| For patients ≥2 years of age experiencing seizures associated with |
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| Thank you for attending the recent discussion on Evolving the Treatment of Dravet Syndrome: Focus on FINTEPLA® (fenfluramine) |
| We hope the insights shared by Dr. Joseph Sullivan and Kristin Adkins, RN, BSN, will be valuable to your clinical practice and help improve the lives of patients living with Dravet syndrome. |
| As a reminder, the key points of discussion included: |
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FINTEPLA provides a profound* and sustained reduction in median monthly convulsive seizure frequency in patients with Dravet syndrome1-3
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In a 14-week clinical study, the placebo-adjusted percent reduction in median monthly convulsive seizure frequency with FINTEPLA 0.7 mg/kg/day was 70% (P<0.001). The median reduction from baseline was 79.4% vs 16.5% with placebo2,3 |
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No worsening of behavior, emotion, and cognition vs placebo was observed in clinical trials3,4
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Some cases of aggression have been identified in post-approval use of FINTEPLA. A causal relationship between this adverse reaction and drug exposure has not been established2 |
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FINTEPLA has a well-established safety profile2 |
| *A profound level of response was defined as ≥75% MCSF. |
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| We appreciate your feedback. |
| Please click the button below to take a short survey about the program. |
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| We hope to see you at future educational programs and appreciate your commitment to advancing treatment for Dravet syndrome. |
| Sincerely, |
| The FINTEPLA Brand Team |
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INDICATIONS AND USAGE
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| FINTEPLA is indicated for the treatment of seizures associated with Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) in patients 2 years of age and older. |
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IMPORTANT SAFETY INFORMATION
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BOXED WARNING: VALVULAR HEART DISEASE and PULMONARY ARTERIAL HYPERTENSION
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There is an association between serotonergic drugs with 5-HT2B receptor
agonist activity, including fenfluramine (the active ingredient in FINTEPLA),
and valvular heart disease and pulmonary arterial hypertension.
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Echocardiogram assessments are required before, during, and after treatment
with FINTEPLA.
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FINTEPLA is available only through a restricted program called the FINTEPLA
REMS.
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CONTRAINDICATIONS
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FINTEPLA is contraindicated in patients with hypersensitivity to fenfluramine or any of the
excipients in FINTEPLA and with concomitant use, or within 14 days of the administration, of
monoamine oxidase inhibitors because of an increased risk of serotonin syndrome.
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WARNINGS AND PRECAUTIONS
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Valvular Heart Disease and Pulmonary Arterial Hypertension (see Boxed Warning):
Because of the association between serotonergic drugs with 5-HT2B receptor agonist activity,
including fenfluramine (the active ingredient in FINTEPLA), and valvular heart disease (VHD)
and pulmonary arterial hypertension (PAH), cardiac monitoring via echocardiogram is required
prior to starting treatment, during treatment, and after treatment with FINTEPLA concludes.
Cardiac monitoring via echocardiogram can aid in early detection of these conditions. In
clinical trials for DS and LGS of up to 3 years in duration, no patient receiving FINTEPLA
developed VHD or PAH.
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Monitoring: Prior to starting treatment,
patients must undergo an echocardiogram to evaluate for VHD and PAH. Echocardiograms should be
repeated every 6 months, and once at 3-6 months post treatment with FINTEPLA.
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The prescriber must consider the benefits versus the risks of initiating or continuing
treatment with FINTEPLA if any of the following signs are observed via echocardiogram:
valvular abnormality or new abnormality; VHD indicated by mild or greater aortic regurgitation
or moderate or greater mitral regurgitation, with additional characteristics of VHD (eg, valve
thickening or restrictive valve motion); PAH indicated by elevated right heart/pulmonary
artery pressure (PASP >35 mm Hg).
