Home Drug Guide Luspatercept-aamt

Drug Guide

Generic Name

Luspatercept-aamt

Brand Names Reblozyl

Classification

Therapeutic: Blood Modifier

Pharmacological: Erythroid Maturation Agent

FDA Approved Indications

Anemia in adult patients with beta-thalassemia who require regular blood transfusions
Anemia in adult patients with myelodysplastic syndromes (MDS) with ring sideroblasts who require red blood cell transfusions

Mechanism of Action

Luspatercept-aamt is a recombinant fusion protein that binds to transforming growth factor-beta (TGF-β) superfamily ligands, reducing signaling and promoting late-stage erythropoiesis to enhance red blood cell production.

Dosage and Administration

Adult: Starting dose is typically 1 mg/kg subcutaneously every 3 weeks; dose may be increased to 1.25 mg/kg based on response and tolerability.

Pediatric: Not approved for pediatric use; safety and efficacy have not been established.

Geriatric: No specific dosage adjustment required, but caution in older adults due to potential comorbidities.

Renal Impairment: No dose adjustment necessary for mild to moderate impairment; use caution in severe impairment.

Hepatic Impairment: No specific dosage adjustments identified.

Pharmacokinetics

Absorption: Rapidly absorbed after subcutaneous injection.

Distribution: Distributed in plasma with a typical protein binding profile.

Metabolism: Metabolized via proteolytic degradation; not via traditional hepatic pathways.

Excretion: Excreted mainly via proteolytic degradation in tissues.

Half Life: Approximately 13-16 days.

Contraindications

Known hypersensitivity to luspatercept or any component of the formulation.

Precautions

Monitor for hypertension, thromboembolic events, and secondary malignancies. Use with caution in patients with a history of or active thromboembolic disease or malignancy.

Adverse Reactions - Common

Fatigue (Common)
Headache (Common)
Hypertension (Common)

Adverse Reactions - Serious

Thromboembolic events (Less common)
Secondary malignancies (Less common)
Pure red cell aplasia (PRCA) (Rare)

Drug-Drug Interactions

Potential interactions are limited, but caution with other agents that increase blood pressure or thrombotic risk.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor hemoglobin levels, transfusion requirements, blood pressure, and signs of thromboembolism.

Diagnoses:

Risk for thrombosis
Ineffective tissue perfusion

Implementation: Administer subcutaneous injections as prescribed, monitor patient response.

Evaluation: Assess hemoglobin levels, transfusion frequency, and adverse effects regularly.

Patient/Family Teaching

Instruct to report symptoms of blood clots, hypertension, or unusual bleeding.
Advise adherence to dosing schedule and regular monitoring appointments.
Inform about potential side effects and when to seek medical attention.

Special Considerations

Black Box Warnings:

Serious cardiovascular and thromboembolic risks; use only under specified conditions.

Genetic Factors: No specific genetic considerations.

Lab Test Interference: May affect hemoglobin and hematocrit levels.

Overdose Management

Signs/Symptoms: Symptoms of excessive erythropoiesis or thrombotic events.

Treatment: Supportive care; discontinue drug and manage symptoms accordingly.

Storage and Handling

Storage: Store at 2°C to 8°C (36°F to 46°F); do not freeze.

Stability: Stable under recommended storage conditions until the expiration date.