From the Guidelines
Granix (tbo-filgrastim) is a granulocyte colony-stimulating factor (G-CSF) medication used to stimulate bone marrow to produce neutrophils, primarily to prevent infection in patients undergoing chemotherapy. The standard adult dose is 5 mcg/kg/day given as a subcutaneous injection, typically starting 1 to 3 days after administration of myelotoxic chemotherapy, as recommended by the American Society of Clinical Oncology 1.
Key Points
- The medication should be continued until reaching an absolute neutrophil count (ANC) of 2 to 3 x 10^9/L.
- The preferred route of tbo-filgrastim administration is subcutaneous.
- Patients should be monitored for bone pain, which is a common side effect that can be managed with analgesics.
- Other potential side effects include allergic reactions, spleen enlargement, and rarely, acute respiratory distress syndrome.
- Granix works by binding to specific receptors on neutrophil precursors in the bone marrow, stimulating their proliferation, differentiation, and activation, which helps prevent neutropenia-related infections during chemotherapy.
Administration and Storage
- The medication should be stored in a refrigerator but can be kept at room temperature for a short period.
- Patients should be educated on proper injection technique if self-administering and instructed to report any fever, shortness of breath, or severe abdominal pain immediately.
Clinical Guidelines
- The use of G-CSF, including tbo-filgrastim, is recommended for primary prophylaxis of febrile neutropenia in patients with a high risk of infection, as stated in the guidelines by the American Society of Clinical Oncology 1 and other organizations 1.
From the FDA Drug Label
GRANIX (tbo-filgrastim) is a non-glycosylated recombinant methionyl human granulocyte colony-stimulating growth factor (r-metHuG-CSF) manufactured by recombinant DNA technology using the bacterium strain E coli K802. Tbo-filgrastim is a human granulocyte colony-stimulating factor (G-CSF) produced by recombinant DNA technology. Tbo-filgrastim binds to G-CSF receptors and stimulates proliferation of neutrophils.
Granix (tbo-filgrastim) is a granulocyte-colony stimulating factor (G-CSF), which is a type of protein that stimulates the production of neutrophils, a type of white blood cell. It is produced by recombinant DNA technology and is used to increase neutrophil counts and activity in patients with certain medical conditions. 2 2 2
From the Research
Definition and Mechanism of Granix (tbo-filgrastim)
- Granix (tbo-filgrastim) is a recombinant human granulocyte colony-stimulating factor (G-CSF) used to reduce the duration of severe neutropenia in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia 3.
- G-CSF stimulates the proliferation, differentiation, and function of neutrophils, which are a type of white blood cell that plays a crucial role in fighting infections 4.
Clinical Safety and Efficacy
- The clinical safety of tbo-filgrastim has been evaluated in three phase III studies in 677 patients receiving myelosuppressive chemotherapy, and the results showed that tbo-filgrastim had a similar safety profile to Neupogen (filgrastim) 3.
- Tbo-filgrastim has been shown to be effective in reducing the duration of severe neutropenia and the incidence of febrile neutropenia in patients receiving myelosuppressive chemotherapy 3.
- The most common adverse events related to tbo-filgrastim were bone pain, myalgia, and asthenia 3.
Comparison with Other G-CSF Agents
- Tbo-filgrastim has been compared to Neupogen (filgrastim) in clinical studies, and the results showed that tbo-filgrastim had similar efficacy and safety profiles to Neupogen 3.
- Pegfilgrastim, a long-acting form of filgrastim, has also been studied as a potential alternative to daily filgrastim injections, and the results showed that pegfilgrastim had similar efficacy and safety profiles to filgrastim 4, 5.