Published on September 8, 2020
What is Darzalex Faspro and Can it Replace Infused Darzalex for Myeloma Patients?
What's the difference between Darzalex Faspro and the infused daratumumab (Darzalex)? What are the side effects myeloma patients should watch out for? Host and myeloma patient Cindy Chmielewski talks to Dr. Cesar Rodriguez of Wake Forest Wake Forest Baptist Health and Dr. Natalie S. Callander from the University of Wisconsin School of Medicine and Public Health about this new medicine.
Transcript | Darzalex Faspro: What is it and Does it Have Side Effects?
Should Myeloma Patients Switch Over to Darzalex Faspro?
Let's move on to another new drug that was recently approved, it's kind of an old drug with a new way of administering it - the Darzalex Faspro. Can we talk a little bit about that? Should patients considered switching over to Faspro? Why or why not? And is there a different side effects profile for Faspro than the Darzalex infusion?
So what Darzalex Faspro is, it's the same medicine same daratumumab but it is blended with something called with something called hyaluronic acid, and what this does is it means that when it's injected into the skin, that it allows the medicine to actually get into the body a little bit more effectively. Now, if people have had a vaccination under the skin or things like that this is a little bit different, it's a little bit more medicine, it's about a tablespoon, if you think of it that way, that is going to be injected under the skin. The study that was done recently showed that essentially it's equivalent to daratumumab, not superior but it has the same effectiveness. But what it did have was a different side effect profile and so that as many of the people here who are listening may know that it's not uncommon even with pre medication for people to have reactions to daratumumab the first time they get it.
Things like chills or fever or sometimes shortness of breath, something that they even sometimes have to stop the infusion. There's a number of maneuvers you can do to try to minimize that but it looks pretty convincing that Faspro has a much lower incidence of side effects like that.
The main difference, like Dr. Callander was saying, is that by using the SubQ version you don't have to be waiting for hours getting an IV access, especially with the first dose that takes around seven hours to give or if you get split in two days. Then the second dose I think is about five hours and then after that it can be shortened to 90 minutes if there's no side effects. The nice thing about the SubQ version is that it's just within five minutes that you give them medication. So it's almost like getting the Velcade or bortezomib, and the one thing that's a little bit different in terms of when you give insulin or bortezomib as opposed to this SubQ daratumumab or Darzalex Faspro is like Dr. Callander said that there's more volume in what's being injected.
So sometimes it makes a little bit of a bubble under the skin or under the belly, and it doesn't hurt and it absorbs but it's just something for everybody to know that can happen so that people don't freak out when they see oh, I've got something new a little bump or something in my belly, it gets reabsorbed. The beauty about the hyaluronic acid is that it allows that drug that has formed into that little bubble to gradually permeate into the body and have slow absorption so that it can be in the system throughout the whole duration of the treatment.
So, if you look at IV infusion of daratumumab there's approximately 30% side effects during the infusion. We have been able to reduce that a lot now that we've incorporated singulair to the therapy and other medication to help reduce at least respiratory reactions. But with the SubQ version the infusion reactions have dropped down to 13% which is a very good drop in terms of infusion reactions.
Good to know. Is it the same premeds for the SubQ as it's for the IV or are the premeds different?
I am using the same premeds just to be safe because the side effects even though respiratory symptoms are a little bit lower, but it still can be an issue. So we are still using the same premeds and making sure that patients have an albuterol inhaler that they take singulair the day before, and continue that for a few days after in addition to their Benadryl and their steroids.
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