European Medicines Agency decision

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EMA/654890/2017 European Medicines Agency decision P/0307/2017 of 30 October 2017 on the acceptance of a modification of an agreed paediatric investigation plan for andexanet alfa (EMEA-001902-PIP01-15-M01) in accordance with Regulation (EC) No 1901/2006 of the European Parliament and of the Council Disclaimer This decision does not constitute entitlement to the rewards and incentives referred to in Title V of Regulation (EC) No 1901/2006. Only the English text is authentic. 30 Churchill Place Canary Wharf London E14 5EU United Kingdom Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Contact EMA www.ema.europa.eu/contact An agency of the European Union

European Medicines Agency decision P/0307/2017 of 30 October 2017 on the acceptance of a modification of an agreed paediatric investigation plan for andexanet alfa (EMEA-001902-PIP01-15-M01) in accordance with Regulation (EC) No 1901/2006 of the European Parliament and of the Council The European Medicines Agency, Having regard to the Treaty on the Functioning of the European Union, Having regard to Regulation (EC) No 1901/2006 of the European Parliament and of the Council of 12 December 2006 on medicinal products for paediatric use and amending Regulation (EEC) No. 1768/92, Directive 2001/20/EC, Directive 2001/83/EC and Regulation (EC) No 726/2004 1, Having regard to Regulation (EC) No 726/2004 of the European Parliament and of the Council of 31 March 2004 laying down Community procedures for the authorisation and supervision of medicinal products for human and veterinary use and establishing a European Medicines Agency 2, Having regard to the European Medicines Agency s decision P/0199/2016 issued on 18 July 2016, Having regard to the application submitted by Portola Pharma UK Limited on 23 June 2017 under Article 22 of Regulation (EC) No 1901/2006 proposing changes to the agreed paediatric investigation plan with a deferral, Having regard to the opinion of the Paediatric Committee of the European Medicines Agency, issued on 15 September 2017, in accordance with Article 22 of Regulation (EC) No 1901/2006, Having regard to Article 25 of Regulation (EC) No 1901/2006, Whereas: (1) The Paediatric Committee of the European Medicines Agency has given an opinion on the acceptance of changes to the agreed paediatric investigation plan and to the deferral. (2) It is therefore appropriate to adopt a decision on the acceptance of changes to the agreed paediatric investigation plan, including changes to the deferral. 1 OJ L 378, 27.12.2006, p.1. 2 OJ L 136, 30.4.2004, p. 1. European Medicines Agency decision EMA/654890/2017 Page 2/3

Has adopted this decision: Article 1 Changes to the agreed paediatric investigation plan for andexanet alfa, powder for solution for infusion, intravenous use, including changes to the deferral, are hereby accepted in the scope set out in the opinion of the Paediatric Committee of the European Medicines Agency annexed hereto, together with its appendices. Article 2 This decision is addressed to Portola Pharma UK Limited, 209 Tower Bridge Business Centre, 46-48 East Smithfield, E1W 1AW London, United Kingdom. European Medicines Agency decision EMA/654890/2017 Page 3/3

EMA/PDCO/425090/2017 London, 15 September 2017 Opinion of the Paediatric Committee on the acceptance of a modification of an agreed Paediatric Investigation Plan EMEA-001902-PIP01-15-M01 Scope of the application Active substance(s): Andexanet alfa Condition(s): Treatment of factor Xa inhibitor associated haemorrhage Prevention of factor Xa inhibitor associated haemorrhage Pharmaceutical form(s): Powder for solution for infusion Route(s) of administration: Intravenous use Name/corporate name of the PIP applicant: Portola Pharma UK Limited Basis for opinion Pursuant to Article 22 of Regulation (EC) No 1901/2006 as amended, Portola Pharma UK Limited submitted to the European Medicines Agency on 23 June 2017 an application for modification of the agreed paediatric investigation plan with a deferral as set out in the European Medicines Agency s decision P/0199/2016 issued on 18 July 2016. The application for modification proposed changes to the agreed paediatric investigation plan and to the deferral. The procedure started on 18 July 2017. 30 Churchill Place Canary Wharf London E14 5EU United Kingdom Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5510 Send a question via our website www.ema.europa.eu/contact An agency of the European Un on

Scope of the modification Some timelines of the Paediatric Investigation Plan have been modified. Opinion 1. The Paediatric Committee, having assessed the application in accordance with Article 22 of Regulation (EC) No 1901/2006 as amended, recommends as set out in the appended summary report: to agree to changes to the paediatric investigation plan and to the deferral in the scope set out in the Annex I of this opinion. The Norwegian Paediatric Committee member agrees with the above-mentioned recommendation of the Paediatric Committee. 2. The measures and timelines of the paediatric investigation plan are set out in the Annex I. This opinion is forwarded to the applicant and the Executive Director of the European Medicines Agency, together with its annex and appendix. EMA/PDCO/425090/2017 Page 2/16

Annex I The subset(s) of the paediatric population and condition(s) covered by the waiver and the measures and timelines of the agreed paediatric investigation plan (PIP) EMA/PDCO/425090/2017 Page 3/16

1. Waiver Not applicable 2. Paediatric investigation plan 2.1. Condition Treatment of factor Xa inhibitor associated haemorrhage 2.1.1. Indication(s) targeted by the PIP For the reversal of anticoagulation due to direct and indirect factor Xa inhibitors in patients experiencing an acute major bleeding event 2.1.2. Subset(s) of the paediatric population concerned by the paediatric development From birth to less than 18 years of age 2.1.3. Pharmaceutical form(s) Intravenous use 2.1.4. Measures Area Number of measures Description Quality-related studies Non-clinical studies 1 Study 1 Development of appropriately sized vials to cover all the paediatric population. 0 Not applicable. Clinical studies 5 Study 2 end of their treatment with enoxaparin. Study 3 end of their treatment with rivaroxaban. Study 4 end of their treatment with apixaban. EMA/PDCO/425090/2017 Page 4/16

Study 5 end of their treatment with edoxaban. Study 6 end of their treatment with betrixaban. Extrapolation, modelling and simulation studies 1 Study 7 A population PK/PD model for the determination of andexanet dose and rate of infusion required for reversal of anticoagulation, for direct and indirect fxa inhibitors in paediatric populations. Other studies 0 Not applicable. Other measures 0 Not applicable. 2.2. Condition Prevention of factor Xa inhibitor associated haemorrhage 2.2.1. Indication(s) targeted by the PIP For the reversal of anticoagulation due to direct and indirect factor Xa inhibitors in patients requiring urgent surgery 2.2.2. Subset(s) of the paediatric population concerned by the paediatric development From birth to less than 18 years of age 2.2.3. Pharmaceutical form(s) Intravenous use 2.2.4. Measures The same as measures for condition "Treatment of factor Xa inhibitor associated haemorrhage" EMA/PDCO/425090/2017 Page 5/16

3. Follow-up, completion and deferral of PIP Concerns on potential long term safety/efficacy issues in relation to paediatric use: No Date of completion of the paediatric investigation plan: By March 2026 Deferral for one or more measures contained in the paediatric investigation plan: Yes EMA/PDCO/425090/2017 Page 6/16