Treatment Eligibility
ARE YOUR PATIENTS ELIGIBLE FOR KALYDECO®(ivacaftor)?
Enter your patient's mutations below to see if they are eligible for KALYDECO. You may determine eligibility for up to 5 patients at once.
Enter your patient's mutations below to see if they are eligible for KALYDECO.
KALYDECO is a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator indicated for the treatment of cystic fibrosis (CF) in patients age 1 month and older who have at least one mutation in the CFTR gene that is responsive to ivacaftor potentiation based on clinical and/or in vitro assay data.
Most patients have 2 CFTR mutations, 1 for each allele. However, in rare instances, a single allele can have more than 1 mutation. This is called a compound, or complex, mutation.
To enter 2 or more mutations into 1 entry field, separate them with a semicolon, space, comma, or forward slash. For example, if your patient's genotype is R74W/V201M/D1270N and W1282R, use the Mutation 1 field to enter: R74W/V201M/D1270N and the Mutation 2 field to enter: W1282R.
Please see the responsive mutations below:
| CFTR Mutations Responsive to KALYDECO Based on Clinical and/or In Vitro Data¹⁻³ | |||
|---|---|---|---|
| A1067T | G1349D* | P67L* | S1159P |
| A120T | G178E | Q1291R | S1251N* |
| A234D | G178R* | Q237E | S1255P* |
| A349V | G194R | Q237H | S549N* |
| A455E* | G314E | Q359R | S549R* |
| D110E | G551D* | R1070Q | S589N |
| D110H | G551S* | R1070W* | S737F |
| D1152H* | G576A | R1162L | S945L* |
| D1270N | G970D | R117C* | S977F* |
| D192G | H1375P | R117G | T1053I |
| D579G* | H939R | R117H* | T338I |
| D924N | I1027T | R117L | V1293G |
| E193K | I1139V | R117P | V232D |
| E56K | I148T | R1283M | V562I |
| E822K | I175V | R170H | V754M |
| E831X* | I807M | R347H* | W1282R |
| F1052V | K1060T | R347L | Y1014C |
| F1074L | L1480P | R352Q* | Y1032C |
| F311del | L206W* | R553Q | 2789+ 5G→A* |
| F311L | L320V | R668C | 3272- 26A→G* |
| F508C | L967S | R74W | 3849+10kbC→T* |
| F508C;S1251N† | L997F | R75Q | 711+3A→G* |
| G1069R | M152V | R792G | |
| G1244E* | M952I | R933G | |
| G1249R | M952T | S1159F | |
| CFTR Mutations Responsive to KALYDECO Based on Clinical and/or In Vitro Data¹⁻³ | |||
|---|---|---|---|
| A1067T | G1349D* | P67L* | S1159P |
| A120T | G178E | Q1291R | S1251N* |
| A234D | G178R* | Q237E | S1255P* |
| A349V | G194R | Q237H | S549N* |
| A455E* | G314E | Q359R | S549R* |
| D110E | G551D* | R1070Q | S589N |
| D110H | G551S* | R1070W* | S737F |
| D1152H* | G576A | R1162L | S945L* |
| D1270N | G970D | R117C* | S977F* |
| D192G | H1375P | R117G | T1053I |
| D579G* | H939R | R117H* | T338I |
| D924N | I1027T | R117L | V1293G |
| E193K | I1139V | R117P | V232D |
| E56K | I148T | R1283M | V562I |
| E822K | I175V | R170H | V754M |
| E831X* | I807M | R347H* | W1282R |
| F1052V | K1060T | R347L | Y1014C |
| F1074L | L1480P | R352Q* | Y1032C |
| F311del | L206W* | R553Q | 2789+ 5G→A* |
| F311L | L320V | R668C | 3272- 26A→G* |
| F508C | L967S | R74W | 3849+ 10kbC→T* |
| F508C; S1251N† | L997F | R75Q | 711+3A→G* |
| G1069R | M152V | R792G | |
| G1244E* | M952I | R933G | |
| G1249R | M952T | S1159F | |
*Clinical data exist for these mutations.1
†Complex/compound mutations where a single allele of the CFTR gene has multiple mutations; these exist independent of the presence of mutations on the other allele.1
Important Safety Information
Warnings and Precautions
Transaminase (ALT or AST) Elevations
- Elevated transaminases have been reported in patients with CF receiving KALYDECO. Transaminase elevations were more common in patients with a history of transaminase elevations or in patients who had abnormal transaminases at baseline. ALT and AST should be assessed prior to initiating KALYDECO, every 3 months during the first year of treatment, and annually thereafter. For patients with a history of transaminase elevations, consider more frequent monitoring of liver function tests
- Patients who develop increased transaminase levels should be closely monitored until the abnormalities resolve. Dosing should be interrupted in patients with ALT or AST of greater than 5 times the upper limit of normal (ULN). Following resolution of transaminase elevations, consider the benefits and risks of resuming KALYDECO
Indications and Usage
KALYDECO is indicated for the treatment of cystic fibrosis (CF) in patients age 1 month and older who have at least one mutation in the CFTR gene that is responsive to ivacaftor potentiation based on clinical and/or in vitro assay data.
