Search Results
نشرة الممارس الصحي | نشرة معلومات المريض بالعربية | نشرة معلومات المريض بالانجليزية | صور الدواء | بيانات الدواء |
---|
MINJUVI contains the active substance tafasitamab. This is a type of
protein called a monoclonal antibody designed to kill cancer cells. This
protein acts by attaching to a specific target on the surface of a type
of white blood cell called B cells or B lymphocytes. When tafasitamab
sticks to the surface of these cells, the cells die.
Do not use MINJUVI
• if you are allergic to tafasitamab or any of the other ingredients of
this medicine (listed in section 6)
Warnings and precautions
Talk to your doctor or pharmacist or nurse before using MINJUVI if you
have an infection or a history of recurring infections.
You might notice the following during treatment with MINJUVI:
• Infusion-related reactions
Infusion-related reactions may occur most frequently during the first
infusion. Your doctor will monitor you for infusion-related reactions
during your infusion of MINJUVI. Inform your doctor immediately if
you have reactions such as fever, chills, flushing, rash or breathing
difficulties within 24 hours of infusion.
Your doctor will give you treatment before each infusion to reduce
the risk of infusion-related reactions. If you do not have reactions,
your doctor may decide that you do not need these medicines with
later infusions.
• Reduced number of blood cells
Treatment with MINJUVI can severely reduce the number of
some types of blood cells in your body, such as white blood cells
called neutrophils, platelets and red blood cells. Tell your doctor
immediately if you have fever of 38 °C or above, or any signs of
bruising or bleeding, as these may be signs of such a reduction.
Your doctor will check your blood cell counts throughout treatment
and before starting each treatment cycle.
• Infections
Serious infections, including infections that can cause death, can
occur during and following MINJUVI treatment. Tell your doctor if
you notice signs of an infection, such as fever of 38 °C or above,
chills, cough or pain on urination.
• Tumour lysis syndrome
Some people may develop unusually high levels of some
substances (such as potassium and uric acid) in the blood caused
by the fast breakdown of cancer cells during treatment. This is
called tumour lysis syndrome. Tell your doctor if you have symptoms
such as nausea, vomiting, lack of appetite or fatigue, dark urine,
decreased urine or side or back pain, muscle cramps, numbness, or
heart palpitations. Your doctor may give you treatment before each
infusion to reduce the risk of tumour lysis syndrome and perform
blood tests to check you for tumour lysis syndrome.
Tell your doctor immediately if you notice any of these problems.
Children and adolescents
MINJUVI is not recommended in children and adolescents under 18
years, as there is no information about the use in this age group.
Other medicines and MINJUVI
Tell your doctor or pharmacist if you are using, have recently used or
might use any other medicines.
The use of live vaccines during treatment with tafasitamab is not
recommended.
Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or
are planning to have a baby, ask your doctor or pharmacist for advice
before taking this medicine.
• Contraception
Use of effective contraception during treatment with MINJUVI and
for at least 3 months after end of treatment is recommended for
women of childbearing potential.
• Pregnancy
Do not use MINJUVI during pregnancy and if you are of childbearing
potential not using contraception. Pregnancy must be ruled out
before treatment. Tell your doctor immediately if you become
pregnant or think you may be pregnant during treatment with
MINJUVI.
MINJUVI is given with lenalidomide for up to 12 cycles.
Lenalidomide can harm the unborn baby and must not
be used during pregnancy and in women of childbearing
potential, unless all of the conditions of the lenalidomide pregnancy
prevention programme are met. Your doctor will provide you with
more information and recommendations.
• Breast-feeding
Do not breast-feed during treatment with MINJUVI until at least
3 months after the last dose. It is not known whether tafasitamab
passes into breast milk.
Driving and using machines
MINJUVI has no or negligible influence on the ability to drive and
use machines. However, fatigue has been reported in patients taking
tafasitamab and this should be taken into account when driving or
using machines.
MINJUVI contains sodium
This medicine contains 37.0 mg sodium (main component of cooking/
table salt) in each dose of 5 vials (the dose of a patient weighing 83
kg). This is equivalent to 1.85% of the recommended maximum daily
dietary intake of sodium for an adult.
A doctor experienced in treating cancer will supervise your treatment.
MINJUVI will be given into one of your veins via infusion (drip). During
and after the infusion, you will be checked regularly for infusion-related
side effects.
MINJUVI will be given to you in cycles of 28 days. The dose you get is
based on your weight and will be worked out by your doctor.
The recommended dose is 12 mg tafasitamab per kilogram body
weight. This is given as an infusion into a vein according to the
following schedule:
• Cycle 1: infusion on day 1, 4, 8, 15 and 22 of the cycle
• Cycles 2 and 3: infusion on day 1, 8, 15 and 22 of each cycle
• Cycle 4 and after: infusion on day 1 and 15 of each cycle
In addition, your doctor will prescribe you to take lenalidomide
capsules for up to twelve cycles. The recommended starting dose of
lenalidomide is 25 mg daily on days 1 to 21 of each cycle.
The doctor adjusts the starting dose and subsequent dosing if needed.
After a maximum of twelve cycles of combination therapy, treatment
with lenalidomide is stopped.
Treatment cycles with MINJUVI alone are then continued until the
disease gets worse or you develop unacceptable side effects.
If you have been given more MINJUVI than you should
Because the medicine is given in hospital under a doctor’s supervision,
this is unlikely. Tell your doctor if you think you may have been given
too much MINJUVI.
If you have any further questions on the use of this medicine, ask your
doctor or pharmacist or nurse.
Like all medicines, this medicine can cause side effects, although not
everybody gets them.
Contact your doctor or nurse immediately if you notice any of
the following serious side effects – you may need urgent medical
treatment. These may be new symptoms or a change in your current
symptoms.
• serious infections, possible symptoms: fever, chills, sore throat,
cough, shortness of breath, nausea, vomiting, diarrhoea. These
could be particularly significant if you have been told you have a low
level of white blood cells called neutrophils.
• pneumonia (lung infection)
• sepsis (infection within the bloodstream)
Other side effects
Tell your doctor or nurse if you notice any of the following side effects:
Very common (may affect more than 1 in 10 people)
• reduced number of blood cells
– white blood cells, especially a type called neutrophils; possible
symptoms: fever of 38 °C or above, or any symptoms of an
infection
– platelets; possible symptoms: unusual bruising or bleeding
without or on only minor injury
– red blood cells; possible symptoms: pale skin or lips, tiredness,
shortness of breath
• bacterial, viral or fungal infections, such as respiratory tract
infections, bronchitis, lung inflammation, urinary tract infections
• rash
• low blood potassium level in tests
• muscle cramps
• back pain
• swelling of arms and/or legs due to build-up of fluid
• weakness, tiredness, feeling generally unwell
• fever
• diarrhoea
• constipation
• abdominal pain
• nausea
• vomiting
• cough
• shortness of breath
• decreased appetite
Common (may affect up to 1 in 10 people)
• worsening of breathing difficulties caused by narrowed lung airways
called chronic obstructive pulmonary disease (COPD)
• headache
• abnormal sensation of the skin, such as tingling, prickling,
numbness
• itching
• redness of skin
• infusion-related reactions
These reactions may occur during infusion of MINJUVI or within 24
hours after infusion.
