Brand Name(s): Casgevy^®

WHY is this medicine prescribed?

Exagamglogene autotemcel is used in adults and children 12 years of age and older who have sickle cell disease (SCD; inherited disease of the red blood cells that cause them to not move as well causing disruption of blood flow) with a history of vaso-occlusive events (complications from SCD that may include pain crises, chest pain, and stroke) or with transfusion-dependent beta thalassemia (TDT; inherited blood disorder where body does not product enough beta globin, required to make hemoglobin, so blood transfusions are required for survival). Exagamglogene autotemcel is in a class of medications called autologous cellular immunotherapy, a type of medication prepared using cells from the patient's own blood. It works by helping the body to make hemoglobin which helps keep cells from sickling in SCD and helps produce more healthy hemoglobin in TDT patients.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Exagamglogene autotemcel comes as a suspension (liquid) to be injected intravenously (into a vein) by a doctor or nurse in a hospital or infusion center. Before you receive your exagamglogene autotemcel dose, your doctor or nurse will administer other chemotherapy medications to prepare your body for exagamglogene autotemcel.

Before your dose of exagamglogene autotemcel injection is to be given, a sample of your blood stem cells will be taken at a hospital or treatment center using a process called mobilization and apheresis (a process that removes blood stem cells from the body). This process usually takes about 1 week and may need to be repeated. The sample will be sent to the manufacturer to prepare a dose of exagamglogene autotemcel injection. It may take up to 6 months after your blood stem cells are collected before they are ready to be given to you. Because this medication is made from your own cells, it must be given only to you.

You will have to stay in the hospital for about 4-6 weeks after you receive your exagamglogene autotemcel dose to monitor you for any side effects. Talk to your doctor about how to prepare for mobilization and apheresis and what to expect during and after the procedure.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before receiving exagamglogene autotemcel,

• tell your doctor and pharmacist if you are allergic to exagamglogene autotemcel, dimethyl sulfoxide (DMSO), any other medications, or any of the ingredients in exagamglogene autotemcel injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

• The following nonprescription or herbal products may interact with exagamglogene autotemcel: iron chelators. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking lovotibeglogene autotemcel. Do not start any of these medications while taking exagamglogene autotemcel without discussing with your healthcare provider.

• tell your doctor if you have or have ever had low platelets, or liver or kidney disease. Tell your doctor if you have an infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV). Tell your doctor if you have a history of hematopoietic stem cell (HSC) transplant.

• tell your doctor if you are pregnant or plan to become pregnant. You should not become pregnant while you are receiving exagamglogene autotemcel injection. You will need to have a pregnancy test before mobilization, and you should use birth control to prevent pregnancy starting with mobilization and for 6 months after you receive exagamglogene autotemcel injection. If you are a male with a female partner who may become pregnant, you should use birth control to prevent pregnancy during you treatment and for 6 months after you receive exagamglogene autotemcel injection. Talk to your doctor about birth control methods that will work for you. If you or your partner become pregnant while receiving exagamglogene autotemcel injection, call your doctor immediately. Exagamglogene autotemcel injection may cause fetal harm.

• tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while your are receiving exagamglogene autotemcel injection therapy.

• do not donate blood, organs, tissues, or cells for transplantation after you receive exagamglogene autotemcel injection.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Exagamglogene autotemcel may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• mouth sores
• abdominal pain
• decreased appetite
• muscle aches or pains
• itching
• nosebleeds

Some side effects can be serious. If you experience any of these symptoms, tell your doctor immediately:

• unusual bruising or bleeding, nose bleeding, severe headache, blood in urine, stool, or vomit, coughing up blood, or unusual abdominal or back pain
• fever, sore throat, ongoing cough and congestion, or other signs of infection
• hives; rash; itching; swelling of the lips, tongue, or throat; shortness of breath or difficulty breathing

Exagamglogene autotemcel may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will may order certain lab tests to check your body's response to exagamglogene autotemcel injection.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are receiving exagamglogene autotemcel injection.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: April 20, 2024.