Reason for request

First listing

Key points

Favourable opinion for reimbursement in “routine prevention of recurrent attacks of hereditary angi oedema (HAE) in patients aged from 2 years to less than 12 years.”  


Clinical Benefit

Substantial

The Committee deems that the clinical benefit of TAKHZYRO (lanadelumab) 150 mg solution for injection in pre-filled syringe is substantial in the preven tion of recurrent attacks of hereditary angioedema (HAE) in patients aged from 2 years to less than 12 years. 


Clinical Added Value

moderate

Considering: 

  • the suggested efficacy of TAKHZYRO (lanadelumab) in a non-comparative phase 3 study in  21 patients with a median age of 8.7 years (min 3.5 - max 10.9 years) over a significant period of 52 weeks, with a marked reduction in the number of attacks per month, decreasing from 1.8 to 0,08, i.e. a 94.8% reduction, and the number of severe attacks, decreasing from 1.27 to 0.08, i.e. a reduction of 96.8%, 
  •  a safety profile marked primarily by pain at injection site, skin abrasions and headaches, and which appears to be similar to that observed in older patients, 
  •  the convenience of TAKHZYRO (lanadelumab), with subcutaneous administration every 2 to 4 weeks,
  • the unmet medical need in the absence of a therapeutic alternative in these patients and the uncertain efficacy of tranexamic acid used off-label, 

the Committee deems that TAKHZYRO (lanadelumab) 150 mg provides a moderate clinical added value (CAV III) in the prevention of recurrent attacks of hereditary angioedema in patients aged 2 years to less than 6 years.  

minor

Considering: 

  • the suggested efficacy of TAKHZYRO (lanadelumab) in a non-comparative phase 3 study in 21 patients with a median age of 8.7 years (with the majority of patients (81%) aged from 6 years to under 12 years) over a significant period of 52 weeks, with a marked reduction in the number of attacks per month, decreasing from 1.8 to 0,08, i.e. a 94.8 % reduction, and the number of 
    severe attacks, decreasing from 1.27 to 0.08, i.e. a reduction of 96.8%,
  • a safety profile marked primarily by pain at injection site, skin abrasions and headaches, and which appears to be similar to that observed in older patients, 
  • the convenience of TAKHZYRO (lanadelumab), with subcutaneous administration every 2 to 4 weeks, compared with the alternative, CINRYZE (C1 esterase inhibitor), which is administered by the IV route every 3 to 4 days, 
  • but the absence of comparison versus the clinically relevant comparator CINRYZE (C1 esterase inhibitor), despite the fact that such a comparison would have been possible,   

the Committee deems that TAKHZYRO (lanadelumab) 150 mg provides a minor clinical added value (CAV IV) in the prevention of recurrent attacks of hereditary angioedema in patients aged 6 years to 11 years. 


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