National Institute for Health and Care Excellence (NICE) has recommended lanadelumab (Takhzyro) as an option for preventing recurrent attacks of hereditary angioedema.
Lanadelumab is recommended for preventing recurrent attacks of hereditary angioedema in individuals aged ≥12 years if the following conditions are fulfilled:
- They are eligible for preventive C1-esterase inhibitor treatment (in accordance with NHS England's commissioning policy), i.e. having ≥2 clinically significant attacks per week over 8 weeks despite oral preventive therapy, or if oral therapy is contraindicated or not tolerated.
- Lanadelumab is used at the lowest dosing frequency when the condition is in a stable, attack-free phase.
Recommended starting dose for lanadelumab is 300 mg injected subcutaneously every 2 weeks. A dose reduction of 300 mg every 4 weeks can be considered in patients who are stably attack-free, particularly in those with low body weight. Evidence from a randomised trial indicates fewer attacks of hereditary angioedema with lanadelumab vs placebo.
The drug is to be used only when provided by the company in agreement with the commercial arrangement. The recommendations should not affect patients whose treatment with the drug was started before the publication of the guidance.