PATIENT SUPPORT

NAVIGATION YOUR PATIENTS CAN DEPEND ON

IMCIVREE GPS is here to make it easier for patients to seamlessly incorporate IMCIVREE into their lives. Our dedicated team of Care Partners will collaborate with your patients to find out how we can help, and tailor a plan for their unique situation.

We offer:

  • Guidance to help patients get started with their new treatment
  • Partnership as patients navigate their financial considerations
  • Support for their ongoing therapy

We can:

  • Help patients understand their insurance benefits
  • Explore financial support options
  • Provide training for how to inject IMCIVREE
  • Ensure patients’ IMCIVREE and supplies are there when they need them
  • Offer IMCIVREE education and support

Tell your patients they can give us a call
at 1-844-YOUR-GPS (1-844-968-7477)
Monday–Friday, 8 AM to 8 PM ET. We’re ready to help

Interested in starting a patient on IMCIVREE?
Download and complete the Start Form

PATIENT RESOURCES

WE ARE COMMITTED TO PROVIDING SUPPORT TO YOU AND YOUR PATIENTS

Resources are available on the IMCIVREE patient website, www.IMCIVREE.com

STARTING IMCIVREE

GETTING YOUR PATIENT STARTED ON IMCIVREE

To prescribe IMCIVREE, verify that your patient has:

1. A diagnosis of obesity due to POMC, PCSK1, or LEPR deficiency confirmed by genetic testing

2. A completed IMCIVREE Start Form (including a copy of the genetic test results)

Rhythm Pharmaceuticals offers free* genetic testing for rare genetic diseases of obesity to eligible patients. Additional information is available at www.UncommonObesity.com/test or by calling Prevention Genetics at 1-844-513-3994, Monday–Friday from 9 AM to 8 PM ET.

For questions on IMCIVREE, call 1-844-YOUR-GPS (844-968-7477)
Monday–Friday, 8 AM to 8 PM ET

POMC=pro-opiomelanocortin; PCSK1=proprotein convertase subtilisin/kexin type 1; LEPR=leptin receptor.
*Rhythm Pharmaceuticals covers cost of test only—excludes office visit, sample collection, and any other related costs to patient.

FAQs

FREQUENTLY ASKED QUESTIONS ABOUT IMCIVREE

What is IMCIVREE indicated for?

IMCIVREE is indicated for chronic weight management in adult and pediatric patients 6 years of age and older with obesity due to proopiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency. The condition must be confirmed by genetic testing demonstrating variants in POMC, PCSK1, or LEPR genes that are interpreted as pathogenic, likely pathogenic, or of uncertain significance (VUS).1

IMCIVREE is not indicated for the treatment of patients with the following conditions as IMCIVREE would not be expected to be effective1:

  • Obesity due to suspected POMC, PCSK1, or LEPR deficiency with POMC, PCSK1, or LEPR variants classified as benign or likely benign
  • Other types of obesity not related to POMC, PCSK1, or LEPR deficiency, including obesity associated with other genetic syndromes and general (polygenic) obesity

Are there any contraindications to IMCIVREE?

No. There are no contraindications to IMCIVREE.1

Do I have to submit the results of genetic testing with the Start Form?

Yes, you must send your patient’s genetic test results with the IMCIVREE Start Form. Rhythm Pharmaceuticals offers free* genetic testing for rare genetic diseases of obesity to eligible patients. Additional information is available at www.UncommonObesity.com/test or by calling Prevention Genetics at 1-844-513-3994, Monday–Friday, 9 AM to 8 PM ET.

*Rhythm Pharmaceuticals covers cost of test only—excludes office visit, sample collection, and any other related costs to patient.

How is IMCIVREE administered?

IMCIVREE is administered by subcutaneous injection, once per day, at the beginning of each day without regard to meals.1 The process for subcutaneous injection is described in the Instructions for Use, which contains complete administration instructions with illustrations.

What part of the body should patients inject IMCIVREE into?

IMCIVREE should be injected subcutaneously in the abdomen, thigh, or arm, rotating to a different site each day. (Refer to Step 5 of the Instructions for Use.) Do not administer IMCIVREE intravenously or intramuscularly.1

What type of syringe should the patient use to administer IMCIVREE?

Instruct patients to use a 1-mL syringe with a 28- or 29-gauge needle appropriate for subcutaneous injection.1

My patient missed a dose. Does he/she need to retitrate their dose?

