Duvyzat (givinostat oral suspension) — Medica
Duchenne muscular dystrophy
Initial criteria
- Patient is age ≥ 6 years
- Diagnosis of Duchenne muscular dystrophy is confirmed by genetic testing with a confirmed pathogenic variant in the dystrophin gene [documentation required]
- Patient is ambulatory
- Patient is on a stable systemic corticosteroid therapy for at least 6 months
- Medication is prescribed by or in consultation with a physician who specializes in the treatment of Duchenne muscular dystrophy and/or neuromuscular disorders
Reauthorization criteria
- Patient is age ≥ 6 years
- Patient is ambulatory
- Patient is continuing to receive stable systemic corticosteroid therapy
- According to the prescriber, the patient continues to benefit from therapy, as demonstrated by a stabilization or slowed decline on timed function tests (e.g., 4-stair climb, 6-minute walk test, time-to-rise) or in the North Star Ambulatory Assessment (NSAA) score
- Medication is prescribed by or in consultation with a physician who specializes in the treatment of Duchenne muscular dystrophy and/or neuromuscular disorders
Approval duration
1 year