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Key Elements In Monitoring for Potential Adverse Events with Bispecific Antibodies

Opinion
Video

Medical experts dissect critical strategies for monitoring for potential adverse events with bispecific antibodies in a comprehensive panel discussion.

The following is a video synopsis/summary of a Peer Exchange involving Ryan Haumschild, PharmD, MS, MBA, CPEL; Kirollos Hanna, PharmD, BCPS, BCOP, FACCC; Sarah Rockwell, PharmD, BCOP; Melody Chang, RPh, MBA, BCOP; and Ryan Cain, PA-C.

Sarah Rockwell, PharmD, BCOP, focuses on the critical monitoring procedures and protocols associated with the use of bispecific antibodies in patient treatment. Dr. Rockwell, with extensive experience in creating protocols, emphasizes the importance of ensuring correct procedures, consistency, and understanding throughout the entire treatment continuum. The conversation delves into the monitoring of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) during the step-up phase, highlighting the significance of risk evaluation and mitigation strategy (REMS) programs and inpatient administration.

Even in the maintenance setting, where the risk of CRS and ICANS is statistically lower, meticulous documentation of patient stability is crucial. The discussion extends to the infectious risks associated with long-term therapy, emphasizing the need for laboratory monitoring, including complete blood count (CBC) assessments. The consideration of intravenous immunoglobulin (IVIG) therapy is explored, with attention to factors beyond IgG levels, such as infection frequency and patient-specific indicators.

The protocols discussed encompass detailed grading scales and assessments for CRS and ICANS, aiming to ensure comprehensive monitoring and documentation by both physicians and nurses. The importance of proactive monitoring for hematologic toxicities, including neutropenia, is highlighted, with examples of adjusting therapy based on regular CBC assessments. The overall emphasis is on a conservative approach to monitoring, aligning protocols not only for observation but also for decisive actions when encountering specific lab values. The significance of managing patients effectively early on is underscored, not only for treatment success and patient outcomes but also for minimizing the total cost of care by preventing emergency department visits and hospitalizations. The dialogue emphasizes the value of aligning efforts to better manage patients and improve overall results in the context of bispecific antibody therapies.

Video synopsis is AI-generated and reviewed by AJMC editorial staff.

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