Privacy Policy

Vanda Pharmaceuticals Inc. (Vanda) considers the privacy and security of user information an important component of the service offered at its website, vandapharma.com (Site). The following information explains how Vanda collects and uses information obtained from users in connection with services available at the Site (taken together, the Service).

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Information Collected

At your election ("opt-in"), you may request additional information about Vanda or subscribe to various information services concerning Vanda's products, services and business. When you do so, our registration process requires you to provide your name, company name, address, telephone number, email address and certain additional information about your interest in Vanda (collectively, Subscription Data).

When you visit the Site, web servers collect information "traffic data" (such as, for example, time and date, the address of the website from which you entered the Site) about your visit, which is stored as anonymous, aggregate data. Collecting such data may entail the use of IP addresses or other numeric codes used to identify a computer.

Use of Information

Vanda uses Subscription Data to respond to your inquiries for additional information, and in providing additional information according to your preferences. Sometimes Subscription Data is used to send you information about Vanda and its products and services. At your election at any time ("opt-out"), you may choose to stop receiving future communications from Vanda (see below). Vanda uses "traffic data" to help diagnose problems with its server, analyze trends and administer the Site. Your IP address is not linked to personally identifiable information, but is used to gather broad demographic data and to monitor statistics to improve the Service.

Sharing of Information

Currently, Vanda will not share personally identifiable information with any third party for commercial purposes. Vanda may, however, disclose personally identifiable data if (1) it is required to do so by law or (2) it has a good faith belief that such action is necessary to conform to applicable laws or comply with any legal, regulatory or similar requirement or investigation, to protect or defend the rights or property of Vanda or another user or to enforce the Terms of Use.

Vanda may transfer personally identifiable information to any successor to all or substantially all of its business or assets that concern the Service.

Security

Information collected by Vanda is stored in secure operating environments that are not made generally available to the public. Unfortunately, no data transmission over the Internet can be guaranteed to be 100% secure. As a result, Vanda cannot ensure the security of any information you provide, and you do so at your own risk. Once Vanda receives your transmission, it will make reasonable efforts to ensure its security on its systems.

IP Addresses and Cookies.

Vanda also uses cookies. "Cookies" are pieces of information that a website transfers to your computer's hard disk for record-keeping purposes. Cookies in and of themselves do not personally identify users, although they do identify a user's computer. Vanda generally uses cookies to determine which areas of the Site users have visited and to compare users' experiences in using the Site so that it may better tailor the Site content and advertisements to your interests both on and off our sites. You may be able to set your web browser to refuse cookies.

Opt-Out.

The Service may permit you to link to other websites on the Internet, and other websites may contain links to the Site. These other websites are not under Vanda's control. The privacy and security practices of websites linked to or from the Site are not covered by this Privacy Statement, and Vanda is not responsible for the privacy or security practices or the content of such websites.

Changes.

Vanda reserves the right to change or update this Privacy Statement at any time by posting a notice at the Site. Information collected by the Service is subject to the Privacy Statement in effect at the time of use.

Contact

If you have any questions regarding this Privacy Statement or your dealings at this Site, please contact Vanda at:
Vanda Pharmaceuticals Inc.
Attn: Privacy Statement 2200 Pennsylvania Ave NW
Suite 300E
Washington, DC 20037
Tel: 202-734-3400
Email: info@vandapharma.com

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS

PONVORY® is contraindicated in patients who:

  • In the last 6 months experienced myocardial infarction, unstable angina, stroke, transient ischemic attack (TIA), decompensated heart failure requiring hospitalization, or Class III or IV heart failure.
  • Have presence of Mobitz Type II second-degree, third-degree atrioventricular (AV) block, or sick sinus syndrome, or sino-atrial block, unless patient has a functioning pacemaker.

WARNINGS AND PRECAUTIONS

Risk of Infections

PONVORY® causes a dose-dependent reduction in peripheral lymphocyte count to 30-40% of baseline values because of reversible sequestration of lymphocytes in lymphoid tissues. PONVORY® may increase the susceptibility to infections. Life-threatening and rare fatal infections have been reported in association with other sphingosine 1-phosphate (S1P) receptor modulators. Before initiating treatment with PONVORY®, results from a recent complete blood count including lymphocyte count should be reviewed. Monitor for infection during treatment and for 1-2 weeks after discontinuation. Do not start PONVORY® in patients with active infection.