Possible symptoms are fever, chills, flushing or breathing difficulties.
• altered sense of taste
• hair loss
• abnormal sweating
• pain in arms and legs
• muscle and joint pain
• decreased weight
• nasal congestion
• inflammation of the membranes lining organs such as the mouth
• lack of certain white blood cells called lymphocytes in blood tests
• a problem with the immune system called hypogammaglobulinaemia
• in blood tests, low blood level of
– calcium
– magnesium
• in blood tests, increased blood level of
– C-reactive protein, which could be the result of inflammation or
infection
– creatinine, a breakdown product from muscle tissue
– liver enzymes: gamma-glutamyltransferase, transaminases
– bilirubin, a yellow breakdown substance of the blood pigment
• a skin cancer called basal cell carcinoma
Reporting of side effects
If any of the side effects gets serious, or if you notice any side effects
not listed in this leaflet, please tell your doctor or pharmacist.
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the
vial label and carton after EXP. The expiry date refers to the last day of
that month.
Store in a refrigerator (2 °C – 8 °C).
Keep the vial in the outer carton in order to protect from light.
Any unused medicine or waste material should be disposed of in
accordance with local requirements.
• The active substance is tafasitamab. One vial contains 200 mg of
tafasitamab. After reconstitution each mL of solution contains 40 mg
of tafasitamab.
• The other ingredients are sodium citrate dihydrate, citric acid
monohydrate, trehalose dihydrate, polysorbate 20 (see section 2
“MINJUVI contains sodium”).
Incyte Biosciences International Sarl
Rue Docteur-Yersin 12
1110 Morges
Switzerland
Tel: +41(0)215815000
Fax: +41 21 581 5002
Email: globalmedinfo@incyte.com
Manufacturer
Incyte Biosciences Distribution B.V.
Paasheuvelweg 25
1105 BP Amsterdam
Netherlands
Tel: +31 20 26 19 315
Fax: +1 302 4252734
Email: srakhorst@incyte.com
For any information about this medicinal product, please contact the
local representative of the Marketing Authorisation Holder in KSA:
Biologix, FZ Co, Hibatullah Al Ghaffari Street-Suliemaniah Kingdom of
Saudi Arabia P.O.Box 991, Riyadh 11421.
Tel: +966 11 464 6955
Fax: +966 11 463 4362
ما هو مينجوفي؟
يحتوي مينجوفي على المادة الفعالة تافاسيتاماب، وهي نوع من البروتين يُسمى الأجسام المضادة
أحادية النسيلة، المُصمّمة لقتل الخلايا السرطانية. ويؤدي هذا البروتين دوره عن طريق الارتباط
بهدف محدد على سطح أحد أنواع خلايا الدم البيضاء، وتُسمى الخلايا البائية أو الخلايا الليمفاوية
البائية. وعندما يلتصق تافاسيتاماب بسطح هذه الخلايا فإنها تموت.
فيم يُستخدم مينجوفي؟
يُستخدم مينجوفي في علاج البالغين المصابين بسرطان الخلايا البائية ويطلق عليه ليمفوما الخلايا
البائية الكبيرة المنتشرة. ويتم استخدامه عندما يعود السرطان مرة أخرى بعد العلاج السابق، أو أن
السرطان لم يستجب لذلك العلاج، أو إذا كان لا يمكن علاج المرضى بزراعة الخلايا الجذعية بدلاً
من ذلك.
لا تستخدم مينجوفي
• إذا كانت لديك حساسية ضد تافاسيتاماب أو أي من المكونات الأخرى لهذا الدواء )المدرجة في
.) القسم 6
تحذيرات واحتياطات:
استشر طبيبك أو الصيدلي أو الممرضة قبل استخدام مينجوفي إذا كنت تعاني من عدوى أو لديك
تاريخ من العدوى المتكررة.
أثناء العلاج بدواء مينجوفي، قد تلاحظ الآتي:
• التفاعلات المتعلقة بالتسريب.
قد يتكرر ظهور التفاعلات المتعلقة بالتسريب أثناء التسريب الأول. وسيراقبك طبيبك؛ بحثًا عن
ردود الفعل المرتبطة بالتسريب خلال تسريب مينجوفي. أبلغ طبيبك فورًا إذا كانت لديك ردود
فعل مثل الحمى، أو القشعريرة، أو الاحمرار، أو الطفح الجلدي أو صعوبات التنفس خلال 24
ساعة من التسريب.
سيعطيك طبيبك علاج قبل كل تسريب؛ لتقليل مخاطر التفاعلات المتعلقة بالتسريب. وإذا لم يكن لديك
تفاعلات، فقد يقرر طبيبك أنك لست بحاجة إلى هذه الأدوية مع التسريبات اللاحقة.
• انخفاض عدد خلايا الدم.
العلاج بدواء مينجوفي قد يتسبب في تقليل عدد بعض أنواع خلايا الدم في جسمك بشدة، مثل
خلايا الدم البيضاء التي تُسمَّى العدلات، والصفائح الدموية، وخلايا الدم الحمراء. أخبِر طبيبك
على الفور إذا كان لديك حمى تصل إلى 38 درجة مئوية أو أعلى، أو ظهر لديك أي علامات تدل
على كدمات أو نزيف، فمثل هذه العلامات قد تكون إشارة على هذا الانخفاض.
سيتحقق طبيبك من عدد خلايا الدم لديك طوال فترة العلاج، وقبل البدء في كل دورة علاجية.
• العدوى
يمكن أن تظهر لديك عدوى خطيرة، وقد تشمل العدوى التي يمكن أن تسبب الوفاة، أثناء وبعد
العلاج بمينجوفي. أخبر طبيبك إذا لاحظت أي علامات لظهور العدوى، مثل الحمى التي تصل
إلى 38 درجة مئوية أو أعلى، أو القشعريرة، أو السعال، أو الشعور بألم عند التبول.
• متلازمة تحلل الورم.
