ADYNOVATE- antihemophilic factor (recombinant) pegylated
Takeda Pharmaceuticals Amercia, Inc.
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HIGHLIGHTS OF PRESCRIBING INFORMATIONThese highlights do not include all the information needed to use ADYNOVATE® safely and effectively. See full prescribing information for ADYNOVATE.
ADYNOVATE, (Antihemophilic Factor, Recombinant, PEGylated) Lyophilized Powder for Solution for Intravenous Injection Initial U.S. Approval: 2015 INDICATIONS AND USAGEADYNOVATE, Antihemophilic Factor (Recombinant), PEGylated, is a human antihemophilic factor indicated in adult and pediatric patients with hemophilia A (congenital factor VIII deficiency) for:
Limitations of Use ADYNOVATE is not indicated for the treatment of von Willebrand disease. (1) DOSAGE AND ADMINISTRATIONFor intravenous use after reconstitution only.
DOSAGE FORMS AND STRENGTHSADYNOVATE is available as a white to off-white lyophilized powder in single-dose vials containing nominally (approximately) 250, 500, 750, 1000, 1500, 2000, or 3000 international units. (3) CONTRAINDICATIONSDo not use in patients who have had prior anaphylactic reaction to ADYNOVATE, the parent molecule (ADVATE®), mouse or hamster protein, or excipients of ADYNOVATE. (4) WARNINGS AND PRECAUTIONS
ADVERSE REACTIONSThe most common adverse reactions reported in ≥1% of patients were cough, headache, diarrhea, vomiting, rash, nausea, urticaria, and dizziness. (6) To report SUSPECTED ADVERSE REACTIONS, contact Takeda Pharmaceuticals U.S.A., Inc. at 1-877-TAKEDA-7 (1-877-825-3327) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. USE IN SPECIFIC POPULATIONSPediatric Use: Higher clearance, a shorter half-life and lower incremental recovery of factor VIII has been observed in children (<12 years). Dose adjustment or more frequent dosing based on per kg body weight may be needed in this population. (8.4) See 17 for PATIENT COUNSELING INFORMATION and FDA-approved patient labeling. Revised: 10/2025 |
ADYNOVATE® is indicated in adult and pediatric patients with hemophilia A (congenital factor VIII deficiency) for:
Limitations of Use
ADYNOVATE is not indicated for the treatment of von Willebrand disease.
For intravenous use after reconstitution only.
Estimated Increment of factor VIII (IU/dL or % of normal) = [Total Dose (IU)/body weight (kg)] × 2 (IU/dL per IU/kg)
Dose (IU) = Body Weight (kg) × Desired factor VIII Rise (IU/dL or % of Normal) × 0.5 (IU/kg per IU/dL)
On-demand Treatment and Control of Bleeding Episodes
A guide for dosing of ADYNOVATE for the on-demand treatment and control of bleeding episodes is provided in Table 1. Maintain plasma factor VIII activity level at or above the described plasma levels (in IU per dL or % of normal).
| Type of Bleeding | Target Factor VIII Level (IU/dL or % of normal) | Dose*
(IU/kg) | Frequency of Dosing (hours) | Duration of Therapy |
|---|---|---|---|---|
|
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| Minor Early hemarthrosis, mild muscle bleeding, or mild oral bleeding episode. | 20-40 | 10-20 | 12-24 | Until the bleeding is resolved. |
| Moderate Muscle bleeding, moderate bleeding into the oral cavity, definite hemarthroses, and known trauma. | 30-60 | 15-30 | 12-24 | Until the bleeding is resolved. |
| Major Significant gastrointestinal bleeding, intracranial, intra-abdominal or intrathoracic bleeding, central nervous system bleeding, bleeding in the retropharyngeal or retroperitoneal spaces or iliopsoas sheath, fractures, head trauma. | 60-100 | 30-50 | 8-24 | Until the bleeding is resolved. |
Perioperative Management
A guide for dosing ADYNOVATE during surgery (perioperative management) is provided in Table 2. Consideration should be given to maintain a factor VIII activity at or above the target range.
| Type of Surgery | Factor VIII Level Required (% of normal or IU/dL) | Dose (IU/kg) | Frequency of Doses (hours) | Duration of Treatment |
|---|---|---|---|---|
| Minor
Including tooth extraction. | 60-100 | 30-50 | Within one hour before surgery. Repeat after 24 hours if necessary. | Single dose or repeat as needed until bleeding is resolved. |
| Major
Intracranial, intra-abdominal, or intrathoracic surgery, joint replacement surgery. | 80-120 (pre- and post-operative) | 40-60 | Within one hour before the operation to achieve 100% activity. Repeat every 8 to 24 hours (6 to 24 hours for patients <12 years of age) to maintain FVIII activity within the target range. | Until adequate wound healing. |
Routine Prophylaxis
Preparation
Reconstitution
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Administration Steps:
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ADYNOVATE is available as a white to off-white lyophilized powder in single-dose vials containing nominally (approximately) 250, 500, 750, 1000, 1500, 2000, and 3000 International Units (IU, units). The 250-1500 IU strengths come with 2 mL Sterile Water for Injection (sWFI); the 2000 and 3000 IU strengths come with 5 mL of sWFI. The actual factor VIII potency/content is labeled on each ADYNOVATE vial.
