FOR APPROPRIATE PATIENTS
Treatment path
Once you and your eligible patient have decided that TZIELD is right for them, the treatment path begins.
Steps to take before starting TZIELD
Prior to initiating TZIELD with your patient, obtain a complete blood count and liver enzyme tests.
Enroll in TZIELD COMPASS
Your Key Actions
- Complete the enrollment form in its entirety
- Capture patient/caregiver consent
- Most health plans require lab results from the previous 6 months
- Ensure labs confirm Stage 2 diagnostic criteria1:
- Positive for at least 2 islet AAbs
- Diagnosed with dysglycemia without overt hyperglycemia (eg, via OGTT; if not available, use an
alternative method)
- Ensure the patient’s diagnosis confirms an autoimmune origin and does not suggest type 2 diabetes or other forms of diabetes. These may include, but are not limited to, genetic forms of diabetes, maturity-onset diabetes of the young (MODY), latent autoimmune diabetes in adults (LADA), or diabetes secondary to medications or surgery
- Discuss site-of-care options/preferences with patients early
AAb=autoantibody; OGTT=oral glucose tolerance test.
Sanofi Support
- Field Reimbursement Manager
- Answers questions regarding enrollment form submission
- Provides education on payer policy requirements
- COMPASS Navigator
- Connects with patients to answer questions
- Provides copay information to eligible patients
- Clinical Educator
- Educates patients and site-of-care staff on the infusion process
Finalize site of care
(Infusion center, at home, or hybrid)
Your Key Actions
- Identify site of care, considering:
- Insurance coverage
- Location
- Transportation
- Scheduling needs
- Determine method of infusion (daily IV, midline, or PICC)
- Provide above to TZIELD COMPASS
AAb=autoantibody; IV=intravenous; PICC=peripherally inserted central catheter.
Sanofi Support
- COMPASS Navigator and/or Field Reimbursement Manager
- Help you understand treatment site options (based on the patient’s benefits)
- Identify options outside your geographic area if preferred (eg, near patient’s home)
Schedule infusion
Your Key Actions
- Order baseline labs, including:
- EBV and CMV assessment and confirm undetectable viral load (e.g., polymerase chain reaction (PCR) testing)
- Complete blood count with differential
- Liver enzyme tests
- Active serious or chronic active infection (other than localized skin infections) assessment
- Inform patients about possible side effects including but not limited to:
- Viral reactivation
- Cytokine release syndrome
- Serious infections
- Lymphopenia
- Hypersensitivity reactions
- Inform patients regarding pregnancy and lactation risk, as appropriate
- Instruct patients about required vaccines and premedication
- Address any lingering questions
CMV=cytomegalovirus; EBV=Epstein-Barr virus.
Sanofi Support
- Field Reimbursement Manager
- Provides education on payer policy requirements
- Medical Science Liaison
- Available to assist with understanding medical management topics, including:
- Educate about potential side effects and appropriate standards of care for mitigation
- Premedication and vaccine guidance
- Laboratory orders
- Available to assist with understanding medical management topics, including:
Complete infusion
Your Key Actions
- Order and review follow-up labs to monitor blood counts, liver enzymes and signs of infection
- Perform check-ins and discuss side effects
- Discuss continuation of pre-medications beyond Day 5, as appropriate
- Address lingering questions and help patients stay on track with treatment
- Educate on future metabolic monitoring and symptoms consistent with progression to Stage 3 T1D
- Monitor patients for signs and symptoms of viral reactivation during TZIELD treatment and for at least 2 months following the last infusion
Sanofi Support
- Clinical Educator
- Provides TZIELD dosing and nursing order resources
TZIELD COMPASS is there to help support your patients through every step of their treatment path.
Important Safety Information Anchor
IMPORTANT SAFETY INFORMATION
WARNING: Viral Reactivation
- Serious, life-threatening cases of viral reactivation, including Epstein-Barr virus (EBV) and cytomegalovirus (CMV) reactivation have been reported with TZIELD. Patients who are immunocompromised are at increased risk. The majority of serious cases occurred in patients who continued TZIELD treatment despite persistent, severe lymphopenia.
- Test patients for active EBV and CMV infection prior to starting treatment. TZIELD is not recommended in patients with laboratory or clinical evidence of active EBV or CMV infection. Adhere to lymphocyte count monitoring requirements and discontinuation recommendations. Monitor patients for signs and symptoms of viral reactivation following TZIELD treatment and for at least 2 months following the last infusion. If viral reactivation is suspected, discontinue TZIELD.