قد يظهر لدى بعض الأشخاص ارتفاع غير عادي في مستويات بعض المواد )مثل البوتاسيوم
والحامض البولي او حمض اليوريك( في الدم الناجم عن التكسير السريع للخلايا السرطانية أثناء
العلاج، وهذا يسمى متلازمة تحلل الورم. أخبر طبيبك إذا كانت لديك أعراض مثل الغثيان والقيء
ونقص الشهية أو التعب، والبول الداكن، ونقص البول، أو آلام في الجانب أو الظهر، وتشنجات
عضلية، وخدر أو خفقان القلب. وقد يعطيك طبيبك العلاج قبل كل تسريب ؛ لتقليل مخاطر
بمتلازمة تحلل الورم، مع إجراء اختبارات الدم للتحقق من وجود متلازمة تحلل الورلديك.
أخبر طبيبك على الفور إذا لاحظت أيًّا من هذه المشاكل.
الأطفال والمراهقون:
لا ينصح باستخدام مينجوفي لعلاج الأطفال والمراهقين الذين تقل أعمارهم عن 18 عامًا، حيث لا
توجد معلومات عن استخدامه في هذه الفئة العمرية.
مينجوفي والأدوية الأخرى:
أخبر طبيبك أو الصيدلي إذا كنت تستخدم حاليًّا أو قد استخدمت مؤخرًا أو ربما تستخدم لاحقًا أي
أدوية أخرى.
لا ينصح باستخدام اللقاحات الحية أثناء العلاج ب تافاسيتاماب.
الحمل والرضاعة والخصوبة:
إذا كُنتِ حاملاً، أو تُرضعين طفلك رضاعة طبيعية أو تعتقدين أنك حامل أو تخططين للحمل،
فاستشيري طبيبك أو الصيدلي قبل تناول هذا الدواء.
• منع الحمل:
يُوصى باستخدام وسائل منع الحمل الفعالة أثناء العلاج بمينجوفي، ولمدة 3 أشهر على الأقل بعد
نهاية العلاج للنساء في سن الإنجاب.
• الحمل:
لا تستخدمي مينجوفي أثناء الحمل، وإذا كان من المحتمل الإنجاب ولا تستخدمين وسائل منع
الحمل، يجب عدم التفكير في الحمل قبل البدء بالعلاج. أخبري طبيبك على الفور إذا أصبحتِ
حاملاً، أو تعتقدين أنك قد تكونين حاملاً أثناء العلاج بمينجوفي.
يتم إعطاء مينجوفي مع الليناليدوميد لمدة تصل إلى 12 دورة. ويمكن أن يضر ليناليدوميد الطفل
الذي لم يولد بعد؛ لذا يجب عدم استخدامه أثناء الحمل أو مع النساء في سن الإنجاب، ما لم يتم
استيفاء جميع شروط برنامج منع الحمل في ليناليدوميد. وسيزودك طبيبكِ بالمزيد من المعلومات
والتوصيات.
• الرضاعة الطبيعية:
لا تمارسي الرضاعة الطبيعية أثناء العلاج بمينجوفي ولمدة 3 أشهر على الأقل بعد تناول آخر
جرعة؛ من غير المعروف ما إذا كان تافاسيتاماب ينتقل إلى حليب الأم.
القيادة واستخدام الآلات:
مينجوفي ليس له تأثير أو قد يكون له تأثير ضئيل على القدرة على القيادة واستخدام الآلات. ومع ذلك،
فقد تم الإبلاغ عن تعب في المرضى الذين يتناولون تافاسيتاماب، ويجب أخذ ذلك في الاعتبار عند
القيام بالقيادة أو استخدام الآلات.
يحتوي مينجوفي على الصوديوم.
يحتوي هذا الدواء على 37.0 ملغ من الصوديوم )المكون الرئيسي للطبخ/ ملح الطعام( في كل
جرعة من 5 قوارير )جرعة المريض الذي يزن 83 كلغ(. وهذا ما يعادل ٪ 1.85 من الحد الأقصى
المُوصَى به من المقدار الغذائي اليومي من الصوديوم للشخص البالغ.
سيقوم بالإشراف على علاجك طبيب متمرس في علاج السرطان. وسيتم إعطاؤك مينجوفي في أحد
الأوردة عن طريق التسريب )بالتنقيط(، وسيتم فحصك بانتظام أثناء التسريب وبعده؛ بحثًا عن الآثار
الجانبية المتعلقة بالتسريب.
وسيتم إعطاؤك مينجوفي في دورات مدتها 28 يومًا. والجرعة التي ستحصل عليها ستعتمد على
وزنك، وسيحددها طبيبك.
الجرعة المُوصَى بها هي 12 ملغ تافاسيتاماب لكل كيلوغرام من وزن الجسم. ويتم إعطاء الجرعة
على شكل تسريب في الوريد وفقًا للجدول الزمني يلي:
• الدورة 1: التسريب في اليوم 1 و 4 و 8 و 15 و 22 من الدورة.
• الدورات 2 و 3: التسريب في اليوم 1 و 8 و 15 و 22 من كل دورة.
• الدورة 4 وما بعدها: التسريب في اليوم 1 و 15 من كل دورة.
بالإضافة إلى ذلك، سيصف لك طبيبك بأخذ كبسولات الليناليدوميد لمدة تصل إلى اثنتي عشرة دورة.
وجرعة البدء الموصى بها من ليناليدوميد هي 25 ملغ يوميًّا في الأيام من 1 إلى 21 من كل دورة.
وسيقوم الطبيب بتعديل جرعة البدء والجرعات اللاحقة إذا لزم الأمر.
وبعد اثنتي عشرة دورة باعتبار ذلك حدًّا أقصى من العلاج المركب، سيتم إيقاف العلاج بالليناليدوميد،
ثم تستمر دورات العلاج بمينجوفي وحده لحين أن يشعر المريض بازدياد المرض سوءًا، أو يشعر
بأعراض جانبية غير مقبولة.
إذا تم إعطاؤك مينجوفي أكثر مما ينبغي:
نظرًا لأن الدواء يُعطَى في المستشفى تحت إشراف الطبيب، فمن غير المرجح أن يحدث ذلك. ولكن
أخبر طبيبك إذا كنت تعتقد أنه قد تم إعطاؤك أكثر مما ينبغي من مينجوفي.
إذا كانت لديك أي أسئلة أخرى حول استخدام هذا الدواء، فاسأل طبيبك أو الصيدلي أو الممرضة.
مثل جميع الأدوية، يمكن أن يسبب هذا الدواء بعض الآثار الجانبية، على الرغم من أن ذلك لا يحدث
للجميع.
اتصل بطبيبك أو ممرضتك على الفور إذا لاحظت أيًّا من الآثار الجانبية الخطيرة التالية، فإنك قد
تحتاج إلى علاج طبي عاجل، وقد تكون هذه أعراضًا جديدة، أو تغييرًا في الأعراض الحالية.
