Darzalex, otherwise known as daratumumab, is the first monoclonal antibody that has been approved for use in treating multiple myeloma. It can be taken either in combination with other medications or alone.
For multiple myeloma patients who have received at least one prior treatment, Darzalex is used in combination with and , or with and .
For multiple myeloma patients who have received at least three prior treatments, Darzalex is used alone. These patients will need to have been treated previously with a proteasome inhibitor and an immunomodulatory agent and did not respond to either treatment courses.
The patients that can benefit the most from Darzalex are those who have received several previous therapies; who were refractory to proteasome inhibitors and immunomodulatory agents; who have previously received high-dose chemotherapy and/or a stem cell transplant; who have reduced kidney function; or who have mildly reduced liver function.
Darzalex works by binding to CD38, which is a marker found on the surface of myeloma cells. Darzalex may inhibit myeloma cell growth by directly affecting myeloma cells or by enabling immune cells to kill the myeloma cells.
There are several side effects to taking Darzalex. The most common side effects include:
- Infusion reactions*
- Fatigue
- Nausea
- Back pain
- Fever
- Cough
- Upper respiratory infection
*Severe infusion reactions include muscle spasms in the major airways of the lungs, low oxygen levels, difficulty breathing, and high blood pressure. To reduce the risk of infusion reactions, patients may be prescribed premedication with antihistamines, fever-reducing agents, and steroids before starting Darzalex. To reduce the risk of delayed infusion reactions, patients may be prescribed a steroid.
There are also more serious side effects that can occur when taking Darzalex. These include:
- Low lymphocyte count
- Low red blood cell count
- Low neutrophil count
- Low platelet count
Darzalex will be discontinued if a patient experiences any of the above life-threatening infusion reactions or experience multiple severe reactions.
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