How are you currently managing patients with Hunter syndrome, and what limitations do you see with existing therapies in addressing neurologic versus peripheral disease manifestations?

What is your interpretation of the clinical data for tividenofusp alfa, particularly the reported effects on CNS biomarkers, peripheral biomarkers, and clinical measures such as cognition, adaptive behavior, hearing, or organ involvement? 

How clinically meaningful do you believe a brain-penetrant enzyme replacement therapy could be for patients with MPS II, especially if initiated before advanced neurologic impairment?

How do you expect to discuss the option of switching with your patients? Do you expect to have these discussions with stable patients? Right away? At annual check-in?

Do you have any concerns about antibody development/Neutralizing antibodies that could impact the efficacy of Avlayah? How will that be assessed?

What is on your "checklist" for evaluating patients for whether they should switch to Avlayah

will you proactively call in patients for an appointment to switch them or wait for their annual visit - especially if they don't reach out to you immediately

Do you expect any of your patients remaining on Elaprase? Which patients? Why?

Do geneticists at small community hospitals have familiarity around new therapies? Do they treat Hunter patients or refer them out to COEs?

How concerning are the precautions around membranous nephropathy and anemia listed on the label?

What additional data do you wish/hope to have to support your decision to prescribe Avlayah?

Can a patient return to Elaprase if they can not tolerate Avlayah? Will antibodies make that impossible?

Are IRRs a concern with Avlayah?