• عدوى خطيرة، أعراض محتملة: الحمى، أو القشعريرة، أو التهاب الحلق، أو السعال، أو الضيق
في التنفس، أو الغثيان والقيء والإسهال. وإذا تم إخبارك بأن لديك مستوى منخفضًا من خلايا الدم
البيضاء يُسمى العدلات، فقد يكون ذلك مُهمًّا بشكل خاص.
• الالتهاب الرئوي )عدوى الرئة(.
• تعفّن الدم )عدوى في مجرى الدم(.
أعراض جانبية أخرى:
أخبر طبيبك أو ممرضتك إذا لاحظت أيًّا من الآثار الجانبية التالية:
شائعة جدًّا )قد تصيب أكثر من 1 من كل 10 أشخاص(
• انخفاض عدد خلايا الدم.
– خلايا الدم البيضاء، وخاصة نوع يُسمى العدلات، الأعراض المحتملة: حُمى تصل إلى 38
درجة مئوية أو أعلى، أو أي أعراض للعدوى.
– الصفائح، الأعراض المحتملة: كدمات أو نزيف غير عادي بدون أو مع إصابة طفيفة فقط.
– خلايا الدم الحمراء، الأعراض المحتملة: شحوب الجلد أو الشفتين، أو التعب، أو الضيق في
التنفس.
• العدوى البكتيرية أو الفيروسية أو الفطرية مثل: عدوى الجهاز التنفسي، والتهاب الشعب الهوائية،
والتهاب الرئة، وعدوى المسالك البولية.
• طفح جلدي.
• انخفاض مستوى البوتاسيوم في الدم في الاختبارات.
• تشنجات العضلات.
• ألم في الظهر.
• تورم الذراعين و/ أو الساقين بسبب تراكم السوائل.
• الضعف والتعب والشعور بالإعياء بشكل عام.
• حُمّى.
• إسهال.
• إمساك.
• ألم في البطن.
• غثيان.
• قيء.
• سعال.
• ضيق في التنفس.
• قلة الشهية.
شائعة: )قد تصيب ما يصل إلى 1 من كل 10 أشخاص(
• تفاقم صعوبات التنفس الناتجة عن ضيق المسالك الهوائية الرئوية، ويُسمّى مرض الانسداد
.)COPD( الرئوي المزمن
• صداع الرأس.
• إحساس غير طبيعي بالجلد، مثل التنميل، والوخز، والخدر.
• حكة.
• احمرار الجلد.
• ردود الفعل المتعلقة بالتسريب.
وقد تحدث هذه التفاعلات أثناء تسريب مينجوفي أو في غضون 24 ساعة بعد التسريب.
الأعراض المحتملة هي الحمى أو القشعريرة أو الاحمرار أو صعوبات في التنفس.
• تغيّر حاسة التذوق.
• تساقط الشعر.
• تعرّق غير طبيعي.
• ألم في الذراعين والساقين.
• آلام العضلات والمفاصل.
• نقص الوزن.
• احتقان بالأنف.
• التهاب الأغشية المبطنة للأعضاء، مثل الفم.
• نقص بعض خلايا الدم البيضاء المُسمّاة الخلايا الليمفاوية في اختبارات الدم.
• مشكلة في جهاز المناعة تُسمّى نقص غاما غلوبولين الدم.
• في اختبارات الدم، مستوى منخفض بالدم من:
– الكالسيوم.
– المغنيسيوم.
• في اختبارات الدم، مستوى مرتفع بالدم من:
– بروتين سي التفاعلي، والذي يمكن أن يكون نتيجة التهاب أو عدوى.
– الكرياتينين، منتج تكسر الأنسجة العضلية.
– إنزيمات الكبد: ترانسفيراز غاما جلوتاميل ، ترانس أميناس.
– البيليروبين، مادة تكسير صفراء لصبغة الدم.
• سرطان الجلد يُسمَّى سرطان الخلايا القاعدية.
الإبلاغ عن الآثار الجانبية:
إذا تفاقمت لديك أي من الآثار الجانبية، أو إذا لاحظت أي آثار جانبية غير مُدرجة في هذه النشرة،
يُرجى إخبار طبيبك أو الصيدلي.
احفظ هذا الدواء بعيدًا عن متناول ومرأى الأطفال.
- لا تستخدم هذا الدواء بعد تاريخ انتهاء الصلاحية المُدوّن على ملصق القارورة والعبوة الخارجية
ويشير تاريخ انتهاء الصلاحية إلى اليوم الأخير من الشهر نفسه. .EXP بعد
8 درجة مئوية(. - - يُحفظ في الثلاجة عند ) 2
- احتفظ بالقارورة في العبوة الخارجية لحمايتها من الضوء.
- يجب التخلّص من أي دواء غير مُستخدم أو فضلات الأدوية وفقًا للمتطلبات المحلية.
• المادة الفعالة هي تافاسيتاماب. وتحتوي القارورة الواحدة على 200 ملغ من تافاسيتاماب. وبعد
إعادة التركيب، يحتوي كل )مل( من المحلول على 40 ملغ من تافاسيتاماب.
• المكونات الأخرى هي ثنائي هيدرات سترات الصوديوم، ومونوهيدرات حامض الستريك،
مينجوفي يحتوي على « وتريهالوز ثنائي الهيدرات، وبولي سوربات 20 )انظر القسم 2
.)» الصوديو
مينجوفي هو مسحوق مركز لمحلول التسريب، لونه أبيض مائل الى الصفار قليلاً، وهو مسحوق
مجفّف بالتجميد في قارورة زجاجية شفافة مع سدادة مطاطية وختم من الألومنيوم وغطاء بلاستيكي
قابل للفتح.
وتحتوي كل عبوة على قارورة واحدة.
مالك رخصة التسويق والشركة المصنعة:
مالك رخصة التسويق:
شركة إنسايت الدولية للعلوم البيولوجية ش.ذ.م.م
شارع دكتور يرسين 12
1110 مورجس
سويسر ا
+41(0) هاتف: 215815000
+41 21 581 فاكس: 5002
globalmedinfo@incyte.com : البريد الإلكتروني
المصنع المسؤول عن تحرير الصنف:
إنسايت للتوزيع للعلوم البيولوجية بي ڤي.
باشوفيلويج 25
1105 بي بي أمستردام
هولند ا
+31 20 26 19 هاتف: 315
+1 302 فاكس: 4252734
srakhorst@incyte.com : البريد الإلكتروني
للحصول على أي معلومات حول هذا المنتج الطبي، يُرجى الاتصال بالممثل المحلي لمالك رخصة
التسويق في المملكة العربية السعودية:
بيولوجيكس، شركة منطقة حرة، شارع هبة الله الغفاري، السليمانية، المملكة العربية السعودية ص.ب
. 99 ، الرياض 11421 1
+966 11 464 هاتف: 6955
+966 11 463 فاكس: 436
MINJUVI is indicated in combination with lenalidomide followed by MINJUVI monotherapy for the
treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who
are not eligible for autologous stem cell transplant (ASCT). This indication is approved under accelerated approval based on overall response rate [see Pharmacodynamic properties (5.1)]. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).
