Reason for request
Initial inclusion
Summary of opinion
Favourable opinion for reimbursement in “the treatment of obesity and the control of hunger associated with genetically confirmed Bardet-Biedl syndrome (BBS), loss-of-function biallelic pro-opiomelanocortin (POMC), including PCSK1, deficiency or biallelic leptin receptor (LEPR) deficiency, in children aged 2 to < 6 years.”
Clinical Benefit
| Substantial |
The clinical benefit of IMCIVREE (setmelanotide) 10 mg/ml is substantial in children aged 2 to < 6 years.
|
Clinical Added Value
| minor |
Considering:
- the suggested efficacy of setmelanotide in terms of the proportion of responder patients (≥ 0.2 reduction in BMI Z-score) and the mean change from baseline in BMI, based on the results of the non-comparative RM-493-033 study conducted in 12 patients aged from 2 to under 6 years. After 52 weeks of treatment, 83.3% (n=10/12) of patients achieved a reduction from baseline in BMI Z-score of ≥ 0.2, and the mean percent change from baseline in BMI was
-18.4%,
- the expected beneficial impact associated with the reduction in BMI Z-score in these conditions with significant morbidity,
- the absence of robust data concerning the hunger score and change of eating behaviours of the children,
- the absence of robust data relative to quality of life, which is particularly impaired in these conditions, for both patients and their carers,
- the safety profile of setmelanotide, consistent with that already known in patients 6 years of age and above, characterised by hyperpigmentation disorders and injection site reactions as the most common adverse events, with patients treated with IMCIVREE (setmelanotide) required to undergo regular monitoring,
- the unmet medical need in these conditions, both for POMC deficiencies, including PCSK1 and LEPR deficiencies, and for Bardet-Biedl syndrome,
the Committee deems that IMCIVREE (setmelanotide) provides a minor clinical added value (CAV IV) in the treatment of obesity and the control of hunger associated with genetically confirmed Bardet-Biedl syndrome (BBS), loss-of-function biallelic pro-opiomelanocortin (POMC), including PCSK1, deficiency or biallelic leptin receptor (LEPR) deficiency in children aged 2 to < 6 years.
|
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
By2vYQdwPX5xmw4v