Difference between revisions of "Defibrotide (Defitelio)"

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(FDA approval)
 
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==General information==
 
==General information==
Class/mechanism: Profibrinolytic. Defibrotide is a mixture of polydeoxyribonucleotide sodium salts made from porcine intestinal tissue. In vitro, it boosts enzymatic activity of plasmin to hydrolyze fibrin clots. Defibrotide increases tissue plasminogen activator (t-PA) and thrombomodulin expression while decreasing von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1) expression. Endothelial cell fibrinolysis is enchanced and endothelial cell activation is reduced. Defibrotide appears to limit damage caused by chemotherapy, tumor necrosis factor-α (TNF-α), serum starvation, and perfusion.<ref name=insert>[http://defitelio.com/DefitelioPI.pdf Defibrotide (Defitelio) package insert]</ref><ref>[[Media:Defibrotide.pdf|Defibrotide (Defitelio) package insert (locally hosted backup)]]</ref><ref>[http://defitelio.com/ Defitelio manufacturer's website]</ref>
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Class/mechanism: Profibrinolytic. Defibrotide is a mixture of polydeoxyribonucleotide sodium salts made from porcine intestinal tissue. In vitro, it boosts enzymatic activity of plasmin to hydrolyze fibrin clots. Defibrotide increases tissue plasminogen activator (t-PA) and thrombomodulin expression while decreasing von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1) expression. Endothelial cell fibrinolysis is enchanced and endothelial cell activation is reduced. Defibrotide appears to limit damage caused by chemotherapy, tumor necrosis factor-α (TNF-α), serum starvation, and perfusion.<ref name=insert>[http://defitelio.com/DefitelioPI.pdf Defibrotide (Defitelio) package insert]</ref><ref>[[:File:Defibrotide.pdf|Defibrotide (Defitelio) package insert (locally hosted backup)]]</ref><ref>[http://defitelio.com/ Defitelio manufacturer's website]</ref>
 
<br>Route: IV  
 
<br>Route: IV  
 
<br>Extravasation: no information
 
<br>Extravasation: no information
  
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>
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For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [https://online.lexi.com/lco/action/login UpToDate Lexidrug], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information.<ref name="insert"></ref>
  
 
==Diseases for which it is used==
 
==Diseases for which it is used==
*Hepatic veno-occlusive disease (VOD), sinusoidal obstructive syndrome (SOS) with renal or pulmonary dysfunction following [[Transplant conditioning regimens|hematopoietic stem-cell transplantation (HSCT)]].
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*[[Hepatic veno-occlusive disease|Hepatic veno-occlusive disease (VOD)]], sinusoidal obstructive syndrome (SOS) with renal or pulmonary dysfunction following hematopoietic stem-cell transplantation (HSCT)
  
 
==Patient drug information==
 
==Patient drug information==
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==History of changes in FDA indication==
 
==History of changes in FDA indication==
*3/30/2016: [http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm493278.htm FDA approved] "for the treatment of adult and pediatric patients with hepatic veno-occlusive disease (VOD), also known as sinusoidal obstructive syndrome, with renal or pulmonary dysfunction following [[Transplant conditioning regimens|hematopoietic stem-cell transplantation (HSCT)]]."
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*2016-03-30: [http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm493278.htm FDA approved] for the treatment of adult and pediatric patients with [[Hepatic veno-occlusive disease|hepatic veno-occlusive disease (VOD), also known as sinusoidal obstructive syndrome]], with renal or pulmonary dysfunction following hematopoietic stem-cell transplantation (HSCT).
 
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==History of changes in EMA indication==
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*2013-10-18: Initial authorization
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*Uncertain date: Defitelio is indicated for the treatment of severe [[Hepatic veno-occlusive disease|hepatic veno-occlusive disease (VOD) also known as sinusoidal obstructive syndrome (SOS)]] in haematopoietic stem-cell transplantation (HSCT) therapy. It is indicated in adults and in adolescents, children and infants over 1 month of age.
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==History of changes in PMDA indication==
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*2019-06-18: Newly indicated for the treatment of [[Hepatic veno-occlusive disease|sinusoidal obstruction syndrome (SOS) /hepatic veno-occlusive disease (VOD)]].
 
==Also known as==
 
==Also known as==
*Polydeoxyribonucleotide sodium salt
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*'''Generic name:''' polydeoxyribonucleotide sodium salt
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*'''Brand name:''' Defitelio
  
 
==References==
 
==References==
 
<references/>
 
<references/>
  
[[Category:Drug index]]
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[[Category:Drugs]]
[[Category:Hematology medications]]
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[[Category:Intravenous medications]]
[[Category:Drugs FDA approved in 2016]]
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[[Category:Transplant medications]]
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[[Category:Profibrinolytics]]
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[[Category:Hepatic veno-occlusive disease medications]]
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[[Category:EMA approved in 2013]]
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[[Category:FDA approved in 2016]]
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[[Category:PMDA approved in 2019]]

Latest revision as of 01:24, 27 June 2024

General information

Class/mechanism: Profibrinolytic. Defibrotide is a mixture of polydeoxyribonucleotide sodium salts made from porcine intestinal tissue. In vitro, it boosts enzymatic activity of plasmin to hydrolyze fibrin clots. Defibrotide increases tissue plasminogen activator (t-PA) and thrombomodulin expression while decreasing von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1) expression. Endothelial cell fibrinolysis is enchanced and endothelial cell activation is reduced. Defibrotide appears to limit damage caused by chemotherapy, tumor necrosis factor-α (TNF-α), serum starvation, and perfusion.[1][2][3]
Route: IV
Extravasation: no information

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, UpToDate Lexidrug, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]

Diseases for which it is used

Patient drug information

History of changes in FDA indication

History of changes in EMA indication

History of changes in PMDA indication

Also known as

  • Generic name: polydeoxyribonucleotide sodium salt
  • Brand name: Defitelio

References