Ilaris

Drug - Ilaris® (canakinumab) [Novartis Pharmaceuticals]

September 2019

Therapeutic area - Auto-inflammatory diseases

Approval criteria

Patient does not have an active infection or a history of recurring infections AND
Patient has negative tuberculin test or, if positive, therapy with isoniazid was initiated at least 1 month prior to request AND
Patient is not taking tumor necrosis factor (TNF) inhibitors concomitantly AND
Patient has one of the following diagnosis:
- Cryopyrin-Associated Periodic Syndromes (CAPS) including Familial Cold Autoinflammatory Syndrome (FCAS), Muckle-Wells Syndrome (MWS) AND
  - Patient is ≥ 4 years old OR
- Tumor Necrosis Factor Receptor Associated Period Syndrome (TRAPS) OR
- Hyperimmunoglobulin D Syndrome (HIDS)/Mevalonate Kinase Deficiency (MKD) OR
- Familial Mediterranean Fever (FMF) OR
- Active Systemic Juvenile Idiopathic Arthritis (SJIA) AND
  - Patient is ≥ 2 years old

Patient’s most current body weight must be provided at time of request.

Quantity limits depend on patient’s diagnosis.

Patients with CAPS and has:
- Body weight 15 kg to 40 kg: 3 mg/kg every 8 weeks
- Body weight greater than 40 kg: 150 mg every 8 weeks
Patients with TRAPS, HIDS/MKD, FMF and has:
- Body weight 40 kg or less: 4mg/kg every 4 weeks
- Body weight greater than 40 kg: 300 mg every 4 weeks
Patients with SJIA and has:
- Body weight 7.5 kg or more: 4 mg/kg (max 300 mg) every 4 weeks

MHCP Provider Call Center 651-431-2700 or 800-366-5411