MINJUVI must be administered by a healthcare professional experienced in treatment of cancer
patients.
Recommended pre-medication
A pre-medication to reduce the risk of infusion-related reactions should be administered 30 minutes to
2 hours prior to tafasitamab infusion. For patients not experiencing infusion-related reactions during
the first 3 infusions, pre-medication is optional for subsequent infusions.
The pre-medication may include antipyretics (e.g. paracetamol), histamine H1 receptor blockers (e.g.
diphenhydramine), histamine H2 receptor blockers (e.g. cimetidine),or glucocorticosteroids (e.g.
methylprednisolone).
Treatment of infusion-related reactions
If an infusion-related reaction occurs (Grade 2 and higher), the infusion should be interrupted. In
addition, appropriate medical treatment of symptoms should be initiated. After signs and symptoms
are resolved or reduced to Grade 1, MINJUVI infusion can be resumed at a reduced infusion speed
(see Table 1).
If a patient has experienced a Grade 1 to 3 infusion-related reaction, pre-medication should be
administered before subsequent tafasitamab infusions.
Posology
The recommended dose of MINJUVI is 12 mg per kg body weight administered as an intravenous
infusion according to the following schedule:
• Cycle 1: infusion on day 1, 4, 8, 15 and 22 of the cycle.
• Cycles 2 and 3: infusion on day 1, 8, 15 and 22 of each cycle.
• Cycle 4 until disease progression: infusion on day 1 and 15 of each cycle.
Each cycle has 28 days.
In addition, patients should self-administer lenalidomide capsules at the recommended starting dose of
25 mg daily on days 1 to 21 of each cycle. The starting dose and subsequent dosing may be adjusted
according to the lenalidomide Summary of Product Characteristics (SmPC).
MINJUVI plus lenalidomide in combination is given for up to twelve cycles.
Treatment with lenalidomide should be stopped after a maximum of twelve cycles of combination
therapy. Patients should continue to receive MINJUVI infusions as single agent on day 1 and 15 of
each 28-day cycle, until disease progression or unacceptable toxicity.
Dose modifications
Table 1 provides dose modifications in case of adverse reactions. For dose modifications regarding
lenalidomide, please also refer to the lenalidomide SmPC.
Table 1: Dose modifications in case of adverse reactions
Special populations
Paediatric population
The safety and efficacy of MINJUVI in children under 18 years have not been established.
No data are available.
Elderly
No dose adjustment is needed for elderly patients (≥ 65 years).
Renal impairment
No dose adjustment is needed for patients with mild or moderate renal impairment (see section 5.2).
There are no data in patients with severe renal impairment for dosing recommendations.
Hepatic impairment
No dose adjustment is needed for patients with mild hepatic impairment (see section 5.2). There are no
data in patients with moderate or severe hepatic impairment for dosing recommendations.
Method of administration
MINJUVI is for intravenous use after reconstitution and dilution.
• For the first infusion of cycle 1, the intravenous infusion rate should be 70 mL/h for the first
30 minutes. Afterwards, the rate should be increased to complete the first infusion within a
2.5-hour period.
• All subsequent infusions should be administered within a 1.5 to 2-hour period.
• In case of adverse reactions, consider the recommended dose modifications provided in Table 1.
• MINJUVI must not be co-administered with other medicinal products through the same infusion
line.
• MINJUVI must not be administered as an intravenous push or bolus.
For instructions on reconstitution and dilution of the medicinal product before administration, see
section 6.6.
Traceability
In order to improve the traceability of biological medicinal products, the name and the batch number
of the administered product should be clearly recorded.
Infusion-related reactions
Infusion-related reactions may occur and have been reported more frequently during the first infusion
(see section 4.8). Patients should be monitored closely throughout the infusion. Patients should be
advised to contact their healthcare professionals if they experience signs and symptoms of
infusion-related reactions including fever, chills, rash or breathing problems within 24 hours of
infusion. A premedication should be administered to patients prior to starting tafasitamab infusion.
Based on the severity of the infusion-related reaction, tafasitamab infusion should be interrupted or
discontinued and appropriate medical management should be instituted (see section 4.2).
Myelosuppression
Treatment with tafasitamab can cause serious and/or severe myelosuppression including neutropenia,
thrombocytopenia and anaemia (see section 4.8). Complete blood counts should be monitored
throughout treatment and prior to administration of each treatment cycle. Based on the severity of the
adverse reaction, tafasitamab infusion should be withheld (see Table 1). Refer to the lenalidomide
SmPC for dosage modifications.
Neutropenia
Neutropenia, including febrile neutropenia, has been reported during treatment with tafasitamab.
Administration of granulocyte colony-stimulating factors (G-CSF) should be considered, in particular
in patients with Grade 3 or 4 neutropenia. Any symptoms or signs of developing infection should be
anticipated, evaluated and treated.
Thrombocytopenia
Thrombocytopenia has been reported during treatment with tafasitamab. Withholding of concomitant
medicinal products that may increase bleeding risk (e.g. platelet inhibitors, anticoagulants) should be
considered. Patients should be advised to report signs or symptoms of bruising or bleeding
immediately.
Infections
Fatal and serious infections, including opportunistic infections, occurred in patients during treatment
with tafasitamab. Tafasitamab should be administered to patients with an active infection only if the
infection is treated appropriately and well controlled. Patients with a history of recurring or chronic
infections may be at increased risk of infection and should be monitored appropriately.
Patients should be advised to contact their healthcare professionals if fever or other evidence of
potential infection, such as chills, cough or pain on urination, develops.
Tumour lysis syndrome
Patients with high tumour burden and rapidly proliferative tumour may be at increased risk of tumour
lysis syndrome. In patients with DLBCL, tumour lysis syndrome during treatment with tafasitamab
has been observed. Appropriate measures/prophylaxis in accordance with local guidelines should be
taken prior to treatment with tafasitamab. Patients should be monitored closely for tumour lysis
syndrome during treatment with tafasitamab.
Immunisations
The safety of immunisation with live vaccines following tafasitamab therapy has not been investigated
and vaccination with live vaccines is not recommended concurrently with tafasitamab therapy.
Excipient
This medicinal product contains 37.0 mg sodium per 5 vials (the dose of a patient weighing 83 kg),
equivalent to 1.85% of the WHO recommended maximum daily intake of 2 g sodium for an adult.
No interaction studies have been performed.
