Options for getting your patients started with ONPATTRO® (patisiran)
Printable ONPATTRO® (patisiran) Start Form option
Downloadable Start Form

Print, complete with your patient, and fax the Start Form to 1-833-256-2747

Electronic ONPATTRO® (patisiran) Start Form option
Electronic Start Form

Complete and submit the Electronic Start Form online with your patient

DocuSign ONPATTRO® (patisiran) Start Form option
DocuSign Start Form

Begin the Start Form and send to your patient over email to complete via DocuSign

What happens next:

Your patient's dedicated Case Manager will reach out to you and your patient within 1-2 business days of receiving a completed Start Form.

The Alnylam Assist® team will facilitate acquisition of ONPATTRO for your patient via specialty distributor or specialty pharmacy. For some patients, home infusion may also be an option.

Download the following resources for more formulary information:

Download ONPATTRO Order Set Download Product Characteristics

Important Safety Information and Indication

Important Safety Information

Infusion-Related Reactions

Infusion-related reactions (IRRs) have been observed in patients treated with ONPATTRO® (patisiran). In a controlled clinical study, 19% of ONPATTRO-treated patients experienced IRRs, compared to 9% of placebo-treated patients. The most common symptoms of IRRs with ONPATTRO were flushing, back pain, nausea, abdominal pain, dyspnea, and headache.

To reduce the risk of IRRs, patients should receive premedication with a corticosteroid, acetaminophen, and antihistamines (H1 and H2 blockers) at least 60 minutes prior to ONPATTRO infusion. Monitor patients during the infusion for signs and symptoms of IRRs. If an IRR occurs, consider slowing or interrupting the infusion and instituting medical management as clinically indicated. If the infusion is interrupted, consider resuming at a slower infusion rate only if symptoms have resolved. In the case of a serious or life-threatening IRR, the infusion should be discontinued and not resumed.

Reduced Serum Vitamin A Levels and Recommended Supplementation

ONPATTRO treatment leads to a decrease in serum vitamin A levels. Supplementation at the recommended daily allowance (RDA) of vitamin A is advised for patients taking ONPATTRO. Higher doses than the RDA should not be given to try to achieve normal serum vitamin A levels during treatment with ONPATTRO, as serum levels do not reflect the total vitamin A in the body.

Patients should be referred to an ophthalmologist if they develop ocular symptoms suggestive of vitamin A deficiency (e.g. night blindness).

Adverse Reactions

The most common adverse reactions that occurred in patients treated with ONPATTRO were upper respiratory tract infections (29%) and infusion-related reactions (19%).

Indication

ONPATTRO is indicated for the treatment of the polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults.

For additional information about ONPATTRO, please see the full Prescribing Information.