Drug reference
Lanadelumab is a humanised monoclonal antibody which inhibits plasma kallikrein activity, thereby limiting the production of bradykinin, a potent vasodilator associated with angioedema attacks in patients with hereditary angioedema.
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Prevention of recurrent attacks of hereditary angioedema (initiated under specialist supervision) ▶BY SUBCUTANEOUS INJECTION ▶Adult: 300 mg every 2 weeks, reduced to 300 mg every 4 weeks, in those stable and attack free—consult product literature
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Not a treatment for acute attacks of angioedema—initiate individualised treatment for breakthrough attacks
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Lanadelumab is a biological medicine. Biological medicines must be prescribed and dispensed by brand name, see Biological medicines and Biosimilar medicines, under Guidance on prescribing p. 1; manufacturer advises to record the brand name and batch number after each administration. l HANDLING AND STORAGE Manufacturer advises store in a refrigerator (2–8°C) and protect from light—consult product literature for further information regarding storage outside refrigerator.
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NICE decisions ▶Lanadelumab for preventing recurrent attacks of hereditary angioedema (October 2019) NICE TA606 Lanadelumab (Takhzyro ®) is recommended as an option for preventing recurrent attacks of hereditary angioedema in patients aged 12 years and older, only if: . they are eligible for preventive C1-esterase inhibitor treatment, in line with NHS England’s commissioning policy, that is, they are having 2 or more clinically significant attacks per week over 8 weeks despite oral preventive therapy, or oral therapy is contra-indicated or not tolerated, and Respiratory system . the lowest dosing frequency of lanadelumab is used in line with the summary of product characteristics, that is, when the condition is in a stable, attack-free phase, and . the manufacturer provides it according to the commercial arrangement. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they (or their carers) and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta606 Scottish Medicines Consortium (SMC) decisions SMC No. SMC2206 The Scottish Medicines Consortium has advised (December 2019) that lanadelumab (Takhzyro ®) is accepted for restricted use within NHS Scotland for the routine prevention of recurrent attacks of hereditary angioedema (HAE) in patients aged 12 years and older with HAE type I or II, who would otherwise be considered for long-term prophylaxis treatment with C1-esterase inhibitor.This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower.
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▶Common or very common Dizziness. hypersensitivity. myalgia. oral disorders. skin reactions
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Manufacturer advises preferable to avoid— limited or no information available; animal studies do not indicate toxicity.
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Manufacturer advises avoid during first few days after birth—possible risk from transfer of antibodies to infant. After this time, use during breast- feeding only if clinically needed. l EFFECT ON LABORATORY TESTS Manufacturer advises may increase activated partial thromboplastin time (aPTT) due to an interaction with the aPTT assay—consult product literature.
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Manufacturer advises to withdraw dose from the vial into a syringe with an 18 gauge needle and inject, using a suitable gauge needle, into the abdomen, thigh, or upper outer arm within 2 hours—consult product literature for further information. Takhzyro ® may be self-administered or administered by a carer after appropriate training in subcutaneous injection technique.
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There can be variation in the licensing of different medicines containing the same drug. Solution for injection EXCIPIENTS: May contain Polysorbates A ▶Lanadelumab (non-proprietary) Lanadelumab 150 mg per 1 ml Takhzyro 300mg/2ml solution for injection vials | 1 vial P £12,420.00 (Hospital only) DRUGS USED IN HEREDITARY ANGIOEDEMA › SELECTIVE BRADYKININ B2 ANTAGONISTS
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Self-administration Manufacturer advises patients and their carers should be given training in subcutaneous injection technique if appropriate. Missed doses Manufacturer advises if a dose is missed, it should be taken as soon as possible ensuring at least 10 days between doses.
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300 mg every 2 weeks, reduced to 300 mg every
First-line fragment. Read the complete Indications and Dose section above.
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