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Cerezyme® (imiglucerase) 20-Year Gaucher Registry Analysis


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Cerezyme demonstrated improvements in visceral and hematologic parameters over 20 years1

The 20-year ICGG Gaucher Registry analysis

Study description1

The 20-year International Collaborative Gaucher Group (ICGG) Gaucher Registry study is a retrospective, observational, single-arm study of patients with Gaucher disease type 1 who were treated with Cerezymea for about 20 years.

Patient population

Patient stratification
(2 groups)

Definitions

Analysis limitations

Within the database, patients (n=475) were identified with clinical data at baseline, 10 years, and 20 years of follow-up for:

  • Spleen volume
  • Liver volume
  • Hemoglobin level
  • Platelet count
  • Bone pain
  • Bone crisis
Patients were stratified into nonsplenectomized (n=310) and splenectomized (n=165) groups.

Bone pain was defined as being present if the patient reported this event as occurring in the past month before the medical visit.

Bone crisis was defined as pain with acute onset that requires immobilization of the affected area, narcotics for the relief of pain, and may be accompanied by 1 or more of the following: periosteal elevation, elevated white blood cell count, fever, or debilitation >3 days since the last assessment.

Information entry is voluntary and not all the data on every parameter are available for every patient in the registry. ICGG Gaucher Registry includes patients with a variable range of disease status and management.

aThe Cerezyme treatment group from the ICGG Gaucher Registry analyses represents patients with Gaucher disease type 1 who received either alglucerase or imiglucerase.

Improvements in visceral parameters1,2

Mean spleen volume

In nonsplenectomized patients

-71.1% mean spleen volume
First infusion: 18.2 MN
20 years following first infusion: 4.2 MN (n=74; p<0.0001)

Mean liver volume

In nonsplenectomized patients

-38.0% mean liver volume
First infusion: 1.8 MN
20 years following first infusion: 1.0 MN (n=74; p<0.0001)

  

In splenectomized patients

First infusion: 2.3 MN
20 years following first infusion: 1.0 MN

Improvements in hematologic parameters1,2

Mean hemoglobin level

In nonsplenectomized patients
+2.4 g/dL mean hemoglobin change
First infusion: 11.4 g/dL
20 years following first infusion: 13.8 (n=299; p<0.0001)

  

In splenectomized patients
First infusion: 11.7 g/dL
20 years following first infusion: 13.4 g/dL

Mean platelet count

In nonsplenectomized patients
+130.4% mean platelet count
First infusion: 91.6 x 103/mm3
20 years following first infusion: 169.1 (n=293; p<0.0001)

  

In splenectomized patients
First infusion: 229.1 x 109/L
20 years following first infusion: 257.0 x 109/L

Decrease in certain bone parameters related to Gaucher disease type 11,2,a 

Patients reporting bone pain

In nonsplenectomized patients
-5.9% patients reporting bone pain in the last month
First infusion: 56 patients reported bone pain
20 years following first infusion: 49 reported bone pain (n=118; p=0.3368)

  

In splenectomized patients
First infusion: 41 patients reported bone pain
20 years following first infusion: 26 reported bone pain

Patients reporting bone crisis

In nonsplenectomized patients
-11.5% patients reporting bone crisis since last assessment
First infusion: 17 patients reported bone crisis
20 years following first infusion: 4 patients reported bone crisis (n=113; p=0.001)

  

In splenectomized patients
First infusion: 22 patients reported bone crisis
20 years following first infusion: 0 patients reported bone crisis

MN=multiples of normal.

Cerezyme demonstrated improvements in visceral, hematologic, and certain bone parameters over 20 years.1,a

aThe Cerezyme treatment group from the Gaucher Registry analyses represents patients with Gaucher disease type 1 who received either alglucerase or imiglucerase.

Efficacy in certain Gaucher-related bone parameters

Cerezyme effect on bone pain, bone crises, and bone mineral density in patients with GD1

An established ERT for children ages 2 and up

Long-term improvements shown in pediatric patients with Gaucher disease type 1

Indication

Indication and Usage:

Cerezyme® (imiglucerase) for injection is indicated for treatment of adults and pediatric patients 2 years of age and older with Type 1 Gaucher disease that results in one or more of the following conditions:

  • anemia
  • thrombocytopenia
  • bone disease
  • hepatomegaly or splenomegaly

Important Safety Information

WARNING: HYPERSENSITIVITY REACTIONS INCLUDING ANAPHYLAXIS

Patients treated with enzyme replacement therapies have experienced life-threatening hypersensitivity reactions, including anaphylaxis. Anaphylaxis has occurred during the early course of enzyme replacement therapy and after extended duration of therapy.

Initiate CEREZYME in a healthcare setting with appropriate medical monitoring and support measures, including access to cardiopulmonary resuscitation equipment. If a severe hypersensitivity reaction (e.g., anaphylaxis) occurs, discontinue CEREZYME and immediately initiate appropriate medical treatment, including use of epinephrine. Inform patients of the symptoms of life-threatening hypersensitivity reactions, including anaphylaxis, and to seek immediate medical care should symptoms occur.

Warnings and Precautions:

Hypersensitivity Reactions Including Anaphylaxis: See Boxed WARNING.
Patients with antibody to imiglucerase have a higher risk of hypersensitivity reactions. Consider periodic monitoring during the first year of treatment for lgG antibody formation.

Consider risks and benefits of readministering Cerezyme to individual patients following a severe reaction. Consider reducing the rate of infusion, pretreat with antihistamines and/or corticosteroids, and monitor patients for new signs and symptoms of a severe hypersensitivity reaction.

Infusion-Associated Reactions:
Infusion associated reactions (IARs) have been observed in patients treated with Cerezyme. If an IAR occurs, decreasing the infusion rate, temporarily stopping the infusion and/or administering antihistamines and/or antipyretics may ameliorate the symptoms. Closely monitor patients who have experienced IARs when re-administering Cerezyme.

Adverse Reactions:
Adverse reactions reported in adults include back pain, chills, dizziness, fatigue, headache, hypersensitivity reactions, nausea, pyrexia, and vomiting.

Adverse reactions reported in pediatric patients 2 years of age and older are similar to adults.

Please see full Prescribing Information, including Boxed WARNING.

Indication

Important Safety Information

References: 1. Weinreb NJ, Camelo JS, Charrow J, et al. Mol Genet Metab. 2021;123(2):100-111. 2. Data on file. Sanofi. 

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