Revlimid is a medicine containing the active substance lenalidomide. It is available as capsules (white: 5 mg; blue-green and yellow: 10 mg; blue and white: 15 mg; white: 25 mg).
|Table of Contents|
|What is it used for?|
|How is it used?|
|How does it work?|
|How has it been studied?|
|What benefits has it shown during the studies?|
|What is the risk associated?|
|Why has it been approved?|
Revlimid is an anticancer medicine. It is used in combination with dexamethasone (an anti-inflammatory medicine) to treat adult patients with multiple myeloma whose disease has been treated at least once in the past. Multiple myeloma is a cancer of the plasma cells in the bone marrow. Because the number of patients with multiple myeloma is low, the disease is considered ?rare?, and Revlimid was designated an ?orphan medicine? (a medicine used in rare diseases) on 12 December 2003.
The medicine can only be obtained with a prescription.
Treatment with Revlimid must be initiated and monitored by doctors who have experience in the management of multiple myeloma.
Revlimid is taken in repeated 28-day cycles: the patient takes the medicine once a day for 21 days, followed by seven days off the medicine. Dexamethasone should be taken at a dose of 40 mg once a day on days 1 to 4, 9 to 12 and 17 to 20 of the first four cycles, and on days 1 to 4 thereafter. The recommended dose of Revlimid is 25 mg a day. This dose should be reduced or treatment interrupted depending on the patient?s condition and the levels of platelets (components in the blood that aid clotting) and of neutrophils (a type of white blood cell). A lower dose should also be used in patients who have moderate or more severe problems with their kidneys. For more information, see the Summary of Product Characteristics (also part of the EPAR).
Revlimid should be taken at around the same time each day. The capsules should be swallowed whole, preferably with water.
The active substance in Revlimid, lenalidomide, is an immunomodulating agent. This means that it affects the activity of the immune system (the body?s natural defences). Lenalidomide works in a number of different ways in multiple myeloma: it blocks the development of tumour cells, prevents the growth of blood vessels within tumours and also stimulates some of the specialised cells of the immune system to attack the cancerous cells.
The effects of Revlimid were first tested in experimental models before being studied in humans. Revlimid was studied in two main studies involving 704 patients with multiple myeloma. In both studies, Revlimid was compared with placebo (a dummy treatment), both taken in combination with dexamethasone. The main measure of effectiveness was how long it took until the disease got worse.
Revlimid was more effective than placebo at preventing a worsening of multiple myeloma. The results of the two studies taken together showed that, on average, it took 48.3 weeks for the disease to get worse in patients taking Revlimid, compared with 20.1 weeks in those taking placebo.
The most common side effects with Revlimid (seen in more than 1 patient in 10) are neutropenia (low neutrophil counts), fatigue (tiredness), asthenia (weakness), constipation, muscle cramp, thrombocytopenia (low platelet counts), anaemia (low red blood cell counts), diarrhoea and rash. For the full list of all side effects reported with Revlimid, see the Package Leaflet.
Lenalidomide is expected to be harmful to the unborn child. Therefore, Revlimid must not be used in women who are pregnant. It must also not be used in women who could become pregnant, unless they take all of the necessary steps to ensure that they are not pregnant before treatment and that they do not become pregnant during or soon after treatment. Revlimid should not be used by people who may be hypersensitive (allergic) to lenalidomide or any of the other ingredients. For the full list of restrictions, see the Package Leaflet.
The Committee for Medicinal Products for Human Use (CHMP) decided that, in combination with dexamethasone, Revlimid?s benefits are greater than its risks for the treatment of multiple myeloma patients who have received at least one prior therapy. The Committee recommended that Revlimid be given marketing authorisation.