Flutemetamol (18F)

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Flutemetamol (18F) (trade name Vizamyl, by GE Healthcare) is a PET scanning radiopharmaceutical containing the radionuclide fluorine-18, used as a diagnostic tool for Alzheimer's disease.[2]

Flutemetamol (18F)
Clinical data
Trade namesVizamyl
AHFS/Drugs.comMicromedex Detailed Consumer Information
License data
Routes of
administration
Intravenous
ATC code
Legal status
Legal status
  • US: ℞-only
  • EU: Rx-only[1]
  • In general: ℞ (Prescription only)
Identifiers
  • 2-[3-(18F)Fluoro-4-(methylamino)phenyl]-1,3-benzothiazol-6-ol
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
ChEBI
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC14H1118FN2OS
Molar mass273.316 g·mol−1
3D model (JSmol)
  • CNC1=C(C=C(C=C1)C2=NC3=C(S2)C=C(C=C3)O)[18F]
  • InChI=1S/C14H11FN2OS/c1-16-11-4-2-8(6-10(11)15)14-17-12-5-3-9(18)7-13(12)19-14/h2-7,16,18H,1H3/i15-1
  • Key:VVECGOCJFKTUAX-HUYCHCPVSA-N

Adverse effects

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Adverse effects of flutemetamol include headache, nausea, dizziness, flushing and increased blood pressure.[3]

Mechanism of action

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After the substance is given intravenously, it accumulates in beta amyloid plaques in the patient's brain, which thus become visible via positron emission tomography (PET).[2]

Manufacturing and distribution

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Flutemetamol (18F) can be produced within five to six hours. It then undergoes a quality check and is ready to be distributed immediately after. The product must be used within a certain time frame for maximum efficacy. Because of the limited time window, flutemetamol is not produced until an order has been placed.[4]

Flutemetamol is typically administered intravenously in 1 to 10 mL doses.[5] Average costs for PET scans without insurance coverage are around $3,000. Currently Medicare does not cover use of amyloid imaging agents except for in clinical trials.[6] Because of this, there is a low market for flutemetamol.

History

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Flutemetamol was first approved for use in the US by the Food and Drug Administration (FDA) in 2013 for intravenous use.[7]

Clinical trials

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Two clinical trials were conducted for flutemetamol (18F). The first compared PET scans of terminally ill patients with flutemetamol to post mortem standard-of-truth assessments of cerebral cortical neuritic plaque density. The second trial assessed intra-reader reproducibility of PET scans using flutemetamol.[8]

Clinical trial 1

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Of the 176 patients imaged in this trial had a median age was 82, with 57 of patients being female. The initial flutemetamol PET scan resulted in 43 positive and 25 negative results for cerebral cortisol amyloid status. 69 of the initial patients died within 13 months of the flutemetamol PET scan. The autopsy for 67 of those patients determined the global brain neuritic plaque density category. Of those 67 patients 41 were positive and 26 were negative.[7] These results correlate with the pre-mortem scan.

Clinical trial 2

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The second clinical trial included 276 subjects with a median age of 72. The trial measured the effectiveness of an electronic training program for flutemetamol image interpretation using PET scans from trial 1 among other subjects with a variety of cognitive impairment. Final results met the pre-specified success rate with a Fleiss' kappa statistic of 0.83.[7]

References

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  1. ^ "Vizamyl EPAR". European Medicines Agency. 22 August 2014. Retrieved 29 June 2024.
  2. ^ a b Spreitzer H (18 August 2014). "Neue Wirkstoffe – Flutemetamol". Österreichische Apothekerzeitung (in German) (17/2014): 43.
  3. ^ "FDA Press Release". FDA. Retrieved 17 November 2016.
  4. ^ "Manufacturing and Distribution | Vizamyl (Flutemetamol F 18 Injection)". www.gevizamyl.com. Archived from the original on 21 November 2016. Retrieved 21 November 2016.
  5. ^ "Life Sciences Content Alert". www3.gehealthcare.co.uk. Archived from the original on 26 February 2015. Retrieved 21 November 2016.
  6. ^ "Alzheimer's Association" (PDF). Archived from the original (PDF) on 16 February 2017. Retrieved 20 November 2016.
  7. ^ a b c "GE Vizamyl" (PDF). gevizamyl. Archived from the original (PDF) on 16 February 2017. Retrieved 20 November 2016.
  8. ^ "Efficacy and Safety | Vizamyl (Flutemetamol F 18 Injection)". www.gevizamyl.com. Archived from the original on 21 November 2016. Retrieved 20 November 2016.