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Drug Safety-related Labeling Changes (SrLC)

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MYOZYME (BLA-125141)

(ALGLUCOSIDASE ALFA)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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02/18/2020 (SUPPL-223)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.2 Immune-Mediated Reactions

(additions underlined)

Immune tolerance induction administered in conjunction with MYOZYME may also aid tolerability of alglucosidase alfa under the management of a clinical specialist knowledgeable in immune tolerance induction in pediatric Pompe disease.

5.5 Risk of Antibody Development

(new subsection added)

Patients with infantile onset Pompe disease should have a cross-reactive immunologic material (CRIM) assessment early in their disease course and be managed by a clinical specialist knowledgeable in immune tolerance induction in Pompe disease to optimize treatment. Immune tolerance induction administered prior to and in conjunction with initiation of alglucosidase alfa has been reported to aid tolerability of alglucosidase alfa in CRIM-negative patients. CRIM status has been shown to be associated with immunogenicity and patients’ responses to enzyme replacement therapies. CRIM-negative infants with infantile-onset Pompe disease treated with alglucosidase alfa have shown poorer clinical response in the presence of high sustained IgG antibody titers and positive inhibitory antibodies compared to CRIM-positive infants.

5.7 Monitoring: Laboratory Tests

(additions and/or revisions underline)

Testing services for antibodies against alglucosidase alfa are available through Genzyme Corporation. Contact Genzyme Corporation at 1-800-745-4447 for information on testing.

6 Adverse Reactions

6.2 Immunogenicity

(additions underlined)

Most patients who develop do so within the first 3 months of exposure. There is evidence to suggest that sustained greater than or equa12,800 of anti- alglucosidase alfa, including cross-reactive immunologic material (CRIM)–negative patients (i.e., patients in whom no endogenous GAA protein was detected by Western blot analysis and/or predicted based on the genotype) may have a poorer clinical response totreatmentor lose motor as antibody titers increase.

Immunogenicity data from clinical trials and published literature in CRIM-negative, infantile- onset Pompe disease patients suggest that the administration of an immune tolerance induction regimen individualized to alglucosidase alfa–naive patients may be effective in preventing or reducing the development of high sustained antibody titer against alglucosidase alfa.


Infusion reactions were reported in 20 of 39 CRIM-positive patients (51%) treated with MYOZYME in clinical studies and appear to be more common in antibody-positive patients: 8 of 15 patients with high antibody titers experienced infusion reactions, whereas none of 3 antibody-negative patients experienced infusion reactions.

05/30/2019 (SUPPL-222)

Approved Drug Label (PDF)

8 Use in Specific Populations

8.1 Pregnancy

8.2 Lactation

PLLR conversion; please refer to label for complete information.

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

PATIENT COUNSELING INFORMATION

Pompe Registry

Additions and/or revisions underlined:

For information regarding the registry program visit www.registrynxt.com or call 1- 800-745-4447, extension 15500.