The potency assignment employs a factor VIII concentrate standard that is referenced to a WHO (World Health Organization) international standard for factor VIII concentrates and is evaluated by appropriate methodology to ensure accuracy of the results.
ADYNOVATE is contraindicated in patients who have had prior anaphylactic reaction to ADYNOVATE, to the parent molecule (ADVATE®), mouse or hamster protein, or excipients of ADYNOVATE (e.g. Tris, mannitol, trehalose, glutathione, and/or polysorbate 80).
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.
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.
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 clinical trials of another drug and may not reflect the rates observed in practice.
The pooled safety database described in this section reflects exposure of ADYNOVATE in 478 previously treated patients (PTPs) and previously untreated patients (PUPs) with severe hemophilia A (factor VIII less than 1% of normal), who received at least one dose of ADYNOVATE in 7 clinical studies [see Immunogenicity (12.6) and Clinical Studies (14)]. The total number of infusions within the safety database is 92173. Table 3 lists the adverse reactions reported during clinical studies.
The most common adverse reactions (≥1% of patients) were cough, headache, diarrhea, vomiting, rash, nausea, urticaria, and dizziness.
| MedDRA System Organ Class | Adverse Reaction | Number of Patients n (%) (N=478) |
|---|---|---|
| a The event of hypersensitivity was a mild transient non-serious rash, occurring in one 2-year old patient who had developed a previous rash while on ADYNOVATE. | ||
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| Gastrointestinal Disorders | Diarrhea | 38 (8%) |
| Vomiting | 26 (5%) | |
| Nausea | 8 (2%) | |
| Respiratory, Thoracic and Mediastinal Disorders | Cough | 50 (10%) |
| Eye Disorders | Ocular Hyperaemia | 3 (0.6%) |
| Immune System Disorder | Hypersensitivitya | 2 (0.4%) |
| Nervous System Disorders | Headache | 41 (9%) |
| Dizziness | 7 (1%) | |
| Skin and Subcutaneous Tissue Disorders | Rash | 16 (3%) |
| Urticaria | 9 (2%) | |
| Rash Pruritic | 1 (0.2%) | |
| Eyelid Rash | 1 (0.2%) | |
| Vascular Disorders | Flushing | 1 (0.2%) |
| Investigations | Eosinophil Count Increased | 2 (0.4%) |
| Injury, Poisoning and Procedural Complications | Infusion Related Reaction | 2 (0.4%) |
Two cases of acute pancreatitis, with no precipitating cause identified in one case, were reported in adults during an extension study of the clinical trial which evaluated 216 patients. Administration of ADYNOVATE continued and both cases resolved.
Because postmarketing reporting of adverse reactions is voluntary and from a population of uncertain size, it is not always possible to reliably estimate the frequency of these reactions or establish a causal relationship to product exposure.
Immune System Disorders: Anaphylactic Reaction
Risk Summary
There are no data with ADYNOVATE use in pregnant women to inform a drug-associated risk. Animal reproduction studies have not been conducted with ADYNOVATE. It is unknown whether ADYNOVATE can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity.
In the U.S. general population, the estimated background risk of major birth defect and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively.
Risk Summary
There is no information regarding the presence of ADYNOVATE in human milk, the effect on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for ADYNOVATE and any potential adverse effects on the breastfed infant from ADYNOVATE or from the underlying maternal condition.
The safety and efficacy of ADYNOVATE have been established in pediatric patients. The use of ADYNOVATE for routine prophylaxis, on-demand treatment of bleeding episodes, or perioperative management was supported by five clinical studies which included 115 previously treated pediatric patients 1 to 16 years of age (78 patients <12 years of age). The safety and efficacy of ADYNOVATE in routine prophylaxis and the treatment of bleeding episodes were comparable between pediatric patients and adults. [see Adverse Reactions (6), Clinical Pharmacology (12), and Clinical Studies (14)]
Pharmacokinetic studies in children (<12 years) have demonstrated higher clearance, a shorter half-life and lower incremental recovery of factor VIII compared to adults. Because clearance (based on per kg body weight) has been demonstrated to be higher in children (<12 years), dose adjustment or more frequent dosing based on per kg body weight may be needed in this population. [see Clinical Pharmacology (12.3)]
ADYNOVATE, Antihemophilic Factor (Recombinant), PEGylated, is formulated as a sterile, non-pyrogenic, white to off-white lyophilized powder for reconstitution for intravenous injection. The product is supplied in single-dose vials containing nominal (approximate) potencies of 250, 500, 750, 1000, 1500, 2000, or 3000 international units (IU). Each vial of ADYNOVATE is labeled with the actual factor VIII activity in IU determined using one-stage clotting assay, using a reference material calibrated against a World Health Organization (WHO) International Standard for factor VIII concentrates. One IU, as defined by the WHO standard for blood coagulation factor VIII, human, is approximately equal to the level of factor VIII activity found in 1 mL of fresh pooled human plasma.
