Drug Interactions between exagamglogene autotemcel and TheraCys
This report displays the potential drug interactions for the following 2 drugs:
- exagamglogene autotemcel
- TheraCys (bcg)
Interactions between your drugs
BCG exagamglogene autotemcel
Applies to: TheraCys (bcg) and exagamglogene autotemcel
ADJUST DOSING INTERVAL: The administration and safety of vaccines or oncolytic immunotherapy containing live, attenuated virus or bacteria has not been studied in patients during or following administration of autologous hematopoietic stem cell (HSC)-based gene therapy (e.g., exagamglogene autotemcel, lovotibeglogene autotemcel). In general, patients who undergo myeloablative conditioning followed by autologous HSC-based gene therapy have altered immune competence, which may be associated with a risk of disseminated infection due to enhanced replication of vaccine virus or bacteria, an increase in vaccine adverse reactions, and decreased or suboptimal immunologic response to the vaccines or oncolytic immunotherapy. The myeloablative therapy performed prior to HSC transplant (HSCT) is believed to gradually remove immune memory acquired from previous vaccinations, with antibody titers to vaccine-preventable diseases decreasing 1 to 4 years after autologous HSCT if the recipient is not revaccinated. Clinical data specific to exagamglogene autotemcel and lovotibeglogene autotemcel are not available.
MANAGEMENT: The safety of immunizations with live viral vaccines during or following HSC-based gene therapy with exagamglogene autotemcel or lovotibeglogene autotemcel has not been evaluated. Administration of live attenuated vaccines in severely immunocompromised persons is generally considered a contraindication. While the product labeling for these gene therapy products only discusses live viral vaccines, the same guidelines may also apply to the use of vaccines containing live, attenuated bacteria as well as oncolytic immunotherapy containing live, attenuated virus. Until more information is available, local vaccination guidelines specific to post-autologous HSCT and functional asplenia should be consulted for recommendations on vaccines. For example, the Advisory Committee on Immunization Practices (ACIP) has specific recommendations for live vaccines which vary between not being recommended and waiting at least 24 months after HSCT. Other variabilities that should also be considered include the presence of graft-versus-host disease and immunocompetence.
References
- CDC Centers for Disease Control and Prevention (2019) General Best Practice Guidelines for Immunization: Altered Immunocompetence. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/immunocompetence.pdf
- Department of Health. National Health Service (2019) Immunisation Against Infectious Disease - "The Green Book". Chapter 6: Contraindications and special considerations. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/655225/Greenbook_chapter_6.pdf
- Public Health Agency of Canada (2023) Immunization of immunocompromised persons: Canadian immunization guide https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations/page-8-immunization-immunocompromised-p
- (2023) "Product Information. Lyfgenia (lovotibeglogene autotemcel)." bluebird bio
- (2023) "Product Information. Casgevy (exagamglogene autotemcel)." Vertex Pharmaceuticals
- Vertex Pharmaceuticals (Europe) Limited (2024) Casgevy 4-13 x 10Exp6 cells/mL dispersion for infusion https://www.medicines.org.uk/emc/product/15296
- Miller PDE, patel sr, Skinner R, et al. (2023) "Joint consensus statement on the vaccination of adult and paediatric haematopoietic stem cell transplant recipients: prepared on behalf of the British society of blood and marrow transplantation and cellular therapy (BSBMTCT), the children's cancer and le" J Infect, 86, p. 1-8
- Advisory Committee on Immunization Practices: Centers for Disease Control and Prevention General Best Practice Guidelines for Immunization: Contraindications and Precautions: https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html
- Australian Government. Department of Health and Aged Care Australian Immunisation Handbook: Vaccination for people who are immunocompromised https://immunisationhandbook.health.gov.au/contents/vaccination-for-special-risk-groups/vaccination-for-people-who-are-immunocompromised
Drug and food interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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