WARNINGS AND PRECAUTIONS
Viral Reactivation: Serious, life-threatening cases of viral reactivation, including EBV and CMV have been reported with TZIELD. During and within 2 months of TZIELD treatment, if primary infection or reactivation of EBV or CMV occurs, it may present with increased severity, including EBV-associated lymphoproliferative disease and organ failure. Patients who are immunocompromised, including patients with Down syndrome, may be at increased risk. The majority of serious viral reactivation cases occurred in patients who continued TZIELD despite persistent, severe lymphopenia. Prior to initiating treatment with TZIELD, evaluate patients for active EBV and CMV infection and confirm undetectable viral load (e.g., PCR testing). TZIELD is not recommended in patients with laboratory or clinical evidence of active EBV or CMV infection. During treatment with TZIELD, regularly monitor lymphocyte counts and monitor patients for signs and symptoms of viral reactivation during treatment and for at least 2 months following the last infusion. If viral reactivation is suspected, discontinue TZIELD and obtain viral load (e.g., PCR) promptly. If viral reactivation is confirmed, permanently discontinue TZIELD.
Cytokine Release Syndrome (CRS): CRS occurred in TZIELD-treated patients during the treatment period and through 28 days after the last drug administration. CRS manifestations in TZIELD-treated patients included fever, nausea (with or without vomiting), fatigue, headache, myalgia, arthralgia, increased ALT, increased AST, and increased total bilirubin. These manifestations typically occurred during the first 5 days of TZIELD treatment. Prior to TZIELD treatment, premedicate with antipyretics, antihistamines and/or antiemetics, and treat similarly if symptoms occur during treatment. If severe CRS develops, consider pausing dosing for 1 day to 2 days and administering the remaining doses to complete the full 14-day course on consecutive days; or discontinue treatment. Monitor liver enzymes during treatment. Discontinue TZIELD treatment in patients who develop elevated alanine aminotransferase or aspartate aminotransferase more than 5 times the upper limit of normal (ULN) or bilirubin more than 3 times ULN.
Serious Infections: Use of TZIELD is not recommended in patients with active serious infection or chronic infection other than localized skin infections. Monitor patients for signs and symptoms of infection during and after TZIELD administration. If serious infection develops, treat appropriately, and discontinue TZIELD.
Lymphopenia: Lymphopenia occurred in most TZIELD-treated patients. For most patients, lymphocyte levels began to recover after the fifth day of treatment and returned to pretreatment values within two weeks after treatment completion and without dose interruption. Obtain a CBC prior to starting TZIELD and monitor white blood cell counts during TZIELD treatment. If prolonged severe lymphopenia develops (<500 cells per mcL lasting 1 week or longer), permanently discontinue TZIELD.
Hypersensitivity Reactions: Acute hypersensitivity reactions including serum sickness, angioedema, urticaria, rash, vomiting and bronchospasm occurred in TZIELD-treated patients. If severe hypersensitivity reactions occur, discontinue TZIELD and treat promptly.
Vaccinations: The safety of immunization with live-attenuated (live) vaccines with TZIELD-treated patients has not been studied. TZIELD may interfere with immune response to vaccination and decrease vaccine efficacy. Administer all age-appropriate vaccinations prior to starting TZIELD.
- Administer inactivated (killed) vaccines or mRNA vaccines at least 2 weeks prior to treatment. Inactivated vaccines are not recommended during treatment or 6 weeks after completion of treatment.
- Administer live vaccines at least 8 weeks prior to treatment. Live vaccines are not recommended during treatment, or up to 52 weeks after treatment.
ADVERSE REACTIONS
Most common adverse reactions were lymphopenia, vomiting, rash, leukopenia, diarrhea and headache.
USE IN SPECIFIC POPULATIONS
- Pregnancy: May cause fetal harm. To minimize exposure to a fetus, avoid use of TZIELD during pregnancy and at least 30 days prior to planned pregnancy. Report pregnancies to us at our Adverse Event reporting line at 1-800-633-1610 or visit https://ae.reporting.sanofi
- Lactation: A lactating woman may consider pumping and discarding breast milk during and for 20 days after TZIELD administration.
Please see full Prescribing Information, including Boxed WARNING and patient selection criteria.
INDICATION
TZIELD (teplizumab-mzwv) is indicated to delay the onset of Stage 3 type 1 diabetes (T1D) in adults and pediatric patients 1 year of age and older with Stage 2 T1D.
REFERENCE
- TZIELD Prescribing Information. Provention Bio, Inc.
- COMPASS Support START Form
- Call 1-844-778-2246 to speak with a TZIELD COMPASS representative
© 2026 Sanofi. All rights reserved. MAT-US-2503216-v2.0-04/2026
IMPORTANT SAFETY INFORMATION
INDICATION
IMPORTANT SAFETY INFORMATION
WARNING: Viral Reactivation
- Serious, life-threatening cases of viral reactivation, including Epstein-Barr virus (EBV) and cytomegalovirus (CMV) reactivation have been reported with TZIELD. Patients who are immunocompromised are at increased risk. The majority of serious cases occurred in patients who continued TZIELD treatment despite persistent, severe lymphopenia.
