YOUR GUIDE TO INFUSING KRYSTEXXA
KRYSTEXXA is an infusion drug, and like all infusion drugs, there are steps that your office needs to take to prepare your patients for infusion, and to ensure that KRYSTEXXA is administered properly.
PROCESS FOR NEW PATIENTS
Initiates enrollment into KRYSTEXXAConnect services, including PATIENT ACCESS MANAGER
Within 2 business days:
•You receive an Initial Summary of Benefits and your patient receives a Welcome Kit
•If using an Alternate Site of Care (ASOC), refer to ASOC Letter Template (see below)
Perform preinfusion sUA test, preferably within 48 hours prior to each infusion (with exception of the first infusion)
•Predictive biomarker for infusion reactions risk and product efficacy
•2-hour infusion (minimum)
•1 hour of observation (recommended)
KRYSTEXXAConnect Enrollment Form
Starting a patient on KRYSTEXXA? Get them connected to their Patient Access Manager faster by completing this enrollment form.DOWNLOAD FORM
Alternate Site of Care Letter – Template
Download the following resource to recommend infusion of KRYSTEXXA. This template is a suggestion and should be printed on the physician’s letterhead. The physician is responsible for completing this letter in a way that completely and accurately represents a patient’s circumstances.DOWNLOAD LETTER DOWNLOAD INSTRUCTIONS
Download this guide to see if your patients should take an antihistamine, analgesic, or IV corticosteroid prior to infusing KRYSTEXXA.DOWNLOAD GUIDE
STEPS TO A SUCCESSFUL INFUSION DAY
Make sure you perform every step of the infusion process for KRYSTEXXA by downloading the Infusion Checklist.DOWNLOAD CHECKLIST
•Prior to the first infusion, confirm the patient has normal G6PD* activity from lab tests and has discontinued taking urate-lowering therapies (eg, allopurinol, febuxostat)
⚬Do not administer KRYSTEXXA to patients with G6PD deficiency
•Prior to each subsequent infusion, confirm sUA level was tested in the last 48 hours, beginning after the first infusion. Notify prescribing healthcare provider (HCP) if sUA level has not been tested or if any preinfusion sUA level is ≥6 mg/dL, and consider discontinuing therapy, particularly after 2 preinfusion sUA levels are >6 mg/dL. See Stopping Rules
•Answer any questions the patient may have regarding treatment and provide a Medication Guide
•Remind the patient that they may have gout flares, and KRYSTEXXA therapy can be continued regardless of gout flares
⚬A Patient Access Manager (PAM) is available to support the patient throughout therapy
•Visually inspect vial for particulate matter and ensure solution is clear and colorless
•Using aseptic technique, withdraw 1 mL into a sterile syringe and inject into a 250 mL bag of normal or half-normal saline. Gently mix the bag by inverting several times and discard any unused portion of the remaining product. Do not shake
⚬No loading dose recommended or required
⚬KRYSTEXXA is a single-dose vial
•The diluted solution should be used within 4 hours
•Before administration, allow the diluted solution of KRYSTEXXA to reach room temperature
⚬Artificial heating should not be used
⚬If not administered immediately, it is recommended that the diluted solution should be stored in the refrigerator and away from light
•Initiate infusion at a rate of 125 mL/h or slower via infusion pump or gravity feed
•Infuse over no less than 2 hours
DO NOT ADMINISTER AS INTRAVENOUS PUSH OR BOLUS
•Use your normal protocol to monitor for infusion reactions
⚬In the event of an infusion reaction, as clinically indicated, the infusion can be slowed or stopped and restarted at a slower rate
•Observe the patient for approximately 1 hour post-infusion
•Remind the patient of their next sUA test and KRYSTEXXA infusion appointments
⚬KRYSTEXXA should be given every 2 weeks—it is recommended to provide a standing order to the lab to check the patient’s sUA level prior to each infusion
*KRYSTEXXA is contraindicated for patients with G6PD deficiency. G6PD deficiency is an abnormally low level of glucose-6-phosphate dehydrogenase. Patients of African, Mediterranean, and Southern Asian ancestry have a higher risk of deficiency.3
†Available through Group Purchasing Organization (GPO) wholesalers and specialty pharmacies, depending on patient benefit design.
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- KRYSTEXXA [prescribing information]. Horizon Pharma Rheumatology LLC. September 2016.
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