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Cerezyme® (imiglucerase) 6-Month Pivotal Study


Cerezyme improved visceral and hematologic parameters1,2

Pivotal, phase 3 study design and outcomes

Cerezyme was proven to be safe and effective, as shown in a pivotal, phase 3 study that studied visceral, hematologic, and bone parameters in adult and pediatric patients with Gaucher disease type 1.1

Study design1

At 9 months, patients were unblinded and patients were allowed to cross over to Cerezyme. Twenty-nine patients continued treatment for total duration of 24 months.

CT=computed tomography; MRI=magnetic resonance imaging.

Cerezyme showed similar reductions in visceral parameters at 6 months vs alglucerase1

Spleen volume

The mean baseline spleen volume was 2369 mL for Cerezyme patients and 2603 mL for alglucerase patients.

The absolute change from baseline was -902 mL for Cerezyme and -874 mL for alglucerase. Difference of absolute change was -28 mL (95% CI: -652, 596).

Liver volume

The mean baseline liver volume was 2521 mL for Cerezyme patients and 2788 mL for alglucerase patients.

The absolute change from baseline was -310 mL for Cerezyme and -307 mL for alglucerase. Difference of absolute change was -3 mL (95% CI: -246, 240).

aConfidence intervals were calculated using the t distribution (appropriate for small sample sizes) and the standard error of the difference in sample means (ie, the pooled estimate of the common standard deviation, computed as the weighted average of the standard deviations in the 2 treatment groups); there was no evidence that the assumption of equal variances between the groups was violated.

Cerezyme showed similar improvements in hematologic parameters at 6 months vs alglucerase1

Hemoglobin level

The mean baseline hemoglobin level was 10.7 g/dL for Cerezyme patients and 10.9 g/dL for alglucerase patients.

Platelet count

The mean baseline platelet count level was 68.5 x 103/mL3 for Cerezyme patients and 74.2 x 103/mL3 for alglucerase patients.

aConfidence intervals were calculated using the t distribution (appropriate for small sample sizes) and the standard error of the difference in sample means (ie, the pooled estimate of the common standard deviation, computed as the weighted average of the standard deviations in the 2 treatment groups); there was no evidence that the assumption of equal variances between the groups was violated.

Bone x-rays showed improvements in cortical thickness and lucencies in 7 of 11 Cerezyme-treated patients.

Bone Studies

See the effect of Cerezyme on key bone manifestations

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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. Cerezyme (imiglucerase). Prescribing information. Genzyme Corporation, Cambridge, MA. 2. Weinreb NJ, Camelo JS, Charrow J, et al. Mol Genet Metab. 2021;123(2):100-111.  

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