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ENSIFENTRINE SUSP,INHL

Clinical Criteria Summary

Disease Diagnosis & Severity

  • Diagnosis of asthma (Exclusion)
  • Treatment of acute bronchospasm or an acute exacerbation of chronic obstructive pulmonary disease (COPD) (Exclusion)
  • Moderate to severe COPD (e.g., post-bronchodilator FEV1 30-70% predicted and FEV1/FVC <0.7, confirmed by pulmonary function testing) (Inclusion)
  • Inadequate symptom control (e.g., dyspnea score of at least 2 on Medical Research Council dyspnea scale) (Inclusion)

Prior Therapy & Exacerbation History

  • Receiving maintenance bronchodilator therapy with a long-acting beta-agonist (LABA) AND a long-acting anticholinergic (LAMA) AND an inhaled corticosteroid (unless inhaled corticosteroid is contraindicated) for at least 3 months (Inclusion)
  • Had at least 2 moderate COPD exacerbations (requiring systemic steroids and/or antibiotics) or at least 1 severe COPD exacerbation (requiring hospitalization) in the previous 12 months (Inclusion)
  • Patient is unable to tolerate or had an inadequate response to roflumilast and/or azithromycin after therapeutic trial (e.g., continued exacerbations after at least 6 months) or is clinically not appropriate for either agent (e.g., risks outweigh benefits) (Inclusion)

Psychiatric Considerations

  • History of depression (e.g., major depressive disorder [MDD]), suicidal thoughts or behaviors, unless determined in consultation with a mental health specialist or primary care provider that ensifentrine can be used (Exclusion/Caution)
  • Other psychiatric adverse events including insomnia and anxiety; use with caution in patients with these or other mental health disorders (e.g., psychotic disorder, bipolar disorder, PTSD), especially if not fully controlled (Exclusion/Caution)
  • Potential for psychiatric events with ensifentrine such as mood changes, depression, anxiety and suicidal thoughts and/or behaviors have been discussed with the patient and documented in medical record (Inclusion)

Hepatic Function

  • Moderate to severe hepatic impairment as exposure to ensifentrine may increase up to 2.3-fold (Exclusion/Caution)

Smoking Status

  • Patient is non-smoking or, if not, he/she is enrolled in a quit smoking program or on medications to assist with smoking cessation; current smokers may be considered if unable or refuse to quit (Additional Guidance/Inclusion)

Reproductive Potential

  • For patients who can become pregnant: Counseling provided on potential risks vs benefits of treatment and the use of effective contraception during therapy (Additional Inclusion Criteria)

Provider & Administrative Requirements

  • Provider is a VA or VA Community Care pulmonologist or designated expert (Inclusion)
  • Adherent to COPD medications as evidenced by a review of prescription refill history (Inclusion)
  • Patient has demonstrated correct inhaler technique (documented in medical record) (Inclusion)

Source Documents