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ADAMTS13, RECOMBINANT-KRHN INJ,LYPHL

Clinical Criteria Summary

Indication & Patient Population

  • Prophylactic or on demand enzyme replacement therapy (ERT) in adult and pediatric patients with congenital thrombotic thrombocytopenic purpura (cTTP).

Dosage & Administration

  • Prophylactic: 40 IU/kg once every other week at 2-4 mL per minute.
  • On-demand: Day 1: 40 IU/kg; Day 2: 20 IU/kg; Day 3 and beyond: 15 IU/kg until 2 days after acute event is resolved, administered at 2-4 mL per minute.
  • For on demand replacement: administer daily until 2 days after acute event is resolved.

Safety & Contraindications

  • Contraindicated in patients with life threatening or hypersensitivity reactions to ADAMTS13 or any of its components.
  • Monitor for hypersensitivity and immunogenicity (may develop neutralizing antibodies).
  • Use during pregnancy and lactation is left to clinical judgment due to lack of data.

Place in Therapy & Alternatives

  • For cTTP in remission, administer ADAMTS13 prophylaxis if it is available.
  • If ADAMTS13 is not available, discuss use of Fresh Frozen Plasma in a shared decision-making process.
  • Revisit formulary decision for ADAMTS13 as more data becomes available for acquired/autoimmune thrombotic thrombocytopenic purpura.

Source Documents