Herpes Viral Infections

Cases of herpes viral infection have been reported in the development program of PONVORY®; herpes simplex encephalitis and varicella zoster meningitis have been reported with other S1P receptor modulators. Patients without a healthcare professional confirmed history of varicella (chickenpox) or without documentation of a full course of vaccination should be tested for antibodies to VZV prior to initiating PONVORY®.

Cryptococcal Infections

Cases of fatal cryptococcal meningitis (CM) and disseminated cryptococcal infections have been reported with other S1P receptor modulators. Physicians should be vigilant for clinical symptoms or signs of CM. Patients with symptoms or signs consistent with a cryptococcal infection should undergo prompt diagnostic evaluation and treatment. PONVORY® treatment should be suspended until a cryptococcal infection has been excluded. If CM is diagnosed, appropriate treatment should be initiated.

Progressive Multifocal Leukoencephalopathy (PML)

PML has been reported in patients treated with a S1P receptor modulator and other multiple sclerosis (MS) therapies and has been associated with some risk factors (e.g., immunocompromised patients, polytherapy with immunosuppressants). Physicians should be vigilant for clinical symptoms or magnetic resonance imaging (MRI) findings that may be suggestive of PML. MRI findings may be apparent before clinical signs or symptoms. If PML is suspected, treatment with PONVORY® should be suspended until PML has been excluded.

If PML is confirmed, treatment with PONVORY® should be discontinued.

Immune reconstitution inflammatory syndrome (IRIS) has been reported in patients treated with S1P receptor modulators who developed PML and subsequently discontinued treatment. IRIS presents as a clinical decline in the patient’s condition that may be rapid, can lead to serious neurological complications or death, and is often associated with characteristic changes on MRI. The time to onset of IRIS in patients with PML was generally within a few months after S1P receptor modulator discontinuation. Monitoring for development of IRIS and appropriate treatment of the associated inflammation should be undertaken.

Prior and Concomitant Treatment with Anti-neoplastic, Immune-Modulating, or Immunosuppressive Therapies

Anti-neoplastic, immune-modulating, or immunosuppressive therapies (including corticosteroids) should be co-administered with caution because of the risk of additive immune system effects.

Vaccinations

Patients without a confirmed history of chickenpox or without documentation of a full course of vaccination against VZV should be tested for antibodies to VZV before initiating PONVORY® treatment. A full course of vaccination for antibody-negative patients with varicella vaccine is recommended prior to commencing treatment with PONVORY®, following which initiation of treatment should be postponed for 4 weeks to allow the full effect of vaccination to occur.

No clinical data are available on the efficacy and safety of vaccinations in patients taking PONVORY®. Vaccinations may be less effective if administered during PONVORY® treatment. If live attenuated vaccines are required, administer at least 1 month prior to initiation of PONVORY®. Avoid the use of live attenuated vaccines during and for 1 to 2 weeks after treatment of PONVORY®.

Bradyarrhythmia and Atrioventricular Conduction Delays

Since initiation of PONVORY® treatment results in a transient decrease in heart rate and atrioventricular (AV) conduction delays, an up-titration scheme must be used to reach the maintenance dosage of PONVORY® (20 mg).

Reduction in Heart Rate

Initiation of PONVORY® may result in a transient decrease in heart rate. After the first titration dose of PONVORY®, the decrease in heart rate typically begins within an hour and reaches its nadir within 2-4 hours. The heart rate typically recovers to baseline levels 4-5 hours after administration.

Atrioventricular Conduction Delays

Initiation of PONVORY® treatment has been associated with transient atrioventricular conduction delays that follow a similar temporal pattern as the observed decrease in heart rate during dose titration. If treatment with PONVORY® is considered, advice from a cardiologist should be sought for individuals:

  • With significant QT prolongation (QTc greater than 500 msec).
  • With atrial flutter/fibrillation or arrhythmia treated with Class Ia or Class III anti-arrhythmic drugs.
  • With unstable ischemic heart disease, cardiac decompensated failure occurring more than 6 months prior to treatment initiation, history of cardiac arrest, cerebrovascular disease (TIA, stroke occurring more than 6 months prior to treatment initiation), or uncontrolled hypertension.
  • With a history of Mobitz Type II second degree AV block or higher-grade AV block, sick-sinus syndrome, or sino-atrial heart block.

