The Infusion Process with Teplizumab
The Infusion
Where will I receive the treatment?
The location where you will receive the teplizumab infusions will depend on where is the safest and most convenient for you. We want to make sure that there are as few problems as possible with your ability to receive the treatment. Since this is meant to be given every day for 14 consecutive days, it may not be possible to receive all the treatments in your HCP’s office. They may not have the ability to administer any of the treatments. Many people have received teplizumab in an Infusion Center. Others have had received the treatment at home. And, still others have had a combination (a hybrid) of using two different locations – perhaps the HCPs office or an infusion center for the first five treatments, and then at home for the remaining nine treatments.
It is currently recommended that in pediatric patients infusions take place in a clinical setting (ie, your HCP’s office, an infusion center, or an outpatient clinic) due to the potential for severe acute side effects, at least for the first 7 days. Transition to home infusions is possible if the patient is feeling well and if there is a plan in place for emergencies if the need arises. However, since the location of infusion must be determined prior to starting treatment for insurance purposes, changing locations based on needs may not be feasible. Ideally, home infusions should be limited to adult patients.
If the infusion is done at home, you will have a specialized registered nurse (RN) provide the treatments. The medication will be delivered to your home in a refrigerated container. You will need to take the medication out of the shipping container – but not out of the labeled box that the vial of medication is in – and place it in your refrigerator at home. The temperature must remain between 36° F to 46° F (2° C to 8° C) and cannot freeze. Keep the box upright (so you can read the label) and do not shake it. The RN will prepare the medication for infusion when she comes to your home. In addition, she will have direct contact with your HCP if needed, but if any labs are needed you will still need to go to your local lab (Labcorp or Quest) to have them collected as those are not done in the home setting.
How much time should I plan each day?
The first infusion (day 1) is most often scheduled to fall on a Monday. This is because the dose will increase on days 2 thru 5, which is when most adverse events/side effects are likely to occur. This way you will have quick access to your HCP if any problems develop. For patients ≥8 years of age, the infusion takes at least 30 minutes, and for patients 1 year to <8 years of age, it takes a minimum of 2 hours. However, you should plan for additional time due to monitoring or potential lab work.
Your agenda will include a brief assessment to see how you are feeling, 30 minutes for the pre-medications, the actual infusion time (30 minutes to 2 hours depending on the age of the patient), and 60 minutes for observation after the infusion has been completed.
Some days will be longer if labs are needed, or if you are not feeling well. Other days may be shorter because you might not need blood drawn and the pre-medication is given as needed after day 5.
References
- Mehta S, Ryabets-Lienhard A, Patel N, et al. Pediatric Endocrine Society statement on considerations for use of teplizumab (TzieldTM) in clinical practice. Horm Res Paediatr. 2024;Apr 30:1-12.