When reconstituted with 2 mL or 5 mL sterile water for injection, the final solution contains the following excipients and stabilizers in targeted amounts per mL of reconstituted product:
| Stabilizer and Excipient | 2 mL Reconstitution (for 250, 500, 750, 1000, 1500 IU) Target (per mL) | 5 mL Reconstitution (for 2000, 3000 IU) Target (per mL) |
|---|---|---|
| Tris (hydroxymethyl) aminomethane | 3.05 mg | 1.22 mg |
| Calcium Chloride | 0.60 mg | 0.24 mg |
| Mannitol | 80 mg | 32 mg |
| Sodium Chloride | 13.15 mg | 5.26 mg |
| Trehalose Dihydrate | 20 mg | 8 mg |
| Glutathione | 0.2 mg | 0.08 mg |
| Histidine | 3.90 mg | 1.56 mg |
| Polysorbate 80 | 0.25 mg | 0.10 mg |
ADYNOVATE contains no preservative. The specific activity of ADYNOVATE is 2700-8000 IU/mg protein.
ADYNOVATE is a recombinant full-length human coagulation factor VIII (2,332 amino acids with a molecular weight (MW) of 280 kDa) covalently conjugated with one or more molecules of polyethylene glycol (MW 20 kDa) [see Clinical Pharmacology (12.1)]. The therapeutic activity of ADYNOVATE is derived from its parent drug substance, ADVATE [Antihemophilic Factor (Recombinant)], which is produced by recombinant DNA technology from the CHO cell line. ADVATE is purified from the culture medium using a series of chromatography columns. The purification process includes an immunoaffinity chromatography step in which a monoclonal antibody directed against factor VIII is employed to selectively isolate the factor VIII from the medium. The production process includes a dedicated, viral inactivation solvent-detergent treatment step. The ADVATE molecule is then covalently conjugated with the polyethylene glycol, which mainly targets lysine residues.
The cell culture, pegylation, purification process and formulation used in the manufacture of ADYNOVATE do not use additives of human or animal origins.
ADYNOVATE, a PEGylated form of recombinant antihemophilic factor (ADVATE), [see Description (11)], temporarily replaces the missing coagulation factor VIII needed for effective hemostasis in congenital hemophilia A patients. ADYNOVATE exhibits an extended terminal half-life through pegylation of the parent molecule, ADVATE, which reduces binding to the physiological factor VIII clearance receptor (LRP1).
Hemophilia A is a disorder characterized by a deficiency of functional coagulation factor VIII, resulting in a prolonged, patient plasma clotting time as measured by the activated partial thromboplastin time (aPTT). Treatment with ADYNOVATE normalizes the aPTT over the effective dosing period. The administration of ADYNOVATE increases plasma levels of factor VIII and can temporarily correct the coagulation defect in hemophilia A patients.
The pharmacokinetics (PK) of ADYNOVATE were evaluated in a multicenter, prospective, open-label clinical trial (Study 1) [see Clinical Studies (14)] and compared with ADVATE in 26 patients prior to initiation of prophylactic treatment with ADYNOVATE and in 22 patients after 6 months of treatment with ADYNOVATE. A single dose of 45 IU/kg was utilized for both products. The PK parameters, as shown in Table 4, were based on plasma coagulation factor VIII activity measured by the one-stage clotting assay and are presented by age groups.
Incremental recovery was comparable between both products. The PK parameters determined after 6 months of prophylactic treatment with ADYNOVATE were consistent with the initial parameter estimates.
Pediatric Pharmacokinetics
Pharmacokinetic parameters calculated from 39 patients <18 years of age (intent-to-treat analysis) are available for 14 children (2 to <6 years), 17 older children (6 to <12 years) from Study 2 [see Clinical Studies (14)] and 8 adolescent patients (12 to <18 years of age) from Study 1 [see Clinical Studies (14)], as shown in Table 4. The mean clearance (based on body weight) of ADYNOVATE was higher and the mean half-life was lower in children <12 years of age than adults. A dose adjustment may be required in children <12 years of age.
| PK Parameters | Pediatric Population PK with Sparse Sampling* | Adult and Adolescent Individual PK with Full Sampling† |
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|---|---|---|---|---|
| <6 years N=14 | 6 to <12 years N=17 | 12 to <18 years N = 8 | ≥18 years N = 18 |
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| Abbreviations: MRT: mean residence time; CL: clearance; CI: confidence interval; AUC: area under the curve; Vss: body weight adjusted volume of distribution at steady-state; Cmax: maximum observed activity; Tmax: time to reach the maximum concentration. | ||||
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| Terminal half-life [h] | 11.8 ± 2.43 | 12.4 ± 1.67 | 13.43 ± 4.05 | 14.69 ± 3.79 |
| MRT [h] | 17.0 ± 3.50 | 17.8 ± 2.42 | 17.96 ± 5.49 | 20.27 ± 5.23 |
| CL [mL/(kg∙h)] | 3.53 ± 1.29 | 3.11 ± 0.76 | 3.87 ± 3.31 (2.73 ± 0.93)‡ | 2.27 ± 0.84 |
| Incremental Recovery [(IU/dL)/(IU/kg)] | 1.89 ± 0.49 | 1.95 ± 0.47 | 2.12 ± 0.60 | 2.66 ± 0.68 |
| AUC0-Inf [IU∙h/dL] | 1947 ± 757 | 2012 ± 495 | 1642 ± 752 | 2264 ± 729 |
| Vss [dL/kg] | 0.56 ± 0.12 | 0.54 ± 0.09 | 0.56 ± 0.18 | 0.43 ± 0.11 |
| Cmax [IU/dL] | 115 ± 30 | 115 ± 33 | 95 ± 25 | 122 ± 29 |
| Tmax [h] | -§ | -§ | 0.26 ± 0.10 | 0.46 ± 0.29 |
Incremental recovery was further evaluated in 99 patients (PUP) <6 years of age in a prospective, uncontrolled, open-label, multicenter trial. Incremental recovery remained relatively stable over time of treatment with mean (SD) incremental recovery values (1‑stage clotting method) of 1.670 (0.594) (IU/dL)/(IU/kg) (n=99), 1.617 (0.640) (IU/dL)/(IU/kg) (n=47), 1.805 (0.593) (IU/dL)/(IU/kg) (n=87), and 1.873 (0.440) (IU/dL)/(IU/kg) (n=89), at baseline, visit 3 (ED 15 ± 1), visit 6 (ED 40 ± 3), and trial completion/termination (ED 100 to 110), respectively.