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FINTEPLA REMS Program (see Boxed Warning): FINTEPLA
is available only through a restricted distribution program called the FINTEPLA Risk
Evaluation and Mitigation Strategy (REMS) Program. Prescribers must be certified by enrolling
in the FINTEPLA REMS. Prescribers must counsel patients receiving FINTEPLA about the risk of
VHD and PAH, how to recognize signs and symptoms of VHD and PAH, the need for baseline
(pretreatment) and periodic cardiac monitoring via echocardiogram during FINTEPLA treatment,
and cardiac monitoring after FINTEPLA treatment. Patients must enroll in the FINTEPLA REMS and
comply with ongoing monitoring requirements. The pharmacy must be certified by enrolling in
the FINTEPLA REMS and must only dispense to patients who are authorized to receive FINTEPLA.
Wholesalers and distributors must only distribute to certified pharmacies. Further information
is available at
www.FinteplaREMS.com
or by telephone at 1-877-964-3649.
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Decreased Appetite and Decreased Weight: FINTEPLA
can cause decreases in appetite and weight. Decreases in weight appear to be dose related.
Approximately half of the patients with LGS and most patients with DS resumed the expected
measured increases in weight during the open-label extension studies. Weight should be
monitored regularly during treatment with FINTEPLA, and dose modifications should be
considered if a decrease in weight is observed.
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Somnolence, Sedation, and Lethargy: FINTEPLA can
cause somnolence, sedation, and lethargy. Other central nervous system (CNS) depressants,
including alcohol, could potentiate these effects of FINTEPLA. Prescribers should monitor
patients for somnolence and sedation and should advise patients not to drive or operate
machinery until they have gained sufficient experience on FINTEPLA to gauge whether it
adversely affects their ability to drive or operate machinery.
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Suicidal Behavior and Ideation: Antiepileptic drugs
(AEDs), including FINTEPLA, increase the risk of suicidal thoughts or behaviors in patients
taking these drugs for any indication. Patients treated with an AED for any indication should
be monitored for the emergence or worsening of depression, suicidal thoughts or behaviors, or
any unusual changes in mood or behavior.
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Anyone considering prescribing FINTEPLA or any other AED must balance the risk of suicidal
thoughts or behaviors with the risks of untreated illness. Epilepsy and many other illnesses
for which AEDs are prescribed are themselves associated with morbidity and mortality and an
increased risk of suicidal thoughts and behaviors. Should suicidal thoughts and behaviors
emerge during treatment, consider whether the emergence of these symptoms in any given patient
may be related to the illness being treated.
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Withdrawal of Antiepileptic Drugs: As with most
AEDs, FINTEPLA should generally be withdrawn gradually because of the risk of increased
seizure frequency and status epilepticus. If withdrawal is needed because of a serious adverse
reaction, rapid discontinuation can be considered.
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Serotonin Syndrome: Serotonin syndrome, a
potentially life-threatening condition, may occur with FINTEPLA, particularly during
concomitant administration of FINTEPLA with other serotonergic drugs, including, but not
limited to, selective serotonin-norepinephrine reuptake inhibitors (SNRIs), selective
serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), bupropion, triptans,
dietary supplements (eg, St. John’s Wort, tryptophan), drugs that impair metabolism of
serotonin (including monoamine oxidase inhibitors [MAOIs], which are contraindicated with
FINTEPLA), dextromethorphan, lithium, tramadol, and antipsychotics with serotonergic agonist
activity. Patients should be monitored for the emergence of signs and symptoms of serotonin
syndrome, which include mental status changes (eg, agitation, hallucinations, coma), autonomic
instability (eg, tachycardia, labile blood pressure, hyperthermia), neuromuscular signs (eg,
hyperreflexia, incoordination), and/or gastrointestinal symptoms (eg, nausea, vomiting,
diarrhea). If serotonin syndrome is suspected, treatment with FINTEPLA should be stopped
immediately and symptomatic treatment should be started.
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Increase in Blood Pressure: FINTEPLA can cause an
increase in blood pressure. Rare cases of significant elevation in blood pressure, including
hypertensive crisis, has been reported in adult patients treated with fenfluramine, including
patients without a history of hypertension. In clinical trials for DS and LGS of up to 3 years
in duration, no pediatric or adult patient receiving FINTEPLA developed hypertensive crisis.
Monitor blood pressure in patients treated with FINTEPLA.