- Test patients for active EBV and CMV infection prior to starting treatment. TZIELD is not recommended in patients with laboratory or clinical evidence of active EBV or CMV infection. Adhere to lymphocyte count monitoring requirements and discontinuation recommendations. Monitor patients for signs and symptoms of viral reactivation following TZIELD treatment and for at least 2 months following the last infusion. If viral reactivation is suspected, discontinue TZIELD.
WARNINGS AND PRECAUTIONS
Viral Reactivation: Serious, life-threatening cases of viral reactivation, including EBV and CMV have been reported with TZIELD. During and within 2 months of TZIELD treatment, if primary infection or reactivation of EBV or CMV occurs, it may present with increased severity, including EBV-associated lymphoproliferative disease and organ failure. Patients who are immunocompromised, including patients with Down syndrome, may be at increased risk. The majority of serious viral reactivation cases occurred in patients who continued TZIELD despite persistent, severe lymphopenia. Prior to initiating treatment with TZIELD, evaluate patients for active EBV and CMV infection and confirm undetectable viral load (e.g., PCR testing). TZIELD is not recommended in patients with laboratory or clinical evidence of active EBV or CMV infection. During treatment with TZIELD, regularly monitor lymphocyte counts and monitor patients for signs and symptoms of viral reactivation during treatment and for at least 2 months following the last infusion. If viral reactivation is suspected, discontinue TZIELD and obtain viral load (e.g., PCR) promptly. If viral reactivation is confirmed, permanently discontinue TZIELD.
Cytokine Release Syndrome (CRS): CRS occurred in TZIELD-treated patients during the treatment period and through 28 days after the last drug administration. CRS manifestations in TZIELD-treated patients included fever, nausea (with or without vomiting), fatigue, headache, myalgia, arthralgia, increased ALT, increased AST, and increased total bilirubin. These manifestations typically occurred during the first 5 days of TZIELD treatment. Prior to TZIELD treatment, premedicate with antipyretics, antihistamines and/or antiemetics, and treat similarly if symptoms occur during treatment. If severe CRS develops, consider pausing dosing for 1 day to 2 days and administering the remaining doses to complete the full 14-day course on consecutive days; or discontinue treatment. Monitor liver enzymes during treatment. Discontinue TZIELD treatment in patients who develop elevated alanine aminotransferase or aspartate aminotransferase more than 5 times the upper limit of normal (ULN) or bilirubin more than 3 times ULN.
Serious Infections: Use of TZIELD is not recommended in patients with active serious infection or chronic infection other than localized skin infections. Monitor patients for signs and symptoms of infection during and after TZIELD administration. If serious infection develops, treat appropriately, and discontinue TZIELD.
Lymphopenia: Lymphopenia occurred in most TZIELD-treated patients. For most patients, lymphocyte levels began to recover after the fifth day of treatment and returned to pretreatment values within two weeks after treatment completion and without dose interruption. Obtain a CBC prior to starting TZIELD and monitor white blood cell counts during TZIELD treatment. If prolonged severe lymphopenia develops (<500 cells per mcL lasting 1 week or longer), permanently discontinue TZIELD.
Hypersensitivity Reactions: Acute hypersensitivity reactions including serum sickness, angioedema, urticaria, rash, vomiting and bronchospasm occurred in TZIELD-treated patients. If severe hypersensitivity reactions occur, discontinue TZIELD and treat promptly.
Vaccinations: The safety of immunization with live-attenuated (live) vaccines with TZIELD-treated patients has not been studied. TZIELD may interfere with immune response to vaccination and decrease vaccine efficacy. Administer all age-appropriate vaccinations prior to starting TZIELD.
- Administer inactivated (killed) vaccines or mRNA vaccines at least 2 weeks prior to treatment. Inactivated vaccines are not recommended during treatment or 6 weeks after completion of treatment.
- Administer live vaccines at least 8 weeks prior to treatment. Live vaccines are not recommended during treatment, or up to 52 weeks after treatment.
ADVERSE REACTIONS
Most common adverse reactions were lymphopenia, vomiting, rash, leukopenia, diarrhea and headache.
USE IN SPECIFIC POPULATIONS
- Pregnancy: May cause fetal harm. To minimize exposure to a fetus, avoid use of TZIELD during pregnancy and at least 30 days prior to planned pregnancy. Report pregnancies to us at our Adverse Event reporting line at 1-800-633-1610 or visit https://ae.reporting.sanofi
- Lactation: A lactating woman may consider pumping and discarding breast milk during and for 20 days after TZIELD administration.
Please see full Prescribing Information, including Boxed WARNING and patient selection criteria.
INDICATION
TZIELD (teplizumab-mzwv) is indicated to delay the onset of Stage 3 type 1 diabetes (T1D) in adults and pediatric patients 1 year of age and older with Stage 2 T1D.