The observed incidence of anti-drug antibodies (FVIII, PEG FVIII, PEG, CHO) is highly dependent on the sensitivity and specificity of the assay. Differences in assay methods preclude meaningful comparisons of the incidence of anti-drug antibodies to ADYNOVATE in the studies described below with the incidence of anti-drug antibodies in studies with other products.
Immunogenicity was evaluated during 7 clinical trials with ADYNOVATE in 365 previously treated patients and 120 previously untreated patients with severe hemophilia A.
Previously Treated Patients
In 6 clinical studies with previously treated patients, immunogenicity was evaluated by monitoring neutralizing (inhibitory) antibodies to FVIII and by measuring the development of binding IgG and IgM antibodies against factor VIII, PEGylated (PEG)-factor VIII, PEG and Chinese hamster ovary (CHO) protein using validated ELISA assays.
Two previously treated patients developed a transient low titer FVIII inhibitor at 0.6 BU/mL with ADYNOVATE, only one of which was confirmed with repeat testing. Both of these patients continued treatment without change in the dose of ADYNOVATE.
Out of 365 patients, thirty-six patients showed pre-existing antibodies to factor VIII (n=5), PEG-factor VIII (n=31) and/or PEG (n=6) prior to the first exposure to ADYNOVATE. Twenty-four patients who tested negative at screening developed transient antibodies against factor VIII (n=10), PEG-FVIII (n=16) and/or PEG (n=3) at one or two consecutive study visits. Binding antibodies that were detected prior to exposure to ADYNOVATE, that transiently developed during the trial or were still detectable at study completion or data cutoff could not be correlated to any impaired treatment efficacy or altered pharmacokinetic parameters. There was no causal relationship between observed adverse events and binding antibodies except in one patient where a causal relationship cannot be ruled out based on available data. No patient had pre-existing or treatment-emergent antibodies to CHO protein.
Previously Untreated Patients
In the clinical study with previously untreated patients, immunogenicity was evaluated by monitoring neutralizing (inhibitory) antibodies to FVIII and by measuring the development of binding IgG and IgM antibodies against factor VIII, PEGylated (PEG)-factor VIII, and PEG using validated ELISA assays.
Of the 120 dosed patients, 100 patients were evaluable for inhibitor development. Of these, 11 (11%) patients developed confirmed FVIII inhibitors after mean (SD) exposure days of 7.6 (4) to ADYNOVATE.
Of the 11 patients who developed inhibitors, 6 (55%) developed high titer inhibitors (>5 BU/mL) and 5 (45%) developed low titer inhibitors (≤5 BU/mL).
Of the 120 patients, 4 patients (3%) had preexisting IgG binding antibodies to FVIII, 13 patients (11%) had preexisting IgM binding antibodies to PEG, 11 patients (9%) had preexisting IgG binding antibodies to PEG FVIII, and 7 patients (6%) had preexisting IgM binding antibodies to PEGFVIII. Of the 120 patients, 59 patients developed transient binding non-neutralizing antibodies to FVIII, PEG FVIII, and PEG after exposure to ADYNOVATE. There was no identified clinically significant effect of anti-drug antibodies on pharmacokinetics, pharmacodynamics, safety, or effectiveness of ADYVONATE over the treatment duration.
The efficacy of ADYNOVATE was evaluated in 4 clinical studies, as described below.
Study 1
The safety, efficacy, and PK of ADYNOVATE were evaluated in a multicenter, open-label, prospective, non-randomized, two-arm clinical trial (Study 261201, NCT01736475) that compared the efficacy of a twice weekly prophylactic treatment regimen to on-demand treatment and determined hemostatic efficacy in the treatment of bleeding episodes. A total of 137 male PTPs (12 to 65 years of age) with severe hemophilia A received at least one infusion with ADYNOVATE. Twenty-five of the 137 patients were adolescents (12 to less than 18 years of age).
