Ibalizumab (1) – Trogarzo®

Multidrug-resistant HIV infection

Characteristics

Start date 01.09.2020 – Marketing authorisation: 26.09.2019
Resolution 18.02.2021
INN Ibalizumab
Brand name Trogarzo®
Pharm. company Theratechnologies Europe limited
G-BA Procedure ID D-580
ATC code J05AX23 Other antivirals (J05AX)
ICD-10 codes (AIS) B24, Z21Asymptomatic human immunodeficiency virus [HIV] infection status
Alpha-ID codes (AIS) I24822HIV infection, I29605HIV disease
DDD 57 mg P
Therapeutic area Infectious diseases HIV
Reason for procedure Initial assessment

Therapeutic indication of the resolution

Trogarzo, in combination with other antiretroviral(s), is indicated for the treatment of adults infected with multidrug resistant HIV-1 infection for whom it is otherwise not possible to construct a suppressive antiviral regimen.

Subpopulation Indication Comparator
Adults with multidrug-resistant HIV-1 infection for whom no other suppressive antiviral regimen can be composed Patient-specific antiretroviral therapy with a choice of approved agents; taking into account previous therapy(ies) and the reason for the change in therapy, in particular therapy failure due to virological failure and any associated development of resistance or due to side effects.

Studies and Results

No. of studies
(best subpopulation)
2 (TMB-301, TMB-311) 0 (Data not accepted)
Study design
(best subpopulation)
Data not accepted (Dossier: H2H vs. non-ACT + no ITC)

  • Clinical trials
    • The TMB-301 trial is a single-arm Phase III trial of ibalizumab in combination with a patient-specific, optimised background therapy over 25 weeks.
    • TMB-311 is a two-arm parallel-group trial of ibalizumab, conducted over 110 weeks with patients with multi-resistant HIV – as defined in the TMB-301 trial.
    • In the double-blind, randomised controlled trial TNX-355.03, ibalizumab was compared with placebo, both of which were administered in addition to patient-specific OBT.

Adults with a multi-resistant HIV-1 infection for whom no other suppressive antiviral regimen can be formulated

  • For adults with a multi-resistant HIV-1 infection for whom no other suppressive antiviral regimen can be formulated, the additional benefit is not proven.
  • There are no direct comparative data available for the use of ibalizumab in accordance with the marketing authorisation compared with the appropriate comparator therapy.
  • Furthermore, the indirect historical control presented by the pharmaceutical manufacturer is not suitable for deriving additional benefit, meaning that, overall, there are no data available that are suitable for a benefit assessment.
  • Overall assessment
    • On balance, the indirect historical control presented is considered unsuitable for assessing the additional benefit of ibalizumab compared with the appropriate comparator therapy.
    • The key factor in this decision is, above all, that the appropriate comparator therapy was not implemented in the comparator arm and that, in the intervention arm, active ingredients (INNs) not yet authorised under the OBT were used, which may skew the study results.
    • Furthermore, it is unclear whether the study population is representative of the indication.
    • Consequently, there are no data relevant to the benefit assessment of ibalizumab, meaning that an additional benefit is not proven.

Courtesy translation only, please refer to the German original.

Associated procedures

Ibalizumab (1) Trogarzo® Theratechnologies Europe limited Infectious diseases Multidrug-resistant HIV infection 50–110 100% additional benefit not proven


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