MEPSEVII (vestronidase alfa-vjbk)
OFFICE ADMINISTRATION
Indications for Prior Authorization:
- Treatment of pediatric and adult patients for the treatment of Mucopolysaccharidosis VII
Patients must meet the following criteria for the indication(s) above:
- Prescribed by a specialist, AND
- Confirmed Mucopolysaccharidosis VII diagnosis by biochemical evaluation of urinary glycosaminoglycan (GAG) concentration (fractionation of GAG by electrophoresis or chromatography, and analysis of oligosaccharides) and enzyme activity assay from peripheral blood leukocytes
Dosing:
- Pre-medication with a non-sedating antihistamine with or without an anti-pyretic is recommended 30-60 minutes prior to infusion
- 4 mg/kg administered by IV infusion every 2 weeks
- Administered under the supervision of a healthcare professional with the capability to manage anaphylaxis
Approval:
- Initial: 6 months
- Renewal: 1 year
Last review date: December 17, 2018