tezepelumab-ekko

tez-e-pel-ue-mab

Trade Name(s): (Tezspire)

Do not confuse tezepelumab with avelumab or lanadelumab.

• PHARMACOTHERAPEUTIC: Thymic stromal lymphopoietin (TSLP) blocker. Immunoglobulin G2 monoclonal antibody. CLINICAL: Antiasthmatic.

Add-on maintenance treatment of severe asthma in adult and pediatric pts 12 yrs of age and older.

Contraindications: Hypersensitivity to tezepelumab. Cautions: History of helminth (parasite) infection; long-term use of corticosteroids. Avoid concomitant use with live attenuated vaccines. Not indicated for relief of acute bronchospasm or status asthmaticus.

Binds to human thymic stromal lymphopoietin (TSLP) preventing human TSLP from interacting with TSLP receptor. Reduces biomarkers and cytokines associated with inflammation, including blood eosinophils, immunoglobulin E, interleukin (IL)-5, and IL-13. Therapeutic Effect: Reduces asthma inflammatory cascade; relieves symptoms of asthma.

Widely distributed. Metabolism: undergoes proteolytic degradation via enzymes that are widely distributed in the body. Peak plasma concentration: 3–10 days. Steady-state reached in 12 wks. Eliminated via intracellular catabolism. Halflife: 26 days.

Pregnancy/Lactation: Unknown if distributed in breast milk. However, human immunoglobulin G is present in breast milk and is known to cross placenta. Children: Safety and efficacy not established in pts younger than 12 yrs. Elderly: No age-related precautions noted.

DRUG: May increase adverse/toxicity of vaccines (live). HERBAL: None significant. FOOD: None known. LAB VALUES: None known.

Injection Solution (Prefilled Pen, Prefilled Syringe, Single-Dose Glass Vial): 210 mg/1.91 mL (110 mg/mL).

SQ

Preparation

• Remove prefilled syringe (or vial) from refrigerator and allow solution to warm to room temperature (approx. 1 hr) with needle cap intact.
• Visually inspect for particulate matter or discoloration. Solution should appear clear to opalescent, colorless to slightly yellow. Do not use if solution is cloudy, discolored, or large visible particles are observed. Small air bubbles may be present.

Note: Prefilled pen can be administered by pts, caregivers, or healthcare providers.

Asthma (Severe)

SQ: ADULTS, CHILDREN 12 YRS AND

OLDER: 210 mg once q4wks.

Dosage in Hepatic/Renal Impairment

Not studied; use caution.

Rare (4%): Arthralgia, back pain, pharyngitis.

Hypersensitivity reactions including allergic conjunctivitis, rash may occur within hrs to days after administration. Infections including bacterial/viral pharyngitis may occur. Unknown if treatment will influence the immunologic response to helminth (parasite) infection.

• BASELINE ASSESSMENTObtain pulse rate, oxygen saturation. Auscultate lung sounds. Question history of parasitic infection, hypersensitivity reaction. Pts with preexisting helminth (parasite) infection should be treated prior to initiation. Inhaled or systemic corticosteroids should not be suddenly discontinued upon initiation. Corticosteroids that are not gradually tapered may cause withdrawal symptoms or unmask conditions that were originally suppressed with corticosteroid therapy.INTERVENTION/EVALUATIONMonitor rate, depth, rhythm of respirations. Assess lungs for wheezing. Monitor oxygen saturation. Interrupt or discontinue treatment if hypersensitivity reaction, worsening of asthma-related symptoms occurs (esp. in pts tapering off inhaled corticosteroids). Obtain pulmonary function test to assess clinical improvement. Monitor for increased use of rescue inhalers; may indicate deterioration of asthma.PATIENT/FAMILY TEACHING
• Treatment not indicated for relief of acute asthmatic episodes. Have a rescue inhaler readily available. Increased use of rescue inhaler may indicate worsening of asthma. Seek medical attention if asthma symptoms worsen or remain uncontrolled after starting therapy.
• Report allergic reactions such as rash or allergic conjunctivitis.
• Do not suddenly stop inhaled corticosteroid therapy. If appropriate, a gradual taper should be performed under medical supervision.