Indications and Limitation of Use: ADYNOVATE^® [Antihemophilic factor (Recombinant), PEGylated] is a human antihemophilic factor indicated for use in children and adults with hemophilia A for the control and prevention of bleeding episodes. ADYNOVATE is not indicated for the treatment of von Willebrand disease.¹

Overall hemostatic efficacy was rated as excellent in all evaluable surgical procedures studied with ADYNOVATE^†‡§1,2

study design

In a phase 3, multicenter, prospective, open-label, uncontrolled surgery study, 21 major surgical procedures and 5 minor surgeries were performed in 21 patients. The primary endpoint was the evaluation of perioperative hemostatic efficacy of ADYNOVATE in patients with severe hemophilia A.^1,2

SELECTED IMPORTANT RISK INFORMATION

WARNINGS & PRECAUTIONS

Hypersensitivity Reactions: Hypersensitivity reactions, including anaphylaxis, have been reported with ADYNOVATE. Hypersensitivity reactions that can progress to anaphylaxis may include angioedema, chest tightness, dyspnea, wheezing, urticaria, pruritus, and nausea and vomiting. Immediately discontinue administration and initiate appropriate treatment if hypersensitivity reactions occur.
See Detailed Important Risk Information below.

study results¹

Types of Major surgeries (N=21)
Orthopedic	Achilles Tendon Reconstruction
	Alloplastic Knee Surgery
	Arthroscopic Synovectomy
	Elbow Cyst Extirpation
	Hip Replacement
	Hip Replacement Revision
	Knee Replacement
	Needle Removed From Elbow
Non-Orthopedic	CVAD Placement
	Gastric Band Insertion
	Multiple Tooth Extractions

Types of Minor surgeries (N=5)
Dental Procedure
Dermatological
Radiosynovectomy
Synoviorthesis

^†Using a 4-point rating scale (excellent, good, fair, none), intraoperative and postoperative hemostatic efficacy assessed by the surgeon; overall perioperative hemostatic efficacy evaluated by the investigator at discharge or on postoperative Day 14 (whichever occurred first).

^‡Excellent defined as blood loss less than or equal to that expected for the same type of procedure performed in a nonhemophilic patient, and required blood components for transfusions less than or similar to those expected in nonhemophilic population.

^§Ratings were conducted for 24 evaluable procedures (21 major, 3 minor)

SELECTED IMPORTANT RISK INFORMATION

WARNINGS & PRECAUTIONS

ADYNOVATE [Antihemophilic Factor (Recombinant), PEGylated] Important Information

Indications and Limitation of Use

ADYNOVATE is a human antihemophilic factor indicated in children and adults with hemophilia A (congenital factor VIII deficiency) for:

On-demand treatment and control of bleeding episodes
Perioperative management
Routine prophylaxis to reduce the frequency of bleeding episodes

ADYNOVATE is not indicated for the treatment of von Willebrand disease.

DETAILED IMPORTANT RISK INFORMATION

CONTRAINDICATIONS

Prior anaphylactic reaction to ADYNOVATE, to the parent molecule (ADVATE [Antihemophilic Factor (Recombinant)]), mouse or hamster protein, or excipients of ADYNOVATE (e.g. Tris, mannitol, trehalose, glutathione, and/or polysorbate 80).

WARNINGS & PRECAUTIONS

Neutralizing Antibodies: Formation of neutralizing antibodies (inhibitors) to factor VIII can occur following administration of ADYNOVATE. Monitor patients regularly for the development of factor VIII inhibitors by appropriate clinical observations and laboratory tests. Perform an assay that measures factor VIII inhibitor concentration if the plasma factor VIII level fails to increase as expected, or if bleeding is not controlled with expected dose.

ADVERSE REACTIONS

The most common adverse reactions (≥1% of subjects) reported in the clinical studies were headache, diarrhea, rash, nausea, dizziness and urticaria.

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ADVATE [Antihemophilic Factor (Recombinant)] Important Information

Indications

ADVATE is a recombinant antihemophilic factor indicated for use in children and adults with hemophilia A (congenital factor VIII deficiency) for:

Control and prevention of bleeding episodes
Perioperative management
Routine prophylaxis to prevent or reduce the frequency of bleeding episodes

ADVATE is not indicated for the treatment of von Willebrand disease.

DETAILED IMPORTANT RISK INFORMATION

CONTRAINDICATIONS

Patients who have life-threatening hypersensitivity reactions, including anaphylaxis, to mouse or hamster protein or other constituents of the product.

WARNINGS & PRECAUTIONS

Hypersensitivity Reactions: Allergic-type hypersensitivity reactions, including anaphylaxis, have been reported with ADVATE. Symptoms include dizziness, paresthesia, rash, flushing, facial swelling, urticaria, dyspnea, pruritus, and vomiting. Discontinue ADVATE if hypersensitivity symptoms occur and administer appropriate emergency treatment.

Neutralizing Antibodies: Neutralizing antibodies (inhibitors) have been reported following administration of ADVATE predominantly in previously untreated patients (PUPs) and previously minimally treated patients (MTPs). Monitor all patients for the development of factor VIII inhibitors by appropriate clinical observation and laboratory testing. If expected plasma factor VIII activity levels are not attained, or if bleeding is not controlled with an expected dose, perform an assay that measures factor VIII inhibitor concentration.

ADVERSE REACTIONS

Serious adverse reactions seen with ADVATE are hypersensitivity reactions, including anaphylaxis, and the development of high-titer inhibitors necessitating alternative treatments to factor VIII.
The most common adverse reactions observed in clinical trials (>5% of subjects) were pyrexia, headache, cough, nasopharyngitis, arthralgia, vomiting, upper respiratory tract infection, limb injury, nasal congestion, and diarrhea.

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	MAJOR ORTHOPEDIC SURGERIES¹	MAJOR NON-ORTHOPEDIC SURGERIES¹
Median total dose^¶	629 IU/KG(464 IU/kg- 1,457 IU/kg)	489 IU/KG(296 IU/kg- 738 IU/kg)

	Dose range
Pre operative loading dose	36 IU/KG- 99 IU/KG(median: 60 IU/kg)
Total post- operative dose	23 IU/KG- 769 IU/KG(median: 183 IU/kg)

Overall hemostatic efficacy was rated as excellent in all evaluable surgical procedures studied with ADYNOVATE†‡§1,2

SELECTED IMPORTANT RISK INFORMATION

WARNINGS & PRECAUTIONS

SELECTED IMPORTANT RISK INFORMATION

WARNINGS & PRECAUTIONS

Surgery study dosing information

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Overall hemostatic efficacy was rated as excellent in all evaluable surgical procedures studied with ADYNOVATE^†‡§1,2

Surgery study dosing
information

Are you a U.S. healthcare
professional?