Treatment with tafasitamab in combination with lenalidomide should not be initiated in female
patients unless pregnancy has been excluded. Please also refer to the SmPC of lenalidomide.
Women of childbearing potential/Contraception in females
Women of childbearing potential should be advised to use effective contraception during and for at
least 3 months after end of treatment with tafasitamab.
Pregnancy
Reproductive and developmental toxicity studies have not been conducted with tafasitamab.
There are no data on the use of tafasitamab in pregnant women. However, IgG is known to cross the
placenta and tafasitamab may cause foetal B-cell depletion based on the pharmacological properties
(see section 5.1). In case of exposure during pregnancy, newborns should be monitored for B-cell
depletion and vaccinations with live virus vaccines should be postponed until the infant’s B-cell count
has recovered (see section 4.4).
Tafasitamab is not recommended during pregnancy and in women of childbearing potential not using
contraception.
Lenalidomide can cause embryo-foetal harm and is contraindicated for use in pregnancy and in
women of childbearing potential unless all of the conditions of the lenalidomide pregnancy prevention
programme are met.
Breast-feeding
It is not known whether tafasitamab is excreted in human milk. However, maternal IgG is known to be
excreted in human milk. There are no data on the use of tafasitamab in breast-feeding women and a
risk for breast-feeding children cannot be excluded. Women should be advised not to breast-feed
during and for at least 3 months after the last dose of tafasitamab.
Fertility
No specific studies have been conducted to evaluate potential effects of tafasitamab on fertility. No
adverse effects on male and female reproductive organs were observed in a repeat-dose toxicity study
in animals (see section 5.3).
MINJUVI has no or negligible influence on the ability to drive and use machines. However, fatigue
has been reported in patients taking tafasitamab and this should be taken into account when driving or
using machines.
Summary of the safety profile
The most common adverse reactions are: infections (73%), neutropenia (51%), asthenia (38%),
anaemia (36%), diarrhoea (36%), thrombocytopenia (31%), cough (26%), oedema peripheral (24%),
pyrexia (24%), decreased appetite (22%).
The most common serious adverse reactions were infection (26%) including pneumonia (7%), and
febrile neutropenia (6%).
Permanent discontinuation of tafasitamab due to an adverse reaction occurred in 15% of patients. The
most common adverse reactions leading to permanent discontinuation of tafasitamab were infections
and infestations (5%), nervous system disorders (2.5%), and respiratory, thoracic and mediastinal
disorders (2.5%).
The frequency of dose modification or interruption due to adverse reactions was 65%. The most
common adverse reactions leading to tafasitamab treatment interruption were blood and lymphatic
system disorders (41%).
Tabulated list of adverse reactions
Adverse reactions reported in clinical trials are listed by MedDRA System Organ Class and by
frequency. The frequencies of adverse reactions is based on the pivotal phase 2 trial MOR208C203
(L-MIND) with 81 patients. Patients were exposed to tafasitamab for a median of 7.7 months. The
adverse reaction frequencies from clinical trials are based on all-cause adverse event frequencies,
where a proportion of the events for an adverse reaction may have other causes than the medicinal
product, such as the disease, other medicines or unrelated causes.
Frequencies are defined as follows: very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon
(≥ 1/1,000 to < 1/100); rare (≥ 1/10,000 to < 1/1,000); very rare (< 1/10,000); and not known (cannot
be estimated from the available data). Within each frequency grouping, adverse reactions are presented
in order of decreasing seriousness.
Table 2: Adverse reactions in patients with relapsed or refractory DLBCL who received
tafasitamab in the clinical trial MOR208C203 (L-MIND)
+Further information on this adverse reaction is provided in the text below.
Compared with the incidences on combination therapy with lenalidomide, the incidences of non-haematological adverse
reactions on tafasitamab monotherapy decreased by at least 10% for decreased appetite, asthenia, hypokalaemia, constipation,
nausea, muscle spasms, dyspnoea and C-reactive protein increased.
Description of selected adverse reactions
Myelosuppression
Treatment with tafasitamab can cause serious or severe myelosuppression including neutropenia,
thrombocytopenia and anaemia (see sections 4.2 and 4.4).
In the L-MIND study, myelosuppression (i.e. neutropenia, febrile neutropenia, thrombocytopenia,
leukopenia, lymphopenia or anaemia) occurred in 65.4% of patients treated with tafasitamab.
Myelosuppression was managed by reduction or interruption of lenalidomide, interruption of
tafasitamab and/or administration of G-CSF (see sections 4.2 and 4.4). Myelosuppression led to
interruption of tafasitamab in 41% and to tafasitamab discontinuation in 1.2%.
Neutropenia/febrile neutropenia
Incidence of neutropenia was 51%. Incidence of Grade 3 or 4 neutropenia was 49% and of Grade 3 or
4 febrile neutropenia was 12%. Median duration of any adverse reaction of neutropenia was 8 days
(range 1 – 222 days); median time to onset to first occurrence of neutropenia was 49 days (range 1 –
994 days).
Thrombocytopenia
Incidence of thrombocytopenia was 31%. Incidence of Grade 3 or 4 thrombocytopenia was 17%.
Median duration of any adverse reaction thrombocytopenia was 11 days (range 1 – 470 days); median time to onset to first occurrence of thrombocytopenia was 71 days (range 1 – 358 days).
Anaemia
Incidence of anaemia was 36%. Incidence of Grade 3 or 4 anaemia was 7%. Median duration of any
adverse reaction of anaemia was 15 days (range 1 – 535 days); median time to onset to first occurrence of anaemia was 49 days (range 1 – 1129 days).
When patients in the L-MIND study were switched from tafasitamab and lenalidomide in the
combination therapy phase to tafasitamab alone in the extended monotherapy phase, the incidences of
haematological events decreased by at least 20% for neutropenia, thrombocytopenia and anaemia; no
incidences of febrile neutropenia were reported with tafasitamab monotherapy (see sections 4.2 and
4.4).
Infections
In the L-MIND study, infections occurred in 73% of patients. Incidence of Grade 3 or 4 infections was
28%. The most frequently reported Grade 3 or higher infections were pneumonia (7%), respiratory
tract infections (4.9%), urinary tract infections (4.9%) and sepsis (4.9%). Infection was fatal in < 1%
of patients (pneumonia) within 30 days of last treatment.
Median time to first onset of Grade 3 or 4 infection was 62.5 days (4 – 1014 days). Median duration of any infection was 11 days (1 – 392 days).
Recommendations for management of infections are provided in section 4.4.
Infection led to dose interruption of tafasitamab in 27% and tafasitamab discontinuation in 4.9%.