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Glaucoma: Fenfluramine can cause mydriasis and can
precipitate angle closure glaucoma. Consider discontinuing treatment with FINTEPLA in patients
with acute decreases in visual acuity or ocular pain.
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ADVERSE REACTIONS
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The most common adverse reactions observed in DS studies (incidence at least 10% and greater
than placebo) were decreased appetite; somnolence, sedation, lethargy; diarrhea; constipation;
abnormal echocardiogram; fatigue, malaise, asthenia; ataxia, balance disorder, gait
disturbance; blood pressure increased; drooling, salivary hypersecretion; pyrexia; upper
respiratory tract infection; vomiting; decreased weight; fall; status epilepticus.
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The most common adverse reactions observed in the LGS study (incidence at least 10% and
greater than placebo) were diarrhea; decreased appetite; fatigue; somnolence; vomiting.
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DRUG INTERACTIONS
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Strong CYP1A2, CYP2B6, or CYP3A Inducers: Coadministration with strong CYP1A2, CYP2B6, or
CYP3A inducers will decrease fenfluramine plasma concentrations. If coadministration of a
strong CYP1A2, CYP2B6, or CYP3A inducer with FINTEPLA is necessary, monitor the patient for
reduced efficacy and consider increasing the dosage of FINTEPLA as needed. If a strong CYP1A2,
CYP2B6, or CYP3A inducer is discontinued during maintenance treatment with FINTEPLA, consider
gradual reduction in the FINTEPLA dosage to the dose administered prior to initiating the
inducer.
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Strong CYP1A2 or CYP2D6 Inhibitors: Coadministration with strong CYP1A2 or CYP2D6 inhibitors
will increase fenfluramine plasma concentrations. If FINTEPLA is coadministered with strong
CYP1A2 or CYP2D6 inhibitors, the maximum daily dosage of FINTEPLA is 20 mg. If a strong CYP1A2
or CYP2D6 inhibitor is discontinued during maintenance treatment with FINTEPLA, consider
gradual increase in the FINTEPLA dosage to the dose recommended without CYP1A2 or CYP2D6
inhibitors. If FINTEPLA is coadministered with stiripentol and a strong CYP1A2 or CYP2D6
inhibitor, the maximum daily dosage of FINTEPLA is 17 mg.
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USE IN SPECIFIC POPULATIONS
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In patients with severe impairment of kidney function (estimated glomerular filtration rate
[eGFR]) 15 to 29 mL/min/1.73m2, dosage adjustments are recommended. FINTEPLA has
not been studied in patients with kidney failure (eGFR <15 mL/min/1.73m2).
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Combined molar exposures of fenfluramine and norfenfluramine were increased in subjects with
various degrees of hepatic impairment (Child-Pugh Class A, B, and C), necessitating a dosage
adjustment in these patients.
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To report SUSPECTED ADVERSE REACTIONS, contact UCB, Inc. at
1-844-599-2273 or FDA at
1-800-FDA-1088 or
www.fda.gov/medwatch.
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Please see full
Prescribing Information, including Boxed Warning, for additional Important Safety Information on FINTEPLA.
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| References: 1. Bishop KI, Isquith PK, Gioia GA, et al. Improved everyday executive functioning following profound reduction in seizure frequency with fenfluramine: analysis from a phase 3 long-term extension study in children/young adults with Dravet syndrome. Epilepsy Behav. 2021;121(pt A):108024. doi:10.1016/j.yebeh.2021.108024; 2. FINTEPLA (fenfluramine) oral solution: U.S. prescribing information. Smyrna, GA: UCB, Inc.; 3. Data on file. UCB, Inc.; 4. Lagae L, Sullivan J, Knupp K, et al; FAiRE DS Study Group. Fenfluramine hydrochloride for the treatment of seizures in Dravet syndrome: a randomised, double-blind, placebo-controlled trial. Lancet. 2019;394(10216):2243-2254. doi:10.1016/S0140-6736(19)32500-0 |
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FINTEPLA® is a
registered trademark of the UCB Group of Companies. ©2025 UCB, Inc., 1950 Lake Park Drive, Smyrna, GA 30080. All rights reserved. US-FA-2400476
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