What are the precautions for Ripretinib?

Patients should be aware of the occurrence of palmar-plantar dysesthesia syndrome, new primary cutaneous malignancies, hypertension, cardiac dysfunction, impaired wound healing, and photosensitivity during treatment with Ripretinib.

1. Palm-Plantar Paresthesia Syndrome (PPES): The study showed that 21% of 85 patients who received repetinib treatment developed grade 1-2 palmar-plantar erythrodysesthesia syndrome. PPES resulted in dose interruptions in 1.2% of patients, dose interruptions in 2.4% of patients, and dose reductions in 1.2% of patients. Withholdrepetinib based on severity and resume at the same or reduced dose.

2. New primary cutaneous malignant tumors: In the study, 4.7% of 85 patients who received repetinib developed cutaneous squamous cell carcinoma (cuSCC), and 2.4% of patients developed melanoma. Perform dermatologic evaluation upon initiation of repetinib and routinely during treatment, manage suspected skin lesions with excision and dermatopathology evaluation, and continue repetinib at the same dose.

3. Hypertension: 14% of the 85 patients treated with repetinib developed grade 1-3 hypertension, and 7% of them developed grade 3 hypertension. Do not use ripatinib in patients with uncontrolled hypertension. Control blood pressure adequately before initiating. Discontinue ripatinib based on severity, then resume at the same or reduced dose or permanently discontinue.

4. Heart dysfunction: 1.2% of the 85 patients treated with repetinib developed heart failure, including heart failure, acute left heart failure, diastolic dysfunction and ventricular hypertrophy. Assess ejection fraction by echocardiography or MUGA scan before initiating repetinib and during treatment as clinically indicated. For grade 3 or 4 left ventricular systolic dysfunction, permanently discontinue repetinib.

5. Impaired wound healing: Patients receiving drugs that inhibit the vascular endothelial growth factor (VEGF) signaling pathway may develop complications from wound healing disorders. Discontinue repetinib for at least one week before elective surgery and for at least two weeks after major surgery until the wound has completely healed. Recovery after resolution of wound healing complicationsThe safety of repetinib has not been established.

6. Photosensitivity: It is recommended that patients limit direct exposure to ultraviolet light during treatment with repetinib and for at least one week after stopping treatment.

RipetinibThe original drug has been launched in China and has been approved by the National Medical Insurance Bureau to enter the scope of Class B medical insurance, but only for patients who meet the indications. SpecificationsThe price of each box of 50mg*30 tablets may be around 30,000 yuan, which may increase the pressure on families with heavy financial burdens. The US version of Ripetinib Specifications50mg*90 tablets sold overseas may be priced around RMB 77,000 per box (the price may fluctuate due to exchange rates). The ingredients of foreign original drugs are basically the same as those of domestic original drugs. Currently, there is no generic drug of Ripetinib produced and marketed overseas. For specific prices and drug information, please consult Yaode’s medical consultant.