Neurofibromatosis type 1 (NF1) is a rare genetic disorder, affecting nearly 1 in 3000 people worldwide.
People with NF1 commonly have non-cancerous tumors along nerves in their body. Plexiform neurofibromas, also known as plexiforms, are one type of tumor seen in NF1.
People with NF1 commonly have non-cancerous tumors along nerves in their body. Plexiform neurofibromas, also known as plexiforms, are one type of tumor seen in NF1.
Plexiforms can grow on any nerve in the body.
Regardless of size, any plexiform can cause symptoms, depending on where it’s located in the body.
Regardless of size, any plexiform can cause symptoms, depending on where it’s located in the body.
Plexiforms typically grow fastest in the first 10 years of life, but they may also continue to grow over time.
Plexiform growth may be unpredictable and should not be ignored. Early action is key in the treatment of plexiforms.
Learn more about when to act on NF1 symptoms.
Plexiform growth may be unpredictable and should not be ignored. Early action is key in the treatment of plexiforms.
Learn more about when to act on NF1 symptoms.
Symptoms are varied. Look out for:
A study looked at the medical records of 51 adults with NF1 plexiforms between March and April 2021. The study found that 69% (24/35) of adults with NF1 plexiforms reported pain or discomfort, and more than half of these adults (14/24) rated their pain or discomfort as moderate to extreme.
Plexiforms have the potential to cause ongoing complications, which are unlikely to get better on their own.
One possible serious complication is a plexiform becoming cancerous. This happens in about 8%–13% of people with NF1 plexiforms.
Surgery is an effective treatment for NF1 plexiforms but may not be recommended by your or your child's doctor if the plexiforms are closely intertwined with critical nerves and blood vessels, located near major organs, or cannot be completely removed by surgery.
For those who have surgery, it is sometimes only a temporary solution, because:
One possible serious complication is a plexiform becoming cancerous. This happens in about 8%–13% of people with NF1 plexiforms.
Surgery is an effective treatment for NF1 plexiforms but may not be recommended by your or your child's doctor if the plexiforms are closely intertwined with critical nerves and blood vessels, located near major organs, or cannot be completely removed by surgery.
For those who have surgery, it is sometimes only a temporary solution, because:
- There is a risk of complications, some of which can be permanent
- In some people, plexiforms may regrow after surgery†
†A study looked at the medical records of 121 children who visited the NF clinic at a large children's hospital between 1974 to 1994. These 121 children had a total of 302 surgeries on 168 plexiforms. Another study looked at the medical records of 96 children who visited a different children's NF center. These 96 children had a total of 186 surgeries on 130 plexiforms between 1997 and 2007. Some of the children saw their plexiforms regrow after surgery.
IMPORTANT SAFETY INFORMATION
What are the possible side effects of Koselugo?
Koselugo may cause serious side effects, including:
Before taking Koselugo, tell your healthcare provider about all your medical conditions, including if you:
What should I avoid while taking Koselugo?
Avoid St John’s wort, grapefruit or grapefruit juice, and Seville oranges during treatment.
Most common side effects in children include: vomiting, diarrhea, increased level of an enzyme called creatine phosphokinase (CPK) in your blood, dry skin, redness around the fingernails, nausea, skin bumps that look like acne, fever.
Most common side effects in adults include: rash, diarrhea, skin bumps that look like acne.
These are not all the possible side effects of Koselugo. Call your healthcare provider for medical advice about side effects. You may report side effects to AstraZeneca at 1-800-236-9933 or at https://us-aereporting.astrazeneca.com or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
INDICATION
What is Koselugo?
Koselugo is a prescription medicine that is used to treat adults and children 1 year of age and older with neurofibromatosis type 1 (NF1) who have plexiform neurofibromas that cause symptoms and cannot be completely removed by surgery.
It is not known if Koselugo is safe and effective in children under 1 year of age.
Please see Patient Information and Instructions for Use in the full Prescribing Information for Koselugo (selumetinib) or at https://alexion.com/Documents/koselugo_uspi.pdf.