Infusion-related reactions
In the L-MIND study, infusion-related reactions occurred in 6% of patients. All infusion related
reactions were Grade 1 and resolved on the day of occurrence. Eighty percent of these reactions
occurred during cycle 1 or 2. Symptoms included chills, flushing, dyspnoea and hypertension (see
sections 4.2 and 4.4).
Immunogenicity
In 245 patients treated with tafasitamab, no treatment-emergent or treatment-boosted anti-tafasitamab
antibodies were observed. Pre-existing anti-tafasitamab antibodies were detected in 17/245 patients
(6.9%) with no impact on pharmacokinetics, efficacy or safety of tafasitamab.
Special populations
Elderly
Among 81 patients treated in the L-MIND study, 56 (69%) patients were > 65 years of age. Patients
> 65 years of age had a numerically higher incidence of serious treatment emergent adverse events
(TEAEs) (55%) than patients ≤ 65 years (44%).
To report any side effect(s):
• Saudi Arabia:
The National Pharmacovigilance Centre (NPC)
- Fax: +966-11-205-7662
- SFDA Call Center: 19999
- E-mail: npc.drug@sfda.gov.sa
- Website: https://ade.sfda.gov.sa/
• Kuwait:
• Drug & Food Control, Ministry of Health, Kuwait
- Tel. No.: +965-24811532
- Fax No.: +965-24811507
- E-mail: Adr_reporting@moh.gov.kw
• Oman:
Department of Pharmacovigilance & Drug Information
Phone No.: +968 22357686, 7687
Fax: +968 22358489
Website: http://www.moh.gov.om
Call for reporting: pharma-vigil@moh.gov.om
• United Arab Emirates:
Pharmacovigilance & Medical Device section
P.O.Box: 1853
Tel: 80011111
Email : pv@mohap.gov.ae
Drug Department
Ministry of Health & Prevention
Dubai, UAE
• Other GCC states:
- Please contact the relevant competent authority.
In the case of an overdose, patients should be carefully observed for signs or symptoms of adverse
reactions and supportive care should be administered, as appropriate.
Pharmacotherapeutic group: Antineoplastic agents, monoclonal antibodies, ATC code: L01FX12.
Mechanism of action
Tafasitamab is an Fc-enhanced monoclonal antibody that targets the CD19 antigen expressed on the
surface of pre-B and mature B lymphocytes.
Upon binding to CD19, tafasitamab mediates B-cell lysis through:
• engagement of immune effector cells like natural killer cells, γδ T cells and phagocytes
• direct induction of cell death (apoptosis)
The Fc modification results in enhanced antibody-dependent cellular cytotoxicity and
antibody-dependent cellular phagocytosis.
Pharmacodynamic effects
In patients with relapsed or refractory DLBCL, tafasitamab led to a reduction in peripheral blood
B-cell counts. The reduction relative to baseline B-cell count reached 97% after eight days of
treatment in the L-MIND study. The maximum B-cell reduction at approximately 100% (median) was
reached within 16 weeks of treatment.
Although the depletion of B-cells in the peripheral blood is a measurable pharmacodynamic effect, it
is not directly correlated with the depletion of B-cells in solid organs or in malignant deposits.
Clinical efficacy
Tafasitamab plus lenalidomide followed by tafasitamab monotherapy was studied in the L-MIND
study, an open-label multicentre single-arm study. This study was conducted in adult patients with
relapsed or refractory DLBCL after 1 to 3 prior systemic DLBCL therapies, who at the time of the trial
were not candidates for high dose chemotherapy followed by ASCT or who had refused ASCT. One
of the prior systemic therapies had to include a CD20 targeted therapy. The study excluded patients
with severe hepatic impairment (total serum bilirubin > 3 mg/dL) and patients with renal impairment
(CrCL< 60 mL/min.), as well as patients with history or evidence of clinically significant
cardiovascular, CNS and/or other systemic disease. Patients with a known history of
“double/triple-hit”genetics DLBCL were also excluded at study entry.
For the first three cycles, patients received 12 mg/kg tafasitamab via infusion on day 1, 8, 15 and 22 of
each 28-day cycle, plus a loading dose on day 4 of cycle 1. Thereafter, tafasitamab was administered
on days 1 and 15 of each cycle until disease progression. Pre-medication including antipyretics,
histamine H1 and H2 receptor blockers and glucocorticosteroids was given 30 to 120 minutes prior to
the first three tafasitamab infusions.
Patients self-administered 25 mg lenalidomide daily on days 1 to 21 of each 28-day cycle, up to
12 cycles.
A total of 81 patients were enrolled in the L-MIND study. The median age was 72 years (range 41 to
86 years), 89% were white and 54% were males. Out of 81 patients, 74 (91.4%) had ECOG
performance score of 0 or 1 and 7 (8.6%) had ECOG score of 2. The median number of prior therapies
was two (range: 1 to 4), with 40 patients (49.4%) receiving one prior therapy and 35 patients (43.2%)
receiving 2 prior lines of treatment. Five patients (6.2%) had 3 prior lines of therapies and 1 (1.2%)
had 4 prior lines of treatment. All patients had received a prior CD20-containing therapy. Eight patients had a diagnosis of DLBCL transformed from low-grade lymphoma. Fifteen patients (18.5%)
had primary refractory disease, 36 (44.4%) were refractory to their last prior therapy, and 34 (42.0%)
were refractory to rituximab. Nine patients (11.1%) had received prior ASCT. The primary reasons for
patients not being candidates for ASCT included age (45.7%), refractory to salvage chemotherapy
(23.5%), comorbidities (13.6%) and refusal of high dose chemotherapy/ASCT (16.0%).
One patient received tafasitamab, but not lenalidomide. The remaining 80 patients received at least one dose of tafasitamab and lenalidomide. All patients enrolled in the L-MIND study had a diagnosis of DLBCL based on local pathology. However, as per central pathology review, 10 patients could not be classified as DLBCL.
The median duration of exposure to treatment was 9.2 months (range: 0.23, 54.67 months). Thirty-two
(39.5%) patients completed 12 cycles of tafasitamab. Thirty (37.0%) patients completed 12 cycles of
lenalidomide.
The primary efficacy endpoint was best objective response rate (ORR), defined as the proportion of
complete and partial responders, as assessed by an independent review committee (IRC). Other
efficacy endpoints included duration of response (DoR), progression-free survival (PFS) and overall
survival (OS). The efficacy results are summarised in Table 3.
Table 3: Efficacy results in patients with relapsed or refractory diffuse large B-cell lymphoma
in the MOR208C203 (L-MIND) study
ITT = intention to treat; NR = not reached
*One patient received only tafasitamab
CI: Binomial exact confidence interval using Clopper Pearson method
a Kaplan Meier estimates
Overall survival (OS) was a secondary endpoint in the study. After a median follow up time of
42.7 months (95% CI: 38.0; 47.2), the median OS was 31.6 months (95% CI: 18.3; not reached).