If a dose is missed, the once-daily regimen should be resumed as prescribed with the next scheduled dose.1

My patient discontinued treatment for an extended period of time. Do I need to retitrate the dose?

Dose titration is recommended to initially assess tolerability to the medication and to determine the therapeutic dose. In clinical studies, patients were placed on placebo for a 4-week period, then re-initiated therapy at the therapeutic dose for the remainder of the study.1

My patient accidentally administered an overdose of IMCIVREE. What adverse events should we be most concerned about?

In the event of an overdose, initiate appropriate supportive treatment according to the patient’s clinical signs and symptoms.1

How is IMCIVREE supplied?

IMCIVREE is supplied in a 1-mL, multiple-dose vial, containing 10 mg of medication. The solution should appear clear to slightly opalescent, colorless to slightly yellow.1

How should IMCIVREE be stored?

IMCIVREE should be stored in the original carton and protected from light. Do not freeze IMCIVREE.1,2

Unopened vials of IMCIVREE may be stored in refrigerator at 2°C to 8°C (36°F to 46°F).1

Opened vials can be stored at temperatures ranging from refrigerated to room temperature [2°C to 25°C (36°F to 77°F)] with brief excursions permitted up to 30°C (86°F).1

Discard unused portion 30 days after first opening or if stored above 30°C (86°F).1

Can IMCIVREE cause prolonged erections?

Spontaneous penile erections in males (23%) occurred in clinical trials with IMCIVREE. Patients who have an erection lasting longer than 4 hours should be instructed to seek emergency medical attention.1

What sexual disturbances were reported in females in the clinical trials?

In a 12-week, placebo-controlled clinical study in an unapproved population, 4 female patients (7%) treated with IMCIVREE experienced sexual adverse reactions compared to 0 patients in the placebo group; 3 experienced a disturbance in sexual arousal and 1 experienced hypersensitivity of the labia.1

Does IMCIVREE cause or worsen depression?

Patients with a history of severe depression were excluded from the clinical trials. However, some drugs that target the central nervous system, such as IMCIVREE, may cause depression or suicidal ideation. Depression occurred in 26% of patients, and suicidal ideation occurred in 11% of patients included in the IMCIVREE clinical studies.

Monitor patients for new onset or worsening of depression. Consider discontinuing IMCIVREE if patients experience suicidal thoughts or behaviors.1

Can IMCIVREE be used with antidepressants?

No clinical studies evaluating the drug-drug interaction potential of IMCIVREE have been conducted.1

What is hyperpigmentation? Is it just skin darkening?

Hyperpigmentation can involve the darkening of skin and pre-existing nevi in the absence of ultraviolet (UV) exposure.1

Is skin darkening reversible?

Skin darkening was observed in the majority (78%) of subjects treated with IMCIVREE. This effect is reversible upon discontinuation of the drug.1

Why does my patient need a skin examination before starting IMCIVREE?

Because IMCIVREE can cause hyperpigmentation, a full body skin examination should be conducted prior to initiation and periodically during treatment to monitor pre-existing and new skin pigmentary lesions.1

Can IMCIVREE cause skin cancer?

There is no evidence that this change in pigmentation is detrimental to the patient, and no cases of melanoma have been reported.1,3

What kind of adverse reactions can I expect from this product (most common adverse reactions)?

The most common adverse reactions affecting ≥23% of patients were injection site reactions, skin hyperpigmentation, nausea, headache, diarrhea, abdominal pain, back pain, fatigue, vomiting, depression, upper respiratory tract infection, and spontaneous penile erection.1

Were any serious treatment-related adverse events observed in clinical studies?

No serious treatment-related adverse reactions were observed in the clinical trial. However, because there is benzyl alcohol preservative in IMCIVREE, there is a risk of serious adverse reactions in neonates and low birth weight infants. IMCIVREE is not approved for use in neonates or infants. Serious and fatal adverse reactions including “gasping syndrome” can occur in neonates and low birth weight infants treated with benzyl alcohol–preserved drugs.1

What should a patient do if they think they are or may become pregnant?

Discontinue IMCIVREE when pregnancy is recognized unless the benefits of therapy outweigh the potential risks to the fetus.1

Can patients take IMCIVREE while breastfeeding?

