Lanadelumab

eMC §4.2 (TAKHZYRO 150 mg solution for injection in pre-filled syringe) — routine prevention of recurrent attacks of hereditary angioedema. Same regimen applies to adults and adolescents 12 to less than 18 years of age. In patients with a body weight less than 40 kg, a starting dose of 150 mg every 2 weeks may also be considered, with a reduction to 150 mg every 4 weeks in patients who are stably attack free. NOT intended for treatment of acute HAE attacks — in a breakthrough attack, individualised treatment with an approved rescue medication should be initiated. Consideration should be given to discontinuing treatment in patients with HAE with normal C1 esterase inhibitor (nC1-INH) who have shown insufficient reduction in attacks after 3 months. Missed doses: administer as soon as possible, then adjust the schedule to ensure at least 10 days between doses on a 2-weekly regimen, at least 17 days on a 3-weekly regimen, and at least 24 days on a 4-weekly regimen. Should be initiated under the supervision of a physician experienced in the management of HAE; may be self-administered or given by a caregiver only after training in subcutaneous injection technique. PAEDIATRIC DOSING FOR CHILDREN 2 TO LESS THAN 12 YEARS IS BY WEIGHT BAND, NOT PER KG (§4.2): 10 to less than 20 kg — 150 mg every 4 weeks, with a possible increase to 150 mg every 3 weeks if attacks are insufficiently controlled; 20 to less than 40 kg — 150 mg every 2 weeks, with a possible reduction to 150 mg every 4 weeks if stably attack free; 40 kg or more — 300 mg every 2 weeks, with a possible reduction to 300 mg every 4 weeks if stably attack free. Patients weighing 20 to less than 40 kg who are stably attack free may continue the same dose on reaching 12 years of age. Safety and efficacy in children under 2 years have not been established; in this age group the injection should only be given by a trained caregiver. Verify paediatric use against a children's formulary.