Patients received either prophylactic treatment (n = 120) with ADYNOVATE at a dose of 40-50 IU per kg twice weekly or on-demand treatment (n = 17) with ADYNOVATE at a dose of 10-60 IU per kg for a 6-month period. The mean (SD) dose per prophylaxis infusion was 44.4 (3.9) IU per kg with a median dosing interval of 3.6 days. There were 91 out of 98 (93%) patients previously treated prophylactically prior to enrollment, who experienced a reduction in dosing frequency during routine prophylaxis in the trial, with a median reduction of 33.7% (approximately one more day between doses). One hundred eighteen of 120 (98%) prophylaxis patients remained on the starting recommended regimen without dose adjustment, and 2 patients increased their dose to 60 IU/kg during prophylaxis due to bleeding in target joints.
On-demand Treatment and Control of Bleeding Episodes
A total of 518 bleeding episodes were treated with ADYNOVATE in the per-protocol population, i.e. dosed according to the protocol specific dosing requirements. Of these, 361 bleeding episodes (n=17 patients) occurred in the on-demand arm and 157 (n=61 patients) occurred in the prophylaxis arm. The median dose per infusion to treat all bleeding episodes in the per-protocol population was 29 (Q1: 20.0; Q3: 39.2) IU per kg. The median dose per infusion to treat a minor, moderate, or severe/major bleeding episode in the per-protocol population was 25.5 (Q1: 16.9; Q3: 37.6) IU/kg, 30.9 (Q1: 23.0; Q3: 43.1) IU/kg, or 36.4 (Q1: 29.0; Q3: 44.5) IU/kg, respectively.
A total of 591 bleeding episodes were treated with ADYNOVATE in the treated population, which was identical to the safety analysis set of patients assigned to routine prophylaxis or on-demand treatment with ADYNOVATE and who received at least one dose of the product. Of these, 361 bleeding episodes (n=17 patients) occurred in the on-demand arm and 230 bleeding episodes (n=75 patients) occurred in the routine prophylaxis arm. Efficacy in control of bleeding episodes is summarized in Table 5.
| Bleeding Episode Etiology | All | Joint | Non-joint | |
|---|---|---|---|---|
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| Number of bleeds treated | 591 | 455 | 136 | |
| Number of infusions to treat bleeding episodes | 1 infusions: | 85.4% | 85.9% | 83.8% |
| 2 infusions: | 10.8% | 10.8% | 11.0% | |
| Total (1 or 2 infusions): | 96.2% | 96.7% | 94.8% | |
| Rate of success to treat bleeding episodes* | Excellent or good | 95.3% | 95.8% | 93.4% |
Routine Prophylaxis
A total of 120 patients (treated population) received a twice a week regimen in the prophylaxis arm, and an additional 17 patients were treated episodically in the on-demand arm. In the treated population, the median [mean] annualized bleed rate (ABR) in the on-demand treatment arm was 41.5 [40.8] compared to 1.9 [4.7] while on a twice a week prophylaxis regimen (Table 6). In the per-protocol population, the median [mean] annualized bleed rate (ABR) in the on-demand treatment arm was 41.5 [40.8] compared to 1.9 [3.7] while on a twice a week prophylaxis regimen. Using a negative binomial model to estimate the ABR, there was a significant reduction in the ABR (p <0.0001) for patients in the prophylaxis arm compared to the on-demand arm.
| Bleeding Episode Etiology | On-Demand Treatment | Routine Prophylaxis Treatment | ||
|---|---|---|---|---|
| Median | Mean (SD) | Median | Mean (SD) | |
| Overall | 41.5 | 40.8 (16.3) | 1.9 | 4.7 (8.6) |
| Joint | 38.1 | 34.7 (15.1) | 0.0 | 2.9 (8.0) |
| Non-Joint | 3.7 | 6.1 (6.7) | 0.0 | 1.8 (3.0) |
| Spontaneous | 21.6 | 26.0 (19.6) | 0.0 | 2.9 (7.1) |
| Traumatic | 9.3 | 14.9 (15.3) | 0.0 | 1.8 (3.1) |
In the treated population, the median [mean] ABR for the 23 adolescent patients age 12 to <18 years of age on routine prophylaxis was 2.1 [5.2] compared to a median [mean] ABR of 1.9 [4.6] for the 97 patients 18 years and older. Reduction in ABR between the treatment arms was observed regardless of baseline subgroups examined, including age, presence or absence of target joints, and pre-trial treatment regimen. The majority of the bleeding episodes during prophylaxis (95%) were of minor/moderate severity. Forty-five out of 120 patients (38%) experienced no bleeding episodes and 68 out of 120 patients (57%) experienced no joint bleeding episodes in the prophylaxis arm. Of those patients who were compliant to regimen (per-protocol population), 40 out of 101 patients (40%) experienced no bleeding episodes. All patients in the on-demand arm experienced a bleeding episode, including a joint bleeding episode.
Study 2
Routine Prophylaxis Clinical Trial in Pediatric Patients (<12 years of age)
The safety and efficacy of ADYNOVATE was evaluated in a total of 73 pediatric PTPs with severe hemophilia A, of which 66 patients were dosed (32 patients aged <6 years and 34 patients aged 6 to <12 years) in a separate pediatric clinical trial (Study 261202, NCT02210091). The prophylactic regimen was 40 to 60 IU/kg of ADYNOVATE twice a week, with a mean (SD) dose of 51.1 IU/kg (5.5). The median [mean] overall ABR was 2.0 [3.61] for the 66 patients in the treated population and the median [mean] ABRs for spontaneous and joint bleeding episodes were both 0 [1.18 and 1.12, respectively]. Of the 66 patients treated prophylactically, 25 (38%) experienced no bleeding episodes, 44 (67%) experienced no spontaneous bleeding episodes, and 48 (73%) experienced no joint bleeding episodes.
