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Active Substance: hepatitis B surface antigen
Common Name: hepatitis B (rDNA) vaccine (adjuvanted, adsorbed)
ATC Code: J07BC01
Marketing Authorisation Holder: GlaxoSmithKline Biologicals S.A.
Active Substance: hepatitis B surface antigen
Status: Authorised
Authorisation Date: 2005-02-02
Therapeutic Area: Hepatitis B Immunization
Pharmacotherapeutic Group: Vaccines

Therapeutic Indication

Fendrix is indicated in adolescents and adults from the age of 15 years onwards for active immunisation against hepatitis B virus infection (HBV) caused by all known subtypes for patients with renal insufficiency (including pre-haemodialysis and haemodialysis patients).

What is Fendrix?

Fendrix is a vaccine, which is available as a suspension for injection. It contains parts of the hepatitis B virus as the active substance.

What is Fendrix used for?

Fendrix is used to protect patients with kidney problems against hepatitis B. It can be used in patients from the age of 15 years, including patients needing haemodialysis (a blood clearance technique).

The medicine can only be obtained with a prescription.

How is Fendrix used?

The recommended vaccination schedule for Fendrix is four doses. There should be a gap of one month between the first and second, and between the second and third injections. The fourth injection is given four months after the third. It is recommended that individuals who receive the first dose should complete the course with Fendrix. The vaccine is injected into the muscle at the top of the arm.

A booster dose of Fendrix may be given, according to official recommendations.

How does Fendrix work?

Fendrix is a vaccine. Vaccines work by ‘teaching’ the immune system (the body’s natural defences) how to defend itself against a disease. Fendrix contains small amounts of the ‘surface antigen’ (proteins from the surface) of the hepatitis B virus. When a patient is given the vaccine, the immune system recognises the surface antigens as ‘foreign’ and makes antibodies against them. In the future, the immune system will be able to make antibodies more quickly when it is exposed to the hepatitis B virus. The antibodies will help to protect against the disease caused by the virus.

The surface antigens are produced by a method known as ‘recombinant DNA technology’: they are made by a yeast that has received a gene (DNA), which makes it able to produce the proteins.

The active substance in Fendrix has been available in other vaccines authorised in the European Union (EU) for a number of years, including Engerix-B, Ambirix, Twinrix, Tritanrix-HepB and Infanrix-HepB. In Fendrix, it is used with an ‘adjuvant system’ which contains ‘MPL’, a purified fat from bacteria, and an aluminium compound. This system enhances the response of the immune system, which can help when vaccines are used in patients who may have a lower response, such as those with kidney problems.

How has Fendrix been studied?

Because the active substance in Fendrix has been available in the EU in other vaccines, some of the data used to support the use of the other vaccines were used to support the use of Fendrix.

Fendrix has been studied in one main study involving 165 patients aged 15 years and above who had kidney disease and needed haemodialysis. Fendrix was compared with Engerix-B (another hepatitis B vaccine) used as a double dose. The main measure of effectiveness was the proportion of patients who developed protective levels of antibodies to the hepatitis B virus.

The company also presented data on the use of Fendrix in liver transplant patients, but it withdrew the application for the use of Fendrix in these patients during the assessment.

What benefit has Fendrix shown during the studies?

Fendrix was as effective as a double dose of the comparator vaccine. One month after the last dose, 91% of the patients receiving Fendrix had protective levels of antibodies against hepatitis B, compared with 84% of those receiving the comparator.

The effect of Fendrix lasted longer than that of the comparator vaccine: 80% of the patients receiving Fendrix maintained protective levels of antibody for up to three years, compared with 51% of those receiving the comparator.

What is the risk associated with Fendrix?

The most common side effects with Fendrix (seen in more than 1 patient in 10) are headache, pain, redness, swelling at the injection site and fatigue (tiredness). For the full list of side effects reported with Fendrix, see the package leaflet.

Fendrix must not be used in people who are hypersensitive (allergic) to the active substance or any of the other ingredients, have had an allergic reaction after being given a hepatitis B vaccine. Fendrix should not be given to patients with a severe sudden fever.

Why has Fendrix been approved?

The CHMP decided that Fendrix’s benefits are greater than its risks for active immunisation against hepatitis B virus infection caused by all known subtypes for patients with renal insufficiency (including pre-haemodialysis and haemodialysis patients), from the age of 15 years onwards. The Committee recommended that Fendrix be given marketing authorisation.

Other information about Fendrix

The European Commission granted a marketing authorisation valid throughout the European Union for Fendrix on 2 February 2005.

For more information about treatment with Fendrix, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Source: European Medicines Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.