What are the possible side effects of Koselugo?
Koselugo may cause serious side effects, including:
- Heart problems. Koselugo can lower the amount of blood pumped by your heart, which can be severe. Your healthcare provider will do tests before and during treatment to check how well your heart is working. Tell your healthcare provider right away if you get any of the following signs or symptoms: persistent coughing or wheezing, shortness of breath, swelling of your ankles and feet, tiredness, increased heart rate.
- Eye problems. Koselugo can cause eye problems that can lead to blindness. Your healthcare provider will check your vision before and during treatment. Tell your healthcare provider right away if you get new or worsening vision changes, including: blurred vision, loss of vision, dark spots in your vision (floaters), other changes to your vision.
- Stomach, intestine, and mouth (gastrointestinal) problems. Koselugo can cause diarrhea, vomiting, nausea, and mouth sores. Diarrhea can be severe with Koselugo. Tell your healthcare provider right away the first time that you get diarrhea during treatment. Your healthcare provider may give you medicine to help control your diarrhea and may tell you to drink more fluids.
- Skin problems. Koselugo can cause severe skin rashes. Tell your healthcare provider if you get any of the following signs of skin problems: rash that covers a large area of your body, flat skin rash, raised bumps on your skin, skin bumps that look like acne, blisters, peeling skin, itchy rash, hair thinning or hair loss (alopecia).
- Increased level of an enzyme called creatine phosphokinase (CPK) in your blood and muscle problems. Koselugo can cause severe muscle problems. Treatment with Koselugo may increase the level of an enzyme in your blood called creatine phosphokinase (CPK), which may be a sign of muscle damage. Increased level of CPK in the blood is common during treatment and can also be severe. Your healthcare provider should do a blood test to check your blood levels of CPK before you start taking Koselugo and during treatment. Tell your healthcare provider right away if you get any of the following signs or symptoms: muscle aches or pain; muscle spasms and weakness; dark, reddish urine.
Before taking Koselugo, tell your healthcare provider about all your medical conditions, including if you:
- Have heart problems.
- Have eye problems.
- Have liver problems.
- Females who are able to become pregnant:
- Your healthcare provider should check to see if you are pregnant before you begin treatment.
- You should use effective birth control (contraception) during treatment and for 1 week after your last dose.
- Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment.
- Males with female partners who are able to become pregnant:
- You should use effective birth control (contraception) during treatment and for 1 week after your last dose.
- Are breastfeeding or plan to breastfeed. It is not known if Koselugo passes into your breast milk. Do not breastfeed during treatment and for 1 week after your last dose. Talk to your healthcare provider about the best way to feed your baby during this time.
What should I avoid while taking Koselugo?
Avoid St John’s wort, grapefruit or grapefruit juice, and Seville oranges during treatment.
Most common side effects in children include: vomiting, diarrhea, increased level of an enzyme called creatine phosphokinase (CPK) in your blood, dry skin, redness around the fingernails, nausea, skin bumps that look like acne, fever.
Most common side effects in adults include: rash, diarrhea, skin bumps that look like acne.
These are not all the possible side effects of Koselugo. Call your healthcare provider for medical advice about side effects. You may report side effects to AstraZeneca at 1-800-236-9933 or at https://us-aereporting.astrazeneca.com or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
INDICATION
What is Koselugo?
Koselugo is a prescription medicine that is used to treat adults and children 1 year of age and older with neurofibromatosis type 1 (NF1) who have plexiform neurofibromas that cause symptoms and cannot be completely removed by surgery.
It is not known if Koselugo is safe and effective in children under 1 year of age.
Please see Patient Information and Instructions for Use in the full Prescribing Information for Koselugo (selumetinib) or at https://alexion.com/Documents/koselugo_uspi.pdf.
MRI=magnetic resonance imaging; NF=neurofibromatosis; NF1=neurofibromatosis type 1; PN=plexiform neurofibromas.