Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Mepact
Drug ID BADD_D01381
Description Mifamurtide is an immunomodulator with antitumor activity via activation of macrophages and monocytes. Also called L-MTP-PE, mifamurtide may be a liposomal form of of the active ingredient MTP-PE, which is a synthetic, less pyrogenic, and longer-acting derivative of muramyl dipeptide (MDP). MDP is a motif present in all gram-positive and gram-negative bacterial walls that is recognized by different signalling molecules and activators such as nucleotide-binding and oligomerization domain (NOD)-like receptors (NLRs) and toll-like receptors present in macrophages and monocytes. The overall result of MDP recognition leads to the production of proinflammatory cytokines and promotion of bactericidal and tumoricidal effects [A31745]. As a liposomal formulation, mifamurtide demonstrates an enhanced tumoricidal effect and improved safety profile [A31745]. Mifamurtide is marketed in Europe as Mepact for intravenous infusion. It is administered as an adjuvant therapy to postoperative combination chemotherapy in pediatric, adolescent or adult patients with high-grade, resectable, non-metastatic osteosarcoma after macroscopically complete surgical resection. In the US, it is currently under investigation that holds orphan drug status for the treatment of osteosarcoma [A31746]. Osteosarcoma is the most common primary malignant bone tumor that usually arises in the metaphyses of long bone in children and adolescents [A31744]. The standard therapy for osteosarcoma is comprised of macroscopic surgical resection and multi-agent chemotherapy consisting of doxorubicin, cisplatin, high-dose methotrexate with leucovorin rescue, and ifosfamide [A31744]. While about 90% of patients with newly diagnosed osteosarcoma may achieve complete remission from first-line therapies, the prognosis is still poor for patients with non-metastatic osteosarcoma with lower 5-year event-free survival. In a large, randomized, open-label, multicenter, phase III trial, the treatment of mifamurtide in conjunction with three- or four-drug combination chemotherapy (doxorubicin, cisplatin, and high-dose methotrexate with, or without, ifosfamide) was associated with significant improvement in survival rates and good tolerance [A31746]. The adverse events (AEs) associated with mifamurtide were generally mild to moderate in severity [A31748].
Indications and Usage Indicated in children, adolescents and young adults for the treatment of high-grade, resectable, non-metastatic osteosarcoma after macroscopically complete surgical resection, typically in combination with post-operative multi-agent chemotherapy [L1203].
Marketing Status Not Available
ATC Code L03AX15
DrugBank ID DB13615
KEGG ID D06619
MeSH ID C037144
PubChem ID 23663962
TTD Drug ID D01NTX
NDC Product Code Not Available
Synonyms mifamurtide | muramyl tripeptide phosphatidylethanolamine | muramyl tripeptide-1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine conjugate | muramylNAc-Ala-isoGln-Lys-tripeptide-PE | muramylNAc-Ala-isoGln-Lys-tripeptide-phosphatidylethanolamine | N-acetylmuramyl-alanyl-isoglutaminyl-alanyl-sn-glycero-3-phosphoethanolamine | muramyl tripeptide-1,2-dipalmitoylphosphatidylethanolamine conjugate | MLV 19835 | Mepact | muramyl tripeptide phosphatidylethanolamine, monosodium salt | mifamurtide sodium | mifamurtide anhydrous | mifamurtide sodium salt | muramyl tripeptide phosphatidylethanolamine, sodium salt | CGP 19835 A | CGP-19835A | mifamurtide acid | mifamurtide free acid anhydrous
Chemical Information
Molecular Formula C59H110N6NaO20P
CAS Registry Number 838853-48-8
SMILES CCCCCCCCCCCCCCCC(=O)OCC(COP(=O)([O-])OCCNC(=O)C(C)NC(=O)CCC(C(=O)N)NC(=O)C(C)NC( =O)C(C)OC1C(C(OC(C1O)CO)O)NC(=O)C)OC(=O)CCCCCCCCCCCCCCC.O.[Na+]
Chemical Structure
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Abdominal distension07.01.04.001--
Abdominal pain07.01.05.002--
Abdominal pain lower07.01.05.010--Not Available
Abdominal pain upper07.01.05.003--
Acute leukaemia01.10.02.001; 16.01.02.001--Not Available
Acute myeloid leukaemia01.10.05.001; 16.01.05.001--Not Available
Agranulocytosis01.02.03.001--Not Available
Alopecia23.02.02.001--
Anaemia01.03.02.001--
Anxiety19.06.02.002--
Arthralgia15.01.02.001--
Asthenia08.01.01.001--Not Available
Back pain15.03.04.005--
Blood creatinine increased13.13.01.004--
Body temperature decreased13.15.01.010--Not Available
Body temperature increased13.15.01.001--Not Available
Bone pain15.02.01.001--
Cellulitis11.02.01.001; 23.09.01.001--Not Available
Chest discomfort02.02.02.009; 08.01.08.019; 22.02.08.001--Not Available
Chest pain02.02.02.011; 08.01.08.002; 22.02.08.003--Not Available
Chills08.01.09.001; 15.05.03.016--
Confusional state17.02.03.005; 19.13.01.001--
Constipation07.02.02.001--
Cough22.02.03.001--
Cyanosis02.01.02.002; 22.02.02.007; 24.03.01.007--
Cyst08.03.05.001; 16.02.02.002--Not Available
Deafness04.02.01.001--Not Available
Dehydration14.05.05.001--
Depression19.15.01.001--
Dermatitis23.03.04.002--Not Available
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