Of the 70 bleeding episodes observed during the pediatric trial, 82.9% were controlled with 1 infusion and 91.4% were controlled with 1 or 2 infusions. Control of bleeding was rated excellent or good in 63 out of 70 (90%) bleeding episodes. The definitions of excellent or good in the pediatric clinical trial were unchanged as compared to the previously conducted prophylaxis clinical trial in adolescent and adult patients.
Study 3
An extension study (Study 261302, NCT01945593) in adult and pediatric patients evaluated the safety and efficacy of prophylactic treatment regimen in 216 previously treated patients with severe hemophilia A. Majority had completed the adult and adolescent study or the pediatric study. Similar efficacy was noted in this extension study.
Study 4
Perioperative Management Clinical Trial
The safety and efficacy of ADYNOVATE in PTPs (aged 12 to 65 years) with severe hemophilia A, who were undergoing elective surgical or other invasive procedures, was evaluated in a multicenter, open-label clinical trial (Study 261204, NCT01913405). In this clinical trial 21 major surgical procedures comprising of 14 orthopedic, and 7 non-orthopedic procedures, and 5 additional minor surgeries were performed in 21 patients. The preoperative loading dose ranged from 36 IU/kg to 99 IU/kg (median: 60 IU/kg) and the total post-operative dose ranged from 23 IU/kg to 769 IU/kg (median: 183 IU/kg). The median total dose (including all administrations from pre-surgical PK and loading doses to post-hospital follow up) was 629 IU/kg (range: 464 – 1,457 IU/kg) for major orthopedic surgeries, 489 IU/kg (range: 296 – 738 IU/kg) for major non-orthopedic surgeries.
Overall hemostatic efficacy was rated as excellent (blood loss less than or equal to that expected for the same type of procedure performed in a non-hemophilic patient, for all 24 (21 major, 3 minor) procedures with available assessments.
How Supplied
ADYNOVATE in a BAXJECT III system is packaged with 2 mL or 5 mL of Sterile Water for Injection, one Terumo Microbore Infusion set (2 mL only), one full prescribing physician insert and one patient insert. Components not made with natural rubber latex.
ADYNOVATE is available in single-dose vials that contain the following nominal product strengths:
| Nominal Strength | Potency Color Code | Carton NDC (Includes 2 mL sWFI Diluent) | Carton NDC (Includes 5 mL sWFI Diluent) |
|---|---|---|---|
| 250 IU | Light Blue | 0944-4622-01 | |
| 500 IU | Pink | 0944-4623-01 | |
| 750 IU | Red | 0944-4626-01 | |
| 1000 IU | Light Green | 0944-4624-01 | |
| 1500 IU | Purple | 0944-4627-01 | |
| 2000 IU | Orange | 0944-4625-01 | |
| 3000 IU | Silver | 0944-4628-01 |
Actual factor VIII activity in IU is stated on the label of each ADYNOVATE carton and housing.
Storage and Handling
Advise the patients to:
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ADYNOVATE, ADVATE and BAXJECT are registered trademarks of Baxalta Incorporated.
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Patient Information
ADYNOVATE® (ah-DYE-noh-vayt)
[Antihemophilic Factor (Recombinant), PEGylated]
This leaflet summarizes important information about ADYNOVATE. Please read it carefully before using this medicine. This information does not take the place of talking with your healthcare provider, and it does not include all of the important information about ADYNOVATE. If you have any questions after reading this, ask your healthcare provider.
What is the most important information I need to know about ADYNOVATE?
Do not attempt to do an infusion to yourself unless you have been taught how by your healthcare provider or hemophilia center.
You must carefully follow your healthcare provider's instructions regarding the dose and schedule for infusing ADYNOVATE so that your treatment will work best for you.
What is ADYNOVATE?
ADYNOVATE is an injectable medicine that is used to help treat and control bleeding in adults and children with hemophilia A (congenital Factor VIII deficiency). Your healthcare provider may give you ADYNOVATE when you have surgery.
ADYNOVATE can reduce the number of bleeding episodes when used regularly (prophylaxis).
ADYNOVATE is not used to treat von Willebrand disease.
Who should not use ADYNOVATE?
You should not use ADYNOVATE if you:
Tell your healthcare provider if you are pregnant or breastfeeding because ADYNOVATE may not be right for you.
How should I use ADYNOVATE?
ADYNOVATE is given directly into the bloodstream.
You may infuse ADYNOVATE at a hemophilia treatment center, at your healthcare provider's office or in your home. You should be trained on how to do infusions by your healthcare provider or hemophilia treatment center. Many people with hemophilia A learn to infuse their ADYNOVATE by themselves or with the help of a family member.
Your healthcare provider will tell you how much ADYNOVATE to use based on your individual weight, level of physical activity, the severity of your hemophilia A, and where you are bleeding.
Reconstituted product (after mixing dry product with wet diluent) must be used within 3 hours and cannot be stored or refrigerated. Discard any ADYNOVATE left in the vial at the end of your infusion as directed by your healthcare professional.
