Empaveli

— THERAPEUTIC CATEGORIES —
  • Anemias

Empaveli Generic Name & Formulations

General Description

Pegcetacoplan 54mg/mL; soln for SC infusion.

Pharmacological Class

Complement inhibitor.

How Supplied

Single-dose vials (20mL)—8

Generic Availability

NO

Mechanism of Action

Pegcetacoplan binds to complement protein C3 and its activation fragment C3b, thereby regulating the cleavage of C3 and the generation of downstream effectors of complement activation. Pegcetacoplan acts proximally in the complement cascade controlling both C3b-mediated extravascular hemolysis and terminal complement-mediated intravascular hemolysis.

Empaveli Indications

Indications

Treatment of paroxysmal nocturnal hemoglobinuria (PNH).

Empaveli Dosage and Administration

Adult

Give SC via infusion pump or Empaveli on-body injector. For infusion pump: administer into abdomen, thighs, hips, upper arms over ~30mins (if using 2 infusion sites) or ~60mins (if using 1 infusion site). For Empaveli injector: administer only into the abdomen over ~30–60mins. Both: rotate infusion/injection sites. Administer 1080mg twice weekly via infusion pump with a reservoir of ≥20mL or Empaveli injector. For LDH levels >2×ULN: adjust to 1080mg every 3 days; for dose increase: monitor LDH twice weekly for at least 4 weeks. Switching from eculizumab: initiate pegcetacoplan while continuing eculizumab at current dose; after 4 weeks discontinue eculizumab. Switching from ravulizumab: initiate pegcetacoplan no more than 4 weeks after the last dose of ravulizumab.

Children

Not established.

Empaveli Contraindications

Contraindications

Individuals not vaccinated against certain encapsulated bacteria unless the risks of delaying pegcetacoplan therapy outweigh the risks of a bacterial infection with an encapsulated organism. Unresolved serious infections caused by encapsulated bacteria including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae.

Empaveli Boxed Warnings

Boxed Warning

Serious infections caused by encapsulated bacteria.

Empaveli Warnings/Precautions

Warnings/Precautions

Increased risk of serious infections caused by encapsulated bacteria including Streptococcus pneumoniae, Neisseria meningitidis types A, C, W, Y, and B, and Haemophilus influenzae type B. Vaccinate or revaccinate against these bacteria according to ACIP guidelines. Immunize patients without a history of vaccination at least 2 weeks prior to treatment. Give 2 weeks of antibacterial prophylaxis if pegcetacoplan must be initiated immediately and vaccines administered <2 weeks before starting therapy. Monitor closely for signs of serious infection; evaluate immediately if infection is suspected. Consider discontinuing pegcetacoplan if undergoing treatment for serious infections. Discontinue immediately if severe hypersensitivity reaction occurs. Risk of hemolysis and other reactions (eg, thrombosis) after treatment discontinuation; monitor closely for at least 8 weeks; if hemolysis (eg, elevated LDH) occurs, consider restarting pegcetacoplan. Pregnancy: exclude status prior to initiation. Advise females of reproductive potential to use effective contraception during and for 40 days after the last dose. Nursing mothers: not recommended (during and for 40 days after the last dose).

REMS

YES

Empaveli Pharmacokinetics

Absorption

Median Tmax: 108–144 hours (4.5–6.0 days) after a single dose.

Distribution

Mean volume of distribution: ~3.98 L. 

Metabolism

Catabolic pathways.

Elimination

Half-life: 8.6 days. Mean clearance: 0.36 L/day.

Empaveli Interactions

Interactions

May interfere with silica reagents in coagulation panels and result in artificially prolonged activated partial thromboplastin time (aPTT); avoid concomitant use.

Empaveli Adverse Reactions

Adverse Reactions

Inj-site reactions, infections, diarrhea, abdominal pain, respiratory tract infection, viral infection, fatigue; serious infections (may be fatal), infusion-related reactions.

Empaveli Clinical Trials

See Literature

Empaveli Note

Not Applicable

Empaveli Patient Counseling

See Literature

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