Indication
Gamifant® (emapalumab-lzsg) is an interferon gamma (IFNγ)–blocking antibody indicated for
the treatment of adult and pediatric (newborn and older) patients with primary hemophagocytic
lymphohistiocytosis (HLH) with refractory, recurrent, or progressive disease or intolerance with
conventional HLH therapy.
Important Safety Information
Infections
Before initiating Gamifant, patients should be evaluated for infection, including latent tuberculosis (TB).
Prophylaxis for TB should be administered to patients who are at risk for TB or known to have a positive
purified protein derivative (PPD) test result or positive IFNγ release assay.
During Gamifant treatment, patients should be monitored for TB, adenovirus, Epstein-Barr virus (EBV), and
cytomegalovirus (CMV) every 2 weeks and as clinically indicated.
Patients should be administered prophylaxis for herpes zoster, Pneumocystis jirovecii, and fungal
infections prior to Gamifant administration.
Increased Risk of Infection With Use of Live Vaccines
Do not administer live or live attenuated vaccines to patients receiving Gamifant and for at least 4 weeks
after the last dose of Gamifant. The safety of immunization with live vaccines during or following Gamifant
therapy has not been studied.
Infusion-Related Reactions
Infusion-related reactions, including drug eruption, pyrexia, rash, erythema, and hyperhidrosis, were
reported with Gamifant treatment in 27% of patients. In one-third of these patients, the infusion-related
reaction occurred during the first infusion.
Adverse Reactions
In the pivotal trial, the most commonly reported adverse reactions (≥10%) for Gamifant included infection
(56%), hypertension (41%), infusion-related reactions (27%), pyrexia (24%), hypokalemia (15%), constipation
(15%), rash (12%), abdominal pain (12%), CMV infection (12%), diarrhea (12%), lymphocytosis (12%), cough
(12%), irritability (12%), tachycardia (12%), and tachypnea (12%).
Additional selected adverse reactions (all grades) that were reported in less than 10% of patients treated
with Gamifant included vomiting, acute kidney injury, asthenia, bradycardia, dyspnea, gastrointestinal
hemorrhage, epistaxis, and peripheral edema.
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Prescribing Information for Gamifant.
You may also contact Sobi at medinfo.us@sobi.com or 866-773-5274.
References
- Gamifant [prescribing information]. Stockholm, Sweden: Swedish Orphan Biovitrum AB.
- Morimoto A, Nakazawa Y, Ishii E. Hemophagocytic lymphohistiocytosis: pathogenesis, diagnosis, and
management. Pediatr Int. 2016;58(9):817-825.
- FDA approves first treatment specifically for patients with rare and life-threatening type of immune
disease [news release]. Silver Spring, MD: Food and Drug Administration; November 20, 2018. https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm626263.htm. Accessed
June 11, 2021.
- Jordan M, Hildeman D, Kappler J, Marrack P. An animal model of hemophagocytic lymphohistiocytosis (HLH):
CD8+ T cells and interferon gamma are essential for the disorder. Blood. 2004;104(3): 735-743.
doi: https://doi.org/10.1182/blood-2003-10-3413.
- Sepulveda F, de Saint Basile G. Hemophagocytic syndrome: primary forms and predisposing conditions.
Curr Opin Immunol. 2017; 49:20-26. http://dx.doi.org/10.1016/j.coi.2017.08.004.
- Locatelli F, Jordan MB, Allen C, et al. Emapalumab in children with primary hemophagocytic
lymphohistiocytosis. N Engl J Med. 2020;382(19):1811-1822.
- Price B, Lines J, Lewis D, Holland N. Haemphagocytic lymphohistiocytosis: a fulminant syndrome associate
with multiorgan failure and high mortality that frequently masquerades as sepsis and shock. S Afr Med
J. 2014; 104(6):401-406. doi:10.7196/samj.7810.
- Jordan MB, Allen CE, Weitzman S, Filipovich AH, McClain KL. How I treat hemophagocytic
lymphohistiocytosis. Blood. 2011;118(15):4041-4052. doi: https://doi.org/10.1182/blood-2011-03-278127.
- Lehmberg K, Nichols KE, Henter J-I, et al. Consensus recommendations for the diagnosis and management of
hemophagocytic lymphohistiocytosis associated with malignancies. Haematologica.
2015:100(8):997-1004.
- Marsh RA, Haddad E. How I treat primary haemophagocytic lymphohistiocytosis. Br J Haematol.
2018;182(2):185-199. doi: 10.1111/bjh.15274.