You may have to have blood tests done after getting ADYNOVATE to be sure that your blood level of factor VIII is high enough to clot your blood.
Call your healthcare provider right away if your bleeding does not stop after taking ADYNOVATE.
What should I tell my healthcare provider before I use ADYNOVATE?
You should tell your healthcare provider if you:
What are the possible side effects of ADYNOVATE?
You can have an allergic reaction to ADYNOVATE.
Call your healthcare provider right away and stop treatment if you get a rash or hives, itching, tightness of the throat, chest pain or tightness, difficulty breathing, lightheadedness, dizziness, nausea or fainting.
The common side effects of ADYNOVATE are cough, headache, diarrhea, vomiting, rash, nausea, hives, and dizziness. Tell your healthcare provider about any side effects that bother you or do not go away.
These are not all the possible side effects with ADYNOVATE. You can ask your healthcare provider for information that is written for healthcare professionals.
What are the ADYNOVATE dosage strengths?
ADYNOVATE with 2 mL or 5 mL Sterile Water for Injection in a BAXJECT® III system comes in seven different dosage strengths: 250 International Units (IU), 500 IU, 750 IU, 1000 IU, 1500 IU, 2000 IU, and 3000 IU. The actual strength will be imprinted on the label and on the box. The seven different strengths are color coded, as follows:
|
| Dosage strength of approximately 250 International Units per vial (with 2 mL sWFI) |
|
| Dosage strength of approximately 500 International Units per vial (with 2 mL sWFI) |
|
| Dosage strength of approximately 750 International Units per vial (with 2 mL sWFI) |
|
| Dosage strength of approximately 1000 International Units per vial (with 2 mL sWFI) |
|
| Dosage strength of approximately 1500 International Units per vial (with 2 mL sWFI) |
|
| Dosage strength of approximately 2000 International Units per vial (with 5 mL sWFI) |
|
| Dosage strength of approximately 3000 International Units per vial (with 5 mL sWFI) |
Always check the actual dosage strength printed on the label to make sure you are using the strength prescribed by your healthcare provider. Always check the expiration date printed on the box. Do not use the product after the expiration date printed on the box.
How do I store ADYNOVATE?
What else should I know about ADYNOVATE and Hemophilia A?
Your body may form inhibitors to Factor VIII. An inhibitor is part of the body's normal defense system. If you form inhibitors, it may stop ADYNOVATE from working properly. Consult with your healthcare provider to make sure you are carefully monitored with blood tests for the development of inhibitors to Factor VIII.
Medicines are sometimes prescribed for purposes other than those listed here. Do not use ADYNOVATE for a condition for which it is not prescribed. Do not share ADYNOVATE with other people, even if they have the same symptoms that you have.
Takeda Pharmaceuticals U.S.A., Inc.
Cambridge, MA 02142
U.S. License No. 1898
ADYNOVATE, ADVATE and BAXJECT are registered trademarks of Baxalta Incorporated.
Takeda and
are registered trademarks of Takeda Pharmaceutical Company Limited.
©2025 Takeda Pharmaceutical Company Limited. All rights reserved.
Patented: see www.takeda.com/en-us/patents
This Patient Information has been approved by the U.S. Food and Drug Administration.
Revised: 10/2025
Instructions For Use
ADYNOVATE®
[Antihemophilic Factor (Recombinant), PEGylated]
(For intravenous use only)
Do not attempt to do an infusion to yourself unless you have been taught how by your healthcare provider or hemophilia center.
Step-by-step instructions for reconstituting ADYNOVATE are found at the end of this leaflet.
Always follow the specific instructions given by your healthcare provider. The steps listed below are general guidelines for using ADYNOVATE. If you are unsure of the procedures, please call your healthcare provider before using.
Call your healthcare provider right away if bleeding is not controlled after using ADYNOVATE.
Your healthcare provider will prescribe the dose that you should take.
Reconstituted product (after mixing dry product with wet diluent) must be used within 3 hours and cannot be stored or refrigerated.
Your healthcare provider may need to take blood tests from time to time.
Talk to your healthcare provider before traveling. Plan to bring enough ADYNOVATE for your treatment during this time.
Dispose of all materials, including any leftover reconstituted ADYNOVATE product, in an appropriate container.
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Important: Contact your healthcare provider or local hemophilia treatment center if you experience any problems.
Takeda Pharmaceuticals U.S.A., Inc.
Cambridge, MA 02142
U.S. License No. 1898
ADYNOVATE is a registered trademark of Baxalta Incorporated.
Takeda and
are registered trademarks of Takeda Pharmaceutical Company Limited.
©2025 Takeda Pharmaceutical Company Limited. All rights reserved.
Patented: see www.takeda.com/en-us/patents
Revised: 10/2025
ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4622-01
Single-dose only
For Intravenous Administration After Reconstitution Only
Lyophilized powder for reconstitution
ADYNOVATE and diluent preassembled in BAXJECT III system
Rx Only
Actual potency
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
For Intravenous Administration Only
ADYNOVATE and diluent preassembled
in BAXJECT® III system
Directions for use: see package insert
Rx Only
IU:
LOT:
EXP:
Takeda
6521221

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4622-02
Single-dose only
6521479
For Intravenous Administration Only
ADYNOVATE and diluent preassembled in BAXJECT® III system
Do not open until time of use
Do not use if packaging is opened or damaged
Discard unused portion.
