Tryngolza (olezarsen) — Medica
Familial chylomicronemia syndrome
Initial criteria
- age ≥ 18 years
- fasting triglyceride level ≥ 880 mg/dL [documentation required]
- Patient has undergone genetic testing and meets ONE of the following:
- i. Molecular genetic test results demonstrate biallelic pathogenic variants in at least one gene causing familial chylomicronemia syndrome [documentation required] (genes may include LPL, GPIHBP1, APOA5, APOC2, or LMF1); OR
- ii. Molecular genetic test results are inconclusive and the patient has ONE of the following [documentation required]:
- a) familial chylomicronemia syndrome score ≥ 10; OR
- b) North American familial chylomicronemia syndrome score ≥ 45; OR
- c) history of pancreatitis; OR
- d) history of eruptive xanthomas; OR
- e) history of lipemia retinalis
- Medication will be used concomitantly with a low-fat diet
- Medication is prescribed by a cardiologist, endocrinologist, or physician specializing in severe hypertriglyceridemia
Approval duration
1 year