Obtain an ECG in all patients to determine whether preexisting conduction abnormalities are present. For patients taking other drugs that decrease heart rate, treatment with PONVORY® should generally not be initiated without consultation from a cardiologist because of the potential effect on heart rate. In all patients, a dose titration is recommended for initiation of PONVORY® treatment to help reduce cardiac effects.

Respiratory Effects

Dose-dependent reductions in forced expiratory volume over 1 second (FEV1) and reductions in diffusion lung capacity for carbon monoxide (DLCO) were observed in PONVORY®-treated patients mostly occurring in the first month after treatment initiation. Spirometric evaluation of respiratory function should be performed during therapy with PONVORY® if clinically indicated.

Liver Injury

Elevations of transaminases may occur in PONVORY®-treated patients. Obtain transaminase and bilirubin levels, if not recently available (i.e., within last 6 months) before initiation of PONVORY® therapy.

Patients who develop symptoms suggestive of hepatic dysfunction, such as unexplained nausea, vomiting, abdominal pain, fatigue, anorexia, rash with eosinophilia, or jaundice and/or dark urine during treatment, should have hepatic enzymes checked. PONVORY® should be discontinued if significant liver injury is confirmed.

No dosage adjustment is necessary in patients with mild hepatic impairment (Child-Pugh class A). PONVORY® is not recommended in patients with moderate or severe hepatic impairment (Child-Pugh class B and C, respectively).

Increased Blood Pressure

PONVORY®-treated patients had an average increase of 2.9 mmHg in systolic blood pressure and 2.8 mmHg in diastolic blood pressure. Blood pressure should be monitored during treatment with PONVORY® and managed appropriately.

Cutaneous Malignancies

Cases of basal cell carcinoma and other skin malignancies have been reported in patients treated with S1P receptor modulators, including PONVORY®. Periodic skin examination is recommended for all patients, particularly those with risk factors for skin cancer. Providers and patients are advised to monitor for suspicious skin lesions. If a suspicious skin lesion is observed, it should be promptly evaluated. As usual for patients with increased risk for skin cancer, exposure to sunlight and ultraviolet light should be limited by wearing protective clothing and using a sunscreen with a high protection factor. Concomitant phototherapy with UV-B radiation or PUVA-photochemotherapy is not recommended in patients taking PONVORY®.

Fetal Risk

Based on animal studies, PONVORY® may cause fetal harm. Because it takes approximately 1 week to eliminate PONVORY® from the body, women of childbearing potential should use effective contraception to avoid pregnancy during and for 1 week after stopping PONVORY® treatment.

Macular Edema

S1P receptor modulators, including PONVORY®, have been associated with an increased risk of macular edema. An ophthalmic evaluation of the fundus, including the macula, is recommended in all patients before starting treatment and again at any time if a patient reports any change in vision while on PONVORY® therapy. Continuation of therapy in patients with macular edema has not been evaluated.

Macular Edema in Patients with a History of Uveitis or Diabetes Mellitus

Patients with a history of uveitis and patients with diabetes mellitus are at increased risk of macular edema during therapy with S1P receptor modulators, including PONVORY®. Therefore, these patients should have regular follow-up examinations of the fundus, including the macula, during treatment with PONVORY®.

Posterior Reversible Encephalopathy Syndrome

Rare cases of posterior reversible encephalopathy syndrome (PRES) have been reported in patients receiving a sphingosine 1-phosphate (S1P) receptor modulator. Such events have not been reported for PONVORY®-treated patients in the development program. However, should a PONVORY®-treated patient develop any unexpected neurological or psychiatric symptoms/signs (e.g., cognitive deficits, behavioral changes, cortical visual disturbances, or any other neurological cortical symptoms/signs), any symptom/sign suggestive of an increase of intracranial pressure, or accelerated neurological deterioration, the physician should promptly schedule a complete physical and neurological examination and should consider an MRI. Symptoms of PRES are usually reversible but may evolve into ischemic stroke or cerebral hemorrhage. Delay in diagnosis and treatment may lead to permanent neurological sequelae. If PRES is suspected, PONVORY® should be discontinued.

