Difelikefalin (1) – Kapruvia®

Pruritus in chronic kidney disease (CKD), haemodialysis patients

Characteristics

Start date 01.10.2022 – Marketing authorisation: 25.04.2022
Resolution 06.04.2023
Limitation date 15.10.2023 limitation repealed
INN Difelikefalin
Brand name Kapruvia®
Pharm. company Fresenius Medical Care Nephrologica Deutschland GmbH
G-BA Procedure ID D-854
ATC code V03AX04 Other therapeutic products (V03AX)
ICD-10 codes (AIS) L29.8Other pruritus
Alpha-ID codes (AIS) I131199Uremic pruritus
Therapeutic area Skin diseases Pruitus / Prurigo nodularis
Reason for procedure Initial assessment
Specialty ACT change

Therapeutic indication of the resolution

Kapruvia is indicated for the treatment of moderate to severe pruritus associated with chronic kidney disease in adult hemodialysis patients.

Subpopulation Indication Comparator
Adult hemodialysis patients with moderate to severe pruritus associated with chronic kidney disease (CKD-aP). Best Supportive Care

Studies and Results

No. of studies
(best subpopulation)
2 (KALM-1, KALM-2)
Study design
(best subpopulation)
H2H vs. non-ACT + no ITC
Meta analysis
(best subpopulation)
yes
ACT change 21.03.2023 – Stellungnahme der Fachgesellschaften

  • Clinical trials
    • The KALM-1 and KALM-2 studies were submitted for the assessment of the additional benefit of difelikefalin in the treatment of adult haemodialysis patients with moderate to severe pruritus associated with chronic kidney disease (CKD-aP).
    • The KALM-1 and KALM-2 studies have a similar study design. In both studies, the double-blind, randomised, head-to-head treatment phase lasted a total of 12 weeks.

Adult haemodialysis patients with moderate to severe pruritus associated with chronic kidney disease (CKD-aP)

  • An additional benefit is not proven
  • The study duration of just 12 weeks is considered too short within the context of the randomised comparative study phase for the early benefit assessment in a chronic condition.
  • Overall assessment
    • In summary, the studies submitted by the pharmaceutical manufacturer are not suitable for demonstrating an additional benefit of difelikefalin compared with the appropriate comparator therapy (BSC).
    • The study duration of only 12 weeks is considered too short within the context of the randomised comparative study phase for early benefit assessment in a chronic condition. An additional benefit is therefore not proven.

Courtesy translation only, please refer to the German original.

Associated procedures

Difelikefalin (1) Kapruvia® Fresenius Medical Care Nephrologica Deutschland GmbH Skin diseases Pruritus in chronic kidney disease (CKD), haemodialysis patients 3,500–22,000 100% additional benefit not proven


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