TASCENSO ODT SIDE EFFECTS

  • Generic Name: fingolimod orally disintegrating tablets
  • Brand Name: Tascenso ODT
  • Drug Class: IMMUNOMODULATORS, Sphingosine 1-Phosphate Receptor Modulators
Last updated on MDtodate: 10/12/2022

SIDE EFFECTS

The following serious adverse reactions are described elsewhere in labeling:

  • Bradyarrhythmia and Atrioventricular Blocks
  • Infections
  • Progressive Multifocal Leukoencephalopathy
  • Macular Edema
  • Liver Injury
  • Posterior Reversible Encephalopathy Syndrome
  • Respiratory Effects
  • Fetal Risk
  • Severe Increase in Disability After Stopping TASCENSO ODT ]
  • Tumefactive Multiple Sclerosis
  • Increased Blood Pressure
  • Malignancies
  • Immune System Effects Following TASCENSO ODT Discontinuation
  • Hypersensitivity Reactions

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Adults

TASCENSO ODT is not approved for use in adults. In clinical trials (Studies 1, 2, and 3), a total of 1212 patients with relapsing forms of multiple sclerosis received fingolimod 0.5 mg capsules. This included 783 patients who received fingolimod 0.5 mg in the 2-year placebo-controlled trials (Studies 1 and 3) and 429 patients who received fingolimod 0.5 mg in the 1-year active-controlled trial (Study 2). The overall exposure in the controlled trials was equivalent to 1716 person-years. Approximately 1000 patients received at least 2 years of treatment with fingolimod 0.5 mg capsules. In all clinical studies, including uncontrolled extension studies, the exposure to fingolimod 0.5 mg capsules was approximately 4119 person-years.

In placebo-controlled trials, the most frequent adverse reactions (incidence ≥ 10% and greater than placebo) for fingolimod 0.5 mg capsules were headache, liver transaminase elevation, diarrhea, cough, influenza, sinusitis, back pain, abdominal pain, and pain in extremity. Adverse events that led to treatment discontinuation and occurred in more than 1% of patients taking fingolimod 0.5 mg capsules, were serum transaminase elevations (4.7% compared to 1% on placebo) and basal cell carcinoma (1% compared to 0.5% on placebo).

Table 1 lists adverse reactions in clinical studies in adults that occurred in ≥ 1% of fingolimod-treated patients and ≥ 1% higher rate than for placebo.

Table 1: Adverse Reactions Reported in Adult Studies 1 and 3 (Occurring in ≥ 1% of Patients and Reported for Fingolimod 0.5 mg Capsules at ≥ 1% Higher Rate than for Placebo)

Adverse Drug Reactions Fingolimod
0.5 mg Capsules
N = 783
%
Placebo
N = 773
%
Infections
  Influenza 11 8
  Sinusitis 11 8
  Bronchitis 8 5
  Herpes zoster 2 1
  Tinea versicolor 2 <1
Cardiac disorders
  Bradycardia 3 1
Nervous system disorders
  Headache 25 24
  Migraine 6 4
Gastrointestinal disorders
  Nausea 13 12
  Diarrhea 13 10
  Abdominal pain 11 10
General disorders and administration-site conditions
  Asthenia 2 1
Musculoskeletal and connective tissue disorders
  Back pain 10 9
  Pain in extremity 10 7
Skin and subcutaneous tissue disorders
  Alopecia 3 2
  Actinic keratosis 2 1
Investigations
  Liver transaminase elevations (ALT/GGT/AST) 15 4
  Blood triglycerides increased 3 1
Respiratory, thoracic, and mediastinal disorders
  Cough 12 11
  Dyspnea 9 7
Eye disorders
  Vision blurred 4 2
Vascular disorders
  Hypertension 8 4
Blood and lymphatic system disorders
  Lymphopenia 7 <1
  Leukopenia 2 <1
Neoplasms benign, malignant, and unspecified (including cysts and polyps)
  Skin papilloma 3 2
  Basal cell carcinoma 2 1

 

Adverse reactions of seizure, dizziness, pneumonia, eczema, and pruritus were also reported in Studies 1 and 3 but did not meet the reporting rate criteria for inclusion in Table 1 (difference was less than 1%).

Adverse reactions with fingolimod 0.5 mg in Study 2, the 1-year active-controlled (versus interferon beta-1a) study were generally similar to those in Studies 1 and 3.

Vascular Events

Vascular events, including ischemic and hemorrhagic strokes, and peripheral arterial occlusive disease were reported in premarketing clinical trials in patients who received fingolimod doses (1.25-5 mg) higher than recommended for use in MS. Similar events have been reported with fingolimod treatment in the postmarketing setting although a causal relationship has not been established.

Seizure

Cases of seizures, including status epilepticus, have been reported with the use of fingolimod capsules in clinical trials and in the postmarketing setting in adults. In adult clinical trials, the rate of seizures was 0.9% in fingolimod – treated patients and 0.3% in placebo-treated patients. It is unknown whether these events were related to the effects of multiple sclerosis alone, to fingolimod, or to a combination of both.

Pediatric Patients 10 Years Of Age And Older

In the controlled pediatric trial (Study 4), the safety profile in pediatric patients receiving fingolimod capsules daily was similar to that seen in adult patients.

In the pediatric study, cases of seizures were reported in 5.6% of fingolimod-treated patients and 0.9% of interferon beta-1a-treated patients.

Postmarketing Experience

The following adverse reactions have been identified during postapproval use of fingolimod. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Blood and Lymphatic System Disorders: Hemolytic anemia and thrombocytopenia

Hepatobiliary Disorders: Liver injury

Infections: infections including cryptococcal infections, human papilloma virus (HPV) infection, including papilloma, dysplasia, warts and HPV-related cancer, progressive multifocal leukoencephalopathy.

Musculoskeletal and connective tissue disorders: arthralgia, myalgia

Nervous system disorders: posterior reversible encephalopathy syndrome, seizures, including status epilepticus.

Neoplasms, benign, malignant, and unspecified (including cysts and polyps): melanoma, Merkel cell carcinoma, and cutaneous T-cell lymphoma (including mycosis fungoides).

Skin and subcutaneous tissue disorders: hypersensitivity.

 

SRC: NLM .