Earlier defibrotide initiation post-diagnosis of veno-occlusive disease/sinusoidal obstruction syndrome improves Day +100 survival following haematopoietic stem cell transplantation. British Journal of Haematology
Author(s): Richardson PG, Smith AR, Triplett BM, Kernan NA, Grupp SA, Antin JH, Lehmann L, Miloslavsky M, Hume R, Hannah AL, Nejadnik B, Soiffer RJ.
Published: April 2017
Copyright: © 2017 The Authors. British Journal of Haematology published by John Wiley & Sons Ltd.
Disclaimer
This journal article reprint is being provided as a professional courtesy by Jazz Pharmaceuticals, Inc. This scientific publication contains information that may or may not be contained within the accompanying package insert. Providing this reprint should not be construed as a recommendation for use of any Jazz Pharmaceuticals product for nonapproved uses. Prior to prescribing, please refer to the accompanying Prescribing Information, which includes the approved indication and a discussion of the benefits and risks associated with our product.
The opinions expressed in this reprint do not necessarily reflect those of Jazz Pharmaceuticals. Readers are encouraged to contact the primary authors with questions regarding the content of the reprint. Jazz Pharmaceuticals does not assume responsibility for any injury and/or damage to persons or property out of or related to any use of the information contained in this reprint.
There is no transfer of value with the eAcess view of this publication and therefore no Sunshine Act reporting.
Financial Disclosure Statement
Jazz Pharmaceuticals provided funding for the defibrotide treatment IND study. Dr. Paul Richardson has received funding from Jazz Pharmaceuticals for the clinical study, has received compensation as a consultant for, and has served as a member of advisory committees for Jazz Pharmaceuticals.
Conflict-of-interest disclosure: PGR and RJS have served on advisory committees for Gentium S.r.l./Jazz Pharmaceuticals; RBD’A and JM report consultancy fees from Gentium S.r.l. during the conduct of the study; JD, NAK, PLM, PGR, TR, and GS received grants from Gentium S.r.l. during the conduct of the study; SAG and AK have served as consultants to Jazz Pharmaceuticals; SG received personal fees and grants from Gentium S.r.l. during the conduct of the study; ECG’s institution received clinical research fees from Gentium during the conduct of the study; ALH received personal fees from Gentium S.r.l. during the conduct of the study; JHA and PLM have served on advisory committees with Jazz Pharmaceuticals; RC has served as an advisor to Gentium S.r.l. and on advisory committees with Jazz Pharmaceuticals; RLH and MM are employees of Jazz Pharmaceuticals, who in the course of employment have received stock options exercisable for, and other stock awards of, ordinary shares of Jazz Pharmaceuticals plc; BN was an employee of Jazz Pharmaceuticals, who in the course of employment received stock options exercisable for, and other stock awards of, ordinary shares of Jazz Pharmaceuticals plc; and MI was an employee of Gentium S.r.l. during the conduct of the study. The remaining authors declare no competing financial interests.
Detailed information on funding amounts received by the authors of this publication is available at http://www.cms.gov/openpayments.
INDICATION
Defitelio® (defibrotide sodium) is indicated for the treatment of adult and pediatric patients with hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), with renal or pulmonary dysfunction following hematopoietic stem-cell transplantation (HSCT).
IMPORTANT SAFETY INFORMATION
Contraindications
Defitelio is contraindicated in the following conditions:
- Concomitant administration with systemic anticoagulant or fibrinolytic therapy
- Known hypersensitivity to Defitelio or to any of its excipients
Warnings and Precautions
Hemorrhage
Defitelio may increase the risk of bleeding in patients with VOD after HSCT. Do not initiate Defitelio in patients with active bleeding. Monitor patients on Defitelio for signs of bleeding. If bleeding occurs, withhold or discontinue Defitelio.
Concomitant systemic anticoagulant or fibrinolytic therapy may increase the risk of bleeding and should be discontinued prior to Defitelio treatment. Consider delaying Defitelio administration until the effects of the anticoagulant have abated.
Hypersensitivity Reactions
Hypersensitivity reactions including rash, urticaria, and angioedema have occurred in less than 2% of patients treated with Defitelio. One case of an anaphylactic reaction was reported in a patient who had previously received Defitelio. Monitor patients for hypersensitivity reactions, especially if there is a history of previous exposure. If a severe hypersensitivity reaction occurs, discontinue Defitelio, treat according to the standard of care, and monitor until symptoms resolve.
Most Common Adverse Reactions
The most common adverse reactions (incidence ≥10% and independent of causality) with Defitelio treatment were hypotension, diarrhea, vomiting, nausea, and epistaxis.