Amongst the eight patients who had a DLBCL transformed from a prior indolent lymphoma, seven
patients had an objective response (three patients a CR, four patients a PR) and one patient had a
stable disease as the best response to tafasitamab+ lenalidomide treatment.
Elderly
In the ITT set, 36 of 81 patients were ≤ 70 years and 45 of 81 patients were > 70 years. No overall
differences in efficacy were observed for patients ≤ 70 years versus patients > 70 years of age.
Paediatric population
The European Medicines Agency has waived the obligation to submit the results of studies with
MINJUVI in all subsets of the paediatric population in diffuse large B-cell lymphoma (see section 4.2
for information on paediatric use).
This medicinal product has been authorised under a so-called ‘conditional approval’ scheme. This
means that further evidence on this medicinal product is awaited.
The European Medicines Agency will review new information on this medicinal product at least every
year and this SmPC will be updated as necessary.
The absorption, distribution, biotransformation and elimination were documented based on a
population pharmacokinetic analysis.
Absorption
Based on an analysis of tafasitamab in combination with lenalidomide, tafasitamab average serum
trough concentrations (± standard deviation) were 179 (± 53) μg/mL during weekly (plus an additional dose on day 4 of cycle 1) intravenous administrations of 12 mg/kg. During administration every 14 days from cycle 4 onwards, average trough serum concentrations were 153 (± 68) μg/mL. Overall maximum tafasitamab serum concentrations were 483 (± 109) μg/mL.
Distribution
The total volume of distribution for tafasitamab was 9.3 L.
Biotransformation
The exact pathway through which tafasitamab is metabolised has not been characterised. As a human
IgG monoclonal antibody, tafasitamab is expected to be degraded into small peptides and amino acids
via catabolic pathways in the same manner as endogenous IgG.
Elimination
The clearance of tafasitamab was 0.41 L/day and terminal elimination half-life was 16.9 days.
Following long-term observations, tafasitamab clearance was found to decrease over time to
0.19 L/day after two years.
Special populations
Age, body weight, sex, tumour size, disease type, B-cell or absolute lymphocyte counts, anti-drug
antibodies, lactate dehydrogenase and serum albumin levels had no relevant effect on the
pharmacokinetics of tafasitamab. The influence of race and ethnicity on the pharmacokinetics of
tafasitamab is unknown.
Renal impairment
The effect of renal impairment was not formally tested in dedicated clinical trials; however, no
clinically meaningful differences in the pharmacokinetics of tafasitamab were observed for mild to
moderate renal impairment (creatinine clearance (CrCL) ≥ 30 and < 90 mL/min estimated by the Cockcroft-Gault equation). The effect of severe renal impairment to end-stage renal disease (CrCL
< 30 mL/min) is unknown.
Hepatic impairment
The effect of hepatic impairment was not formally tested in dedicated clinical trials; however no
clinically meaningful differences in the pharmacokinetics of tafasitamab were observed for mild
hepatic impairment (total bilirubin ≤ upper limit of normal (ULN) and aspartate aminotransferase
(AST) > ULN, or total bilirubin 1 to 1.5 times ULN and any AST). The effect of moderate to severe
hepatic impairment (total bilirubin > 1.5 times ULN and any AST) is unknown.
Preclinical data reveal no special hazards for humans.
Repeat dose toxicology studies
Tafasitamab has shown to be highly specific to the CD19 antigen on B cells. Toxicity studies
following intravenous administration to cynomolgus monkeys have shown no other effect than the
expected pharmacological depletion of B-cells in peripheral blood and in lymphoid tissues. These
changes reversed after cessation of treatment.
Mutagenicity/carcinogenicity
As tafasitamab is a monoclonal antibody, genotoxicity and carcinogenicity studies have not been
conducted, since such tests are not relevant for this molecule in the proposed indication.
Reproductive toxicity
Reproductive and developmental toxicity studies as well as specific studies to evaluate the effects on
fertility have not been conducted with tafasitamab. However, no adverse effects on reproductive
organs in males and females and no effects on menstrual cycle length in females were observed in the
13-week repeat-dose toxicity study in cynomolgus monkeys.
Sodium citrate dihydrate
Citric acid monohydrate
Trehalose dihydrate
Polysorbate 20
This medicinal product must not be mixed with other medicinal products except those mentioned in
section 6.6.
No incompatibilities have been observed with standard infusion materials.
Store in a refrigerator (2 °C – 8 °C).
Keep the vial in the outer carton in order to protect from light.
For storage conditions after reconstitution and dilution of the medicinal product, see section 6.3.
Clear type I glass vial with a butyl rubber stopper, aluminium seal and a plastic flip-off cap containing
200 mg tafasitamab. Pack size of one vial.
MINJUVI is provided in sterile, preservative-free single-use vials.
MINJUVI should be reconstituted and diluted prior to intravenous infusion.
Use appropriate aseptic technique for reconstitution and dilution.
Instructions for reconstitution
• Determine the dose of tafasitamab based on patient weight by multiplying 12 mg by the patient
weight (kg). Then calculate the number of tafasitamab vials needed (each vial contains 200 mg
tafasitamab) (see section 4.2).
• Using a sterile syringe, gently add 5.0 mL sterile water for injections into each MINJUVI vial.
Direct the stream toward the walls of each vial and not directly on the lyophilised powder.
• Gently swirl the reconstituted vial(s) to aid the dissolution of the lyophilised powder. Do not
shake or swirl vigorously. Do not remove the contents until all of the solids have been
completely dissolved. The lyophilised powder should dissolve within 5 minutes.
• The reconstituted solution should appear as a colourless to slightly yellow solution. Before
proceeding, ensure there is no particulate matter or discolouration by inspecting visually. If the
solution is cloudy, discoloured or contains visible particles, discard the vial(s).
Instructions for dilution
• An infusion bag containing 250 mL sodium chloride 9 mg/mL (0.9%) solution for injection
should be used.
• Calculate the total volume of the 40 mg/mL reconstituted tafasitamab solution needed.
Withdraw a volume equal to this from the infusion bag and discard the withdrawn volume.
• Withdraw the total calculated volume (mL) of reconstituted tafasitamab solution from the vial(s)
and slowly add to the sodium chloride 9 mg/mL (0.9%) infusion bag. Discard any unused
portion of tafasitamab remaining in the vial.
• The final concentration of the diluted solution should be between 2 mg/mL to 8 mg/mL of
tafasitamab.
• Gently mix the intravenous bag by slowly inverting the bag. Do not shake.
Any unused medicinal product or waste material should be disposed of in accordance with local
requirements.
صورة المنتج على الرف
الصورة الاساسية
