Interactions : אינטראקציות

4.5   Interaction with other medicinal products and other forms of interaction
Imlifidase specifically cleaves IgG; the species specificity results in degradation of all subclasses of human and rabbit IgG. As a consequence, medicinal products based on human or rabbit IgG may be inactivated if given in connection with imlifidase. Antibody-based medicinal products cleaved by imlifidase include, but are not limited to basiliximab, rituximab, alemtuzumab, adalimumab, denosumab, belatacept, etanercept, rATG and IVIg.

Imlifidase does not degrade equine anti-thymocyte globulin and no time interval between administrations needs to be considered. Eculizumab is not cleaved by imlifidase at the recommended dose level.

Table 1      Recommended time intervals for administration of antibody-based medicinal products after administration of imlifidase
Medicinal product                         Recommended time interval after administration of 0.25 mg/kg imlifidase equine anti-thymocyte globulin,           No time interval needed (can be administered eculizumab                                concomitantly with imlifidase) intravenous immunoglobulin (IVIg)         12 hours alemtuzumab, adalimumab,                  4 days basiliximab, denosumab, etanercept,
rituximab rabbit anti-human thymocyte globulin      1 week
(rATG), belatacept

Also, IVIg may contain neutralising antibodies against imlifidase, which may inactivate imlifidase if IVIg is given before imlifidase. The half-life of IVIg (3-4 weeks) should be considered before imlifidase administration to patients treated with IVIg. In clinical studies, IVIg was not administered within 4 weeks before imlifidase infusion.