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Azacitidine, sold under the brand name Vidaza among others, is a medication used for the treatment of myelodysplastic syndrome, myeloid leukemia, and juvenile myelomonocytic leukemia. It is a chemical analog of cytidine, a nucleoside in DNA and RNA.[medical citation needed] Azacitidine and its deoxy derivative, decitabine (also known as 5-aza-2′-deoxycytidine) were first synthesized in Czechoslovakia as potential chemotherapeutic agents for cancer.
Read the full article on WikipediaAcute Myeloid Leukaemia Clinical criteria: The treatment must be used in combination with venetoclax (refer to Product Information for timing of azacitidine and venetoclax doses).
Myelodysplastic syndrome Clinical criteria: Treatment Phase: Continuing treatment Patient must have previously received PBS-subsidised treatment with this drug for this condition, AND Patient must not have progressive disease. Up to 6 cycles will be authorised.
Chronic Myelomonocytic Leukaemia Clinical criteria: Treatment Phase: Initial treatment The condition must be chronic myelomonocytic leukaemia confirmed through a bone marrow biopsy report and full blood examination report, AND The condition must have 10% to 29% marrow blasts without Myeloproliferative Disorder. The first authority application must be made via the Online PBS Authorities System (real time assessment), or in writing via HPOS form upload or mail and must include: (a) details (date, unique identifying number/code or provider number) of the bone marrow biopsy report from an Approved Pathology Authority demonstrating that the patient has chronic myelomonocytic leukaemia; and (b) details (date, unique identifying number/code or provider number) of the full blood examination report from an Approved Pathology Authority All reports must be documented in the patient's medical records. If the application is submitted through HPOS form upload or mail, it must include: (i) A completed authority prescription form; and (ii) A completed authority application form relevant to the indication and treatment phase (the latest version is located on the website specified in the Administrative Advice). The following reports must be documented in the patient's medical records: (a) bone marrow biopsy report demonstrating that the patient has chronic myelomonocytic leukaemia; and (b) full blood examination report No more than 3 cycles will be authorised under this restriction in a patient's lifetime.
“Azacitidine is a chemical analogue of the nucleoside cytidine, which is present in DNA and RNA. It is thought to have antineoplastic activity via two mechanisms – at low doses, by inhibiting of DNA methyltransferase, causing hypomethylation of DNA, and at high doses, by its direct cytotoxicity to abnormal hematopoietic cells in the bone marrow through its incorporation into DNA and RNA, resulting in cell death. Azacitidine is a ribonucleoside, so it is incorporated into RNA to a larger extent than into DNA. In contrast, decitabine (5-aza-2'-deoxycytidine) is a deoxyribonucleoside, so it can only incorporate into DNA. Azacitidine's incorporation into RNA leads to the disassembly of polyribosomes, defective methylation and acceptor function of transfer RNA, and inhibition of the production of proteins. Its incorporation into DNA leads to covalent binding with DNA methyltransferases, which prevents DNA synthesis and subsequently leads to cytotoxicity. It has been shown effective against human immunodeficiency virus in vitro and human T-lymphotropic virus.”
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