Unintended Additive Immunosuppressive Effects from Prior Treatment with Immunosuppressive or Immune-Modulating Therapies

When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive effects on the immune system while at the same time minimizing risk of disease reactivation, when initiating PONVORY®. Initiating treatment with PONVORY® after treatment with alemtuzumab is not recommended.

Severe Increase in Disability After Stopping PONVORY®

Severe exacerbation of disease, including disease rebound, has been rarely reported after discontinuation of a S1P receptor modulator. The possibility of severe exacerbation of disease should be considered after stopping PONVORY® treatment. Patients should be observed for a severe increase in disability upon PONVORY® discontinuation and appropriate treatment should be instituted, as required.

After stopping PONVORY® in the setting of PML, monitor for development of immune reconstitution inflammatory syndrome (PML-IRIS).

Immune System Effects After Stopping PONVORY®

After stopping PONVORY® therapy, ponesimod remains in the blood for up to 1 week.

Starting other therapies during this interval will result in concomitant exposure to ponesimod. Lymphocyte counts returned to the normal range in 90% of patients within 1 week of stopping therapy, however, residual pharmacodynamics effects, such as lowering effects on peripheral lymphocyte count, may persist for 1 to 2 weeks after the last dose. Use of immunosuppressants within this period may lead to an additive effect on the immune system, and therefore caution should be applied 1 to 2 weeks after the last dose of PONVORY®.

Strong CYP3A4 and UGT1A1 Inducers

In vitro assessments and limited clinical data indicated that concomitant use of strong CYP3A4 and UGT1A1 inducers (e.g., rifampin, phenytoin, carbamazepine) may decrease the systemic exposure of ponesimod. It is unclear whether this decrease in ponesimod systemic exposure would be considered of clinical relevance. Coadministration of PONVORY® with strong CYP3A4 and UGT1A1 inducers is not recommended.

OVERDOSAGE

In patients with overdosage of PONVORY®, especially upon initiation/re-initiation of treatment, it is important to observe for signs and symptoms of bradycardia as well as AV conduction blocks, which may include overnight monitoring. Regular measurements of pulse rate and blood pressure are required, and ECGs should be performed.

There is no specific antidote to ponesimod. Neither dialysis nor plasma exchange would result in meaningful removal of ponesimod from the body. The decrease in heart rate induced by PONVORY® can be reversed by atropine.

In the event of overdose, PONVORY® should be discontinued, and general supportive treatment given until clinical toxicity has been diminished or resolved. It is advisable to contact a poison control center to obtain the latest recommendations for the management of an overdose.

ADVERSE REACTIONS

Most common adverse reactions (incidence at least 10%) are upper respiratory tract infection, hepatic transaminase elevation, and hypertension.

Please see full Prescribing Information and Medication Guide.

PON0053 3/24

References: 1. PONVORY®. Prescribing information. Vanda Pharmaceuticals, Inc; 2024. 2. Rae-Grant A, Day GS, Marrie RA, et al. Practice guideline recommendations summary: Disease-modifying therapies for adults with multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018;90:777-788. doi:10.1212/WNL.0000000000005347 3. Inojosa H, Proschmann U, Akgün K, Ziemssen T. The need for a strategic therapeutic approach: Multiple sclerosis in check. Ther Adv Chronic Dis. 2022;13:20406223211063032. doi:10.1177/20406223211063032 4. Kappos L, Fox RJ, Burcklen M, et al. Ponesimod compared with teriflunomide in patients with relapsing multiple sclerosis in the active-comparator phase 3 OPTIMUM study: A randomized clinical trial. JAMA Neurol. 2021;78(5):558-567. doi:10.1001/jamaneurol.2021.0405 5. Olsson T, Boster A, Fernández Ó, et al. Oral ponesimod in relapsing–remitting multiple sclerosis: a randomised phase II trial. J Neurol Neurosurg Psychiatry. 2014;85:1198-1208. doi:10.1136/jnnp-2013-307282 6. ZEPOSIA® (ozanimod). Prescribing information. Celgene Corp; 2022. 7. MAYZENT® (siponimod). Prescribing information. Novartis Pharmaceuticals Corp; 2023. 8. GILENYA® (fingolimod). Prescribing information. Novartis Pharmaceuticals Corp; 2022.

INDICATION

PONVORY® is a sphingosine 1-phosphate receptor modulator indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.