There is no information on the presence of IMCIVREE or its metabolites in human milk, the effects on the breastfed infant, or the effects on milk production. Treatment with IMCIVREE is not recommended while breastfeeding.1

What is the mechanism of action?

Setmelanotide is an melanocortin-4 (MC4) receptor agonist with 20-fold less activity at the MC3 and MC1 receptors. MC4 receptors in the brain are involved in regulation of hunger, satiety, and energy expenditure. In patients with obesity due to POMC, PCSK1, and LEPR deficiency associated with insufficient activation of the MC4 receptor, setmelanotide may re-establish MC4 receptor pathway activity to reduce hunger and promote weight loss through decreased caloric intake and increased energy expenditure. Nonclinical evidence shows that MC4 receptors are important for setmelanotide-regulated appetite and weight loss.1

How does IMCIVREE work?

IMCIVREE is thought to work by selectively activating melanocortin-4 receptor (MC4R) neurons to restore proper regulation of hunger, energy expenditure, and consequently body weight.1

Have the pivotal studies on IMCIVREE been published?

Yes. The results of these studies have been published in The Lancet Diabetes & Endocrinology. To see the publication, click here.

How were the safety and effectiveness of IMCIVREE evaluated?

The safety and efficacy of IMCIVREE for the treatment of POMC, PCSK1, or LEPR deficiency obesity were established in 2 identically designed, 1-year, open-label studies, each with an 8-week, double-blind withdrawal period.1

To see the full results of the IMCIVREE clinical trials, click here.

Were the patients who did not achieve at least a 5 kg weight loss (or at least 5% weight loss if baseline body weight was <100 kg) at the end of the open-label treatment period included in any analyses? If so, which ones?

Yes. These patients were included in the primary endpoint analysis and safety analyses.1,3

Do patients regain weight after stopping IMCIVREE?

Yes. When treatment with IMCIVREE was withdrawn in patients who had lost weight during the 10-week open-label period, these patients gained an average of 5.5 kg in Study 1 and 5.0 kg in Study 2 over 4 weeks. Reinitiation of treatment with IMCIVREE resulted in subsequent weight loss.1

To see the full results of the IMCIVREE clinical trials, click here.

The package insert mentions skin darkening as a potential reversible side effect. I have read that IMCIVREE may darken hair as well. Is this also a reversible side effect?

Changes in hair color following discontinuation of IMCIVREE have not been studied.

Is there a pharmacologic therapy recommended to manage nausea and vomiting if it were to occur? Are there any N/V therapies that should be avoided?

Treating physicians should manage and mitigate these side effects based on their own clinical judgment. No clinical studies evaluating the drug-drug interaction potential of IMCIVREE have been conducted.

How do I prescribe IMCIVREE for my patient(s)?

To prescribe IMCIVREE, verify that your patient has:

  • a diagnosis of obesity due to POMC, PCSK1, or LEPR deficiency confirmed by genetic testing
  • a completed IMCIVREE Start Form (including a copy of the genetic test results). Rhythm Pharmaceuticals offers free* genetic testing for rare genetic diseases of obesity to eligible patients. Additional information is available at www.UncommonObesity.com/test or by calling Prevention Genetics at 1-844-513-3994, Monday—Friday from 9 AM to 8 PM ET.

*Rhythm Pharmaceuticals covers cost of test only—excludes office visit, sample collection, and any other related costs to patient.

References: 1. IMCIVREE [prescribing information]. Boston, MA. Rhythm Pharmaceuticals, Inc. 2. IMCIVREE [patient information]. Boston, MA. Rhythm Pharmaceuticals, Inc. 3. Clément K et al. Lancet Diabetes Endocrinol. 2020;8(12):960-970.

Important Safety Information
WARNINGS AND PRECAUTIONS

Disturbance in Sexual Arousal: Sexual adverse reactions may occur in patients treated with IMCIVREE. Spontaneous penile erections in males and sexual adverse reactions in females occurred in clinical studies with IMCIVREE.

Depression and Suicidal Ideation: Some drugs that target the central nervous system, such as IMCIVREE, may cause depression or suicidal ideation. Monitor patients for new onset or worsening of depression. Consider discontinuing IMCIVREE if patients experience suicidal thoughts or behaviors.

Indication

IMCIVREE is indicated for chronic weight management in adult and pediatric patients 6 years of age and older with proopiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency obesity.