Rx Only
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4623-01
Single-dose only
For Intravenous Administration After Reconstitution Only
Lyophilized powder for reconstitution
ADYNOVATE and diluent preassembled in BAXJECT III system
Rx Only
Actual potency
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
For Intravenous Administration Only
ADYNOVATE and diluent preassembled
in BAXJECT® III system
Directions for use: see package insert
Rx Only
IU:
LOT:
EXP:
Takeda
6521223

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4623-02
Single-dose only
6521484
For Intravenous Administration Only
ADYNOVATE and diluent preassembled in BAXJECT® III system
Do not open until time of use
Do not use if packaging is opened or damaged
Discard unused portion.
Rx Only
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4626-01
Single-dose only
For Intravenous Administration After Reconstitution Only
Lyophilized powder for reconstitution
ADYNOVATE and diluent preassembled in BAXJECT III system
Rx Only
Actual potency
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
For Intravenous Administration Only
ADYNOVATE and diluent preassembled
in BAXJECT® III system
Directions for use: see package insert
Rx Only
IU:
LOT:
EXP:
Takeda
6521228

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4626-02
Single-dose only
6521490
For Intravenous Administration Only
ADYNOVATE and diluent preassembled in BAXJECT® III system
Do not open until time of use
Do not use if packaging is opened or damaged
Discard unused portion.
Rx Only
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4624-01
Single-dose only
For Intravenous Administration After Reconstitution Only
Lyophilized powder for reconstitution
ADYNOVATE and diluent preassembled in BAXJECT III system
Rx Only
Actual potency
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
For Intravenous Administration Only
ADYNOVATE and diluent preassembled
in BAXJECT® III system
Directions for use: see package insert
Rx Only
IU:
LOT:
EXP:
Takeda
6521224

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4624-02
Single-dose only
6521493
For Intravenous Administration Only
ADYNOVATE and diluent preassembled in BAXJECT® III system
Do not open until time of use
Do not use if packaging is opened or damaged
Discard unused portion.
Rx Only
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4627-01
Single-dose only
For Intravenous Administration After Reconstitution Only
Lyophilized powder for reconstitution
ADYNOVATE and diluent preassembled in BAXJECT III system
Rx Only
Actual potency
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
For Intravenous Administration Only
ADYNOVATE and diluent preassembled
in BAXJECT® III system
Directions for use: see package insert
Rx Only
IU:
LOT:
EXP:
Takeda
6521225

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4627-02
Single-dose only
6521495
For Intravenous Administration Only
ADYNOVATE and diluent preassembled in BAXJECT® III system
Do not open until time of use
Do not use if packaging is opened or damaged
Discard unused portion.
Rx Only
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4625-01
Single-dose only
For Intravenous Administration After Reconstitution Only
Lyophilized powder for reconstitution
ADYNOVATE and diluent
preassembled in
BAXJECT III system
Rx Only
Actual potency
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
For Intravenous Administration Only
ADYNOVATE and diluent preassembled
in BAXJECT® III system
Directions for use: see package insert
Rx Only
IU:
LOT:
EXP:
Takeda
6521226

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4625-02
Single-dose only
6521498
For Intravenous Administration Only
ADYNOVATE and diluent preassembled in BAXJECT® III system
Do not open until time of use
Do not use if packaging is opened or damaged
Discard unused portion.
Rx Only
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4628-01
Single-dose only
For Intravenous Administration After Reconstitution Only
Lyophilized powder for reconstitution
ADYNOVATE and diluent
preassembled in
BAXJECT III system
Rx Only
Actual potency
Takeda

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
For Intravenous Administration Only
ADYNOVATE and diluent preassembled
in BAXJECT® III system
Directions for use: see package insert
Rx Only
IU:
LOT:
EXP:
Takeda
6521227

ADYNOVATE®
[Antihemophilic Factor
(Recombinant), PEGylated]
NDC 0944-4628-02
Single-dose only
6521500
For Intravenous Administration Only
ADYNOVATE and diluent preassembled in BAXJECT® III system
Do not open until time of use
Do not use if packaging is opened or damaged
Discard unused portion.
Rx Only
Takeda

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antihemophilic factor (recombinant) pegylated kit |
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antihemophilic factor (recombinant) pegylated kit |
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antihemophilic factor (recombinant) pegylated kit |
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antihemophilic factor (recombinant) pegylated kit |
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antihemophilic factor (recombinant) pegylated kit |
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antihemophilic factor (recombinant) pegylated kit |
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antihemophilic factor (recombinant) pegylated kit |
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| Labeler - Takeda Pharmaceuticals Amercia, Inc. (039997266) |
| Establishment | |||
| Name | Address | ID/FEI | Business Operations |
|---|---|---|---|
| BAXALTA US INC. | 009471603 | MANUFACTURE(0944-4622, 0944-4623, 0944-4626, 0944-4624, 0944-4627, 0944-4625, 0944-4628) | |
| Establishment | |||
| Name | Address | ID/FEI | Business Operations |
|---|---|---|---|
| Siegfried Hameln GmbH | 315869123 | MANUFACTURE(64764-514, 64764-515) | |