If the patient's genotype is unknown, an FDA-cleared CF mutation test should be used to detect the presence of a CFTR mutation followed by verification with bi-directional sequencing when recommended by the mutation test instructions for use.
Indications and Usage
KALYDECO is indicated for the treatment of cystic fibrosis (CF) in patients age 1 month and older who have at least one mutation in the CFTR gene that is responsive to ivacaftor potentiation based on clinical and/or in vitro assay data.
If the patient's genotype is unknown, an FDA-cleared CF mutation test should be used to detect the presence of a CFTR mutation followed by verification with bi-directional sequencing when recommended by the mutation test instructions for use.
Important Safety Information
Warnings and Precautions
Transaminase (ALT or AST) Elevations
- Elevated transaminases have been reported in patients with CF receiving KALYDECO. Transaminase elevations were more common in patients with a history of transaminase elevations or in patients who had abnormal transaminases at baseline. ALT and AST should be assessed prior to initiating KALYDECO, every 3 months during the first year of treatment, and annually thereafter. For patients with a history of transaminase elevations, consider more frequent monitoring of liver function tests
- Patients who develop increased transaminase levels should be closely monitored until the abnormalities resolve. Dosing should be interrupted in patients with ALT or AST of greater than 5 times the upper limit of normal (ULN). Following resolution of transaminase elevations, consider the benefits and risks of resuming KALYDECO
Concomitant Use With CYP3A Inducers
- Use of KALYDECO with strong CYP3A inducers, such as rifampin, substantially decreases the exposure of ivacaftor, which may reduce the therapeutic effectiveness of KALYDECO. Co-administration of KALYDECO with strong CYP3A inducers, such as rifampin, rifabutin, phenobarbital, carbamazepine, phenytoin, and St. John's wort is not recommended
Cataracts
- Cases of non-congenital lens opacities/cataracts have been reported in pediatric patients treated with KALYDECO. Baseline and follow-up ophthalmological examinations are recommended in pediatric patients initiating KALYDECO treatment
Adverse Reactions
Serious Adverse Reactions
- Serious adverse reactions, whether considered drug-related or not by the investigators, which occurred more frequently in patients treated with KALYDECO included abdominal pain, increased hepatic enzymes, and hypoglycemia
Most Common Adverse Reactions
- The most common adverse reactions in the 221 patients treated with KALYDECO were headache (17%), upper respiratory tract infection (16%), nasal congestion (16%), nausea (10%), rash (10%), rhinitis (6%), dizziness (5%), arthralgia (5%), and bacteria in sputum (5%)
- The safety profile for the CF patients enrolled in clinical trials (Trials 3-8) was similar to that observed in the 48-week, placebo-controlled trials (Trials 1 and 2)
Use In Specific Populations
Pediatric Use
- The safety and effectiveness of KALYDECO in patients with CF younger than 1 month of age have not been established. The use of KALYDECO in children under the age of 1 month is not recommended
- Use of KALYDECO in patients aged 1 to less than 6 months born at a gestational age less than 37 weeks has not been evaluated
Click here to access full Prescribing Information.
References:
1. KALYDECO [prescribing information]. Boston, MA: Vertex Pharmaceuticals Incorporated; May 2023. 2. The Clinical and Functional Translation of CFTR (CFTR2). Available at http://cftr2.org. Accessed May 2023.