dosages
Side effects in children
Warnings & precautions in children
Contra-indications in children

Interactions
PK
Renal impairment
References

Pharmacokinetics in children

No information is present at this moment.

dose recommendation of formulary compared to licensed use (on-label versus off-label)

No information is present at this moment.

Available formulations

No information is present at this moment.

Dosages

Enzyme replacement therapy in hypophosphatasia
  • Subcutaneous
    • 0 years up to 18 years
      • 2 mg/kg/dose 3 times weekly. Alternative: 1 mg/kg/dose 6 times weekly.

Renal impaiment in children > 3 months

No information available on dose adjustment in renal impairment.

The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here

Side effects in children

Very common (> 10%): headache. Erythema. Pain in extremity. Injection site reaction (including atrophy, abscess, erythema, pain, itching, swelling, lipodystrophy, induration, nodule, rash, papula, hematoma, inflammation, urticaria, calcification, heat, haemorrhage, injection site vesicles), fever, irritability. Bruise.

Common (1-10%): anaphylactoid reactions, hypersensitivity. Injection site cellulite. Increased tendency to bruise. Hypocalcaemia. Hot flashes. Oral hypoaesthesia, nausea. Skin discoloration, stretched skin. Nephrolithiasis. Myalgia. Cold shivers. Scar.

The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here

Contra-indications in children

Severe or life-threatening hypersensitivity to asfotase alfa if the hypersensitivity cannot be controlled

The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here

Warnings & precautions in children

Hypersensitivity reactions may include anaphylactoid reactions (difficulty breathing, choking sensation, periorbital edema and dizziness), nausea, vomiting, fever, headache, flushing, irritability, chills, erythema, rash, itching and oral hypoaesthesia; These side effects occur within minutes of administration and can still occur after 1 year of treatment. If these reactions occur, discontinue administration immediately. Balance the risks and benefits of re-administration after treatment of a severe reaction. Re-administration should take place under medical supervision, with subsequent administrations depending on the physician's judgment.

Injection-related reactions usually occur within the first 12 weeks of treatment, but can still occur up to 1 or more years after starting treatment. Discontinue administration in case of a severe injection-related reaction.

Events of craniostenosis (associated with increased intracranial pressure), including exacerbation of pre-existing craniostenosis and occurrence of Arnold-Chiari malformation, have been reported in patients <5 years of age. There are insufficient data to establish a causal relationship to asfotase alfa exposure. Craniostenosis can also be a manifestation of hypophosphatasia. Periodic monitoring (including fundoscopy to check for signs of papilledema) is recommended in patients <5 years of age.

Ectopic calcification (ophthalmic calcification and nephrocalcinosis) have been reported. There are insufficient data to establish a causal relationship to asfotase alfa exposure. Ophthalmic calcification and nephrocalcinosis can also be manifestations of hypophosphatasia. Eye examination and ultrasound scan of the kidneys are recommended at baseline and periodically.

Serum parathyroid hormone levels may increase during treatment (especially during the first 12 weeks). Monitoring of parathyroid hormone and serum calcium is recommended. Calcium and oral vitamin D supplementation may be required.

Patients may experience disproportionate weight gain. Dietary supervision is recommended.

If the patient is to receive laboratory testing, inform the laboratory that the patient is being treated with medication that affects AF concentration.

Efficacy and safety have not been established in renal or hepatic impairment

Interactions

The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here

OTHER ALIMENTARY TRACT AND METABOLISM PRODUCTS

This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.

Amino acids and derivatives
A16AA06
A16AA05
A16AA01
A16AA04
Enzymes
A16AB03
A16AB04
A16AB07
A16AB22
A16AB17
A16AB08
A16AB09
A16AB02
A16AB05
A16AB14
A16AB10
Various alimentary tract and metabolism products
A16AX10
A16AX09
A16AX
A16AX18
A16AX06
A16AX04
A16AX07
A16AX
A16AX08
A16AX07
A16AX05
AMINO ACIDS AND DERIVATIVES
A16AA06
A16AA05
A16AA01
A16AA04

Reference

  1. Alexion Europe SAS, SmPC Strensiq ( EU/1/15/1015) 08-05-2020, www.geneesmiddeleninformatiebank.nl

Changes

Therapeutic Drug Monitoring


Overdose