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Communiqué Aux Médias
Sandoz International
Industriestr. 25
83607 Holzkirchen,Germany
Tel: +49 8024 476 2596
Fax: +49 8024 476 2599
www.sandoz.com
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MEDIA RELEASE • COMMUNIQUE AUX MEDIAS • MEDIENMITTEILUNG |
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Sandoz is the first company to receive approval of a biosimilar in the US through the new FDA biosimilars pathway established under BPCIA
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Zarxio is approved for all indications included in the reference product’s (NEUPOGEN®) label
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Approval paves way for greater access to high-quality biologics in the US and underscores Sandoz global leadership in biosimilars
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Zarxio is contraindicated in patients with a history of serious allergic reactions to human granulocyte colony-stimulating factors such as filgrastim or pegfilgrastim.
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Splenic rupture, including fatal cases, has been reported following the administration of filgrastim products. Patients who report left upper abdominal or shoulder pain should be evaluated.
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Acute respiratory distress syndrome (ARDS) has been reported in patients receiving filgrastim products. Patients who develop fever and lung infiltrates or respiratory distress should be evaluated. Discontinue Zarxio in patients with ARDS.
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Serious allergic reactions, including anaphylaxis, have been reported in patients receiving filgrastim products. The majority of reported events occurred upon initial exposure. Provide symptomatic treatment for allergic reactions. Allergic reactions, including anaphylaxis, in patients receiving filgrastim products can recur within days after the discontinuation of initial anti-allergic treatment. Permanently discontinue Zarxio in patients with serious allergic reactions.
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Sickle cell crisis, in some cases fatal, has been reported with the use of filgrastim products in patients with sickle cell trait or sickle cell disease.
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Alveolar hemorrhage manifesting as pulmonary infiltrates and hemoptysis requiring hospitalization have been reported in healthy donors treated with filgrastim undergoing peripheral blood progenitor cell (PBPC) collection mobilization. Hemoptysis resolved with discontinuation of filgrastim. The use of Zarxio for PBPC mobilization in healthy donors is not an approved indication.
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Capillary leak syndrome (CLS) has been reported after G-CSF administration, including filgrastim products, and is characterized by hypotension, hypoalbuminemia, edema and hemoconcentration. Episodes vary in frequency, severity and may be life-threatening if treatment is delayed. Patients who develop symptoms of capillary leak syndrome should be closely monitored and receive appropriate treatment.
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Confirm the diagnosis of severe chronic neutropenia (SCN) before initiating Zarxio therapy. Myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML) have been reported to occur in the natural history of congenital neutropenia without cytokine therapy. Cytogenetic abnormalities, transformation to MDS, and AML have also been observed in patients treated with filgrastim for SCN. Abnormal cytogenetics and MDS have been associated with the eventual development of myeloid leukemia. The effect of filgrastim products on the development of abnormal cytogenetics and the effect of continued filgrastim administration in patients with abnormal cytogenetics or MDS are unknown. If a patient with SCN develops abnormal cytogenetics or myelodysplasia‚ the risks and benefits of continuing Zarxio should be carefully considered.
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Thrombocytopenia has been reported in patients receiving filgrastim products. Monitor platelet counts.
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Leukocytosis:
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Patients with Cancer Receiving Myelosuppressive Chemotherapy: White blood cell counts of 100‚000/mm3 or greater were observed in approximately 2% of patients receiving filgrastim at dosages above 5 mcg/kg/day. In patients with cancer receiving ZARXIO as an adjunct to myelosuppressive chemotherapy‚ to avoid the potential risks of excessive leukocytosis‚ it is recommended that ZARXIO therapy be discontinued if the ANC surpasses 10‚000/mm3 after the chemotherapy-induced ANC nadir has occurred. Monitor CBCs at least twice weekly during therapy.
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Peripheral Blood Progenitor Cell (PBPC) Collection and Therapy: During the period of administration of Zarxio for PBPC mobilization in patients with cancer, discontinue Zarxio if the leukocyte count rises to >100,000/mm3.
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Cutaneous vasculitis has been reported in patients treated with filgrastim products. In most cases‚ the severity of cutaneous vasculitis was moderate or severe. Most of the reports involved patients with SCN receiving long-term filgrastim therapy. Hold Zarxio therapy in patients with cutaneous vasculitis. Zarxio may be started at a reduced dose when the symptoms resolve and the ANC has decreased.
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The possibility that filgrastim acts as a growth factor for any tumor type, including myeloid malignancies and myelodysplasia, diseases for which filgrastim is not approved, cannot be excluded. The safety of filgrastim products in chronic myeloid leukemia (CML) and myelodysplasia has not been established. When Zarxio is used to mobilize PBPC‚ tumor cells may be released from the marrow and subsequently collected in the leukapheresis product. Available data is limited and inconclusive.
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The safety and efficacy of filgrastim products given simultaneously with cytotoxic chemotherapy have not been established. Do not use Zarxio in the period 24 hours before through 24 hours after the administration of cytotoxic chemotherapy. The safety and efficacy of filgrastim products have not been evaluated in patients receiving concurrent radiation therapy. Avoid the simultaneous use of Zarxio with chemotherapy and radiation therapy.
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Increased hematopoietic activity of the bone marrow in response to growth factor therapy has been associated with transient positive bone-imaging changes on nuclear imaging.
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With nonmyeloid malignancies receiving myelosuppressive anti-cancer drugs (≥ 5% difference in incidence compared to placebo) are thrombocytopenia, nausea, pyrexia, chest pain, pain, fatigue, back pain, arthralgia, bone pain, pain in extremity, dizziness, cough, dyspnea, rash, blood lactate dehydrogenase increased and blood alkaline phosphatase increased
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With AML (≥ 2% difference in incidence) are epistaxis, back pain, pain in extremity, erythema, and rash maculo-papular
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With nonmyeloid malignancies undergoing myeloablative chemotherapy followed by BMT (≥ 5% difference in incidence) are rash and hypersensitivity
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Undergoing peripheral blood progenitor cell mobilization and collection (≥ 5% incidence) are bone pain, pyrexia, blood alkaline phosphatase increased and headache
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With severe chronic neutropenia (SCN) (≥ 5% difference in incidence) are arthralgia, bone pain, back pain, muscle spasms, musculoskeletal pain, pain in extremity, splenomegaly, anemia, upper respiratory tract infection, urinary tract infection, epistaxis, chest pain, diarrhea, hypoesthesia, and alopecia
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Eric Althoff
Novartis Global Media Relations
+41-61-324-7999
+41-79-593-4202
eric.althoff@novartis.com
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Sreejit Mohan
Sandoz Head Biopharma & OI Communications
+49 (0) 162 429 7971
sreejit.mohan@sandoz.com
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Central phone:
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+41 61 324 7944
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North America:
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Samir Shah
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+41 61 324 7944
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Richard Pulik
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+1 212 830 2448
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Pierre-Michel Bringer
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+41 61 324 1065
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Susan Donofrio
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+1 862 778 9257
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Thomas Hungerbuehler
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+41 61 324 8425
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Isabella Zinck
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+41 61 324 7188
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e-mail: investor.relations@novartis.com
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1.
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NEUPOGEN® is a registered trademark of Amgen.
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ZARXIOTM is a trademark of Novartis AG.
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ZARZIO® is a registered trademark of Novartis AG.
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