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WHAT IS COLD AGGLUTININ DISEASE?

UNDERSTANDING HOW COLD AGGLUTININ DISEASE (CAD) OCCURS
Recognizing common symptoms, and learning how to manage the condition with your healthcare provider may bring you closer to finding the help you need.
CAD is a form of autoimmune hemolytic anemia (AIHA), which means the immune system mistakenly attacks and destroys red blood cells (hemolysis). CAD can affect people as young as 30, but usually affects people between 50-70 years of age.
SYMPTOMS OF CAD CAN BE LIMITING
When the rate of hemolysis is faster than the rate at which the body makes new red blood cells, the result is low levels of red blood cells (anemia). When anemia is ongoing, it can cause you to feel:
Fatigue
Weakness
Shortness of Breath
Palpitations
Chest Pain
WHAT CAUSES SYMPTOMS OF CAD?
Red blood cells are vital for carrying oxygen and carbon dioxide to and from your organs and tissues. For example, your muscles need them to move, and your brain needs them to function. With fewer red blood cells moving around your body due to hemolysis, less oxygen is delivered to your organs and tissues. This can make you feel tired, not have enough energy to do the things you want to do, can make you feel weak, short of breath, or even make thinking or concentrating difficult.
Avoiding exposure to the cold isn’t always enough to avoid hemolysis from occurring in patients with CAD.
How does HEMOLYSIS happen?
In CAD, cold agglutinin antibodies mistake your healthy red blood cells as a threat to the body. When the cold agglutinin antibodies encounter red blood cells they attach to the surface, causing them to clump together (called agglutination). These clumps activate the classical complement pathway, which is responsible for breaking them down for removal from the bloodstream.
Hemolysis starts with a protein called C1 sticking to the clumps, marking them for destruction.
The complement pathway in action
WHAT CAN YOUR BLOOD TELL YOU ABOUT YOUR HEALTH?
One way your doctor can keep an eye on your health is by looking at the different components of your blood. Below is some information on commonly used terms and various blood tests your doctor may request. He or she may perform all of these tests or just a few depending on your needs.
Hemoglobin
Usually found inside red blood cells, this protein helps to transport oxygen and carbon dioxide throughout the body
Bilirubin
A pigment that is released when hemoglobin is broken down
Lactate dehydrogenase (LDH or LD)
An enzyme that is released when cells are destroyed
Haptoglobin
A protein in the blood whose job it is to find hemoglobin that has been released from destroyed red blood cells and flag it for recycling
Reticulocytes
Young (immature) red blood cells that are produced to replace red blood cells that have been destroyed
Antibody titer
Measures the concentration and strength of antibodies (such as cold agglutinins) in your blood
Mean corpuscular volume (MCV)
A measure of the average size and volume of red blood cells in your blood
Blood smear
Evaluates the shape, size, color, and arrangement of red blood cells and also looks at your white blood cells and platelets
The science behind enaymo
See how ENJAYMO is designed to help stop the destruction of red blood cells (hemolysis) before it starts.
INDICATION
ENJAYMO is a prescription medicine used to decrease the need for red blood cell transfusion due to the breakdown of red blood cells (hemolysis) in adults with cold agglutinin disease (CAD).

It is not known if ENJAYMO is safe and effective in children
INDICATION & IMPORTANT SAFETY INFORMATION
IMPORTANT SAFETY INFORMATION
Do not receive ENJAYMO if you are allergic to sutimlimab-jome or any of the ingredients in ENJAYMO.
ENJAYMO can cause serious side effects, including:
Serious Infections: ENJAYMO is a prescription medicine that affects your immune system. ENJAYMO can lower the ability of your immune system to fight infections. People who take ENJAYMO may have an increased risk of getting infections caused by certain kinds of bacteria such as Neisseria meningitides, Streptococcus pneumoniae , and Haemophilus influenzae . These infections may be serious or life-threatening. Some infections may quickly become life-threatening or cause death if not recognized and treated early.
You need to receive vaccinations against infections caused by certain kinds of bacteria at least 2 weeks before your first dose of ENJAYMO. You may need to have additional vaccinations during treatment
If your healthcare provider decides that urgent treatment with ENJAYMO is needed, you should receive vaccinations as soon as possible.
Vaccinations may reduce the risk of these infections, but do not prevent all infections. Call your healthcare provider or get medical help right away if you get any new signs and symptoms of an infection, including:
fever
severe headache with stiff neck or back
pain during urination or urinating more often than usual
cough or difficulty breathing
flu-like symptoms
pain, redness or swelling of the skin
Infusion-related reactions: Treatment with ENJAYMO may cause infusion-related reactions, including allergic reactions that may be serious or life-threatening. Your healthcare provider may slow down or stop your ENJAYMO infusion if you have an infusion-related reaction, and will treat your symptoms if needed. Tell your healthcare provider right away if you develop symptoms during your ENJAYMO infusion that may mean you are having an infusion-related reaction, including:
shortness of breath
rapid heartbeat
nausea
flushing
headache
Risk of autoimmune disease: ENJAYMO may increase your risk for developing an autoimmune disease such as systemic lupus erythematosus (SLE). Tell your healthcare provider and get medical help if you develop any symptoms of SLE, including:
joint pain or swelling
rash on the cheeks and nose
unexplained fever
If you have CAD and you stop receiving ENJAYMO, your healthcare provider should monitor you closely for return of your symptoms after you stop ENJAYMO. Stopping ENJAYMO may cause the breakdown of your red blood cells due to CAD to return. Symptoms or problems that can happen due to red blood cell breakdown include:
tiredness
shortness of breath
rapid heart rate
blood in your urine or dark urine
The most common side effects of ENJAYMO include:
respiratory tract infection
viral infection
diarrhea
indigestion
cough
joint pain
joint inflammation (arthritis)
swelling of the lower legs, ankles, and feet
These are not all the possible side effects of ENJAYMO. Call your doctor for medical advice about side effects.
Before receiving ENJAYMO, tell your healthcare provider about all of your medical conditions, including if you:
have a fever or infection, including a history of human immunodeficiency virus (HIV), hepatitis B, or hepatitis C.
have an autoimmune disease such as systemic lupus erythematosus (SLE), also known as lupus.
are pregnant or plan to become pregnant. It is not known if ENJAYMO will harm your unborn baby.
are breastfeeding or plan to breastfeed. It is not known if ENJAYMO passes into your breast milk.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
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