Would you recommend off-label use of nedosiran for patients with primary hyperoxaluria type 2?

For a couple of reasons, no.

1. The evidence is not clear if it works or not for PH2. If there is an effect, it is probably quite a bit less effective on average than for PH1.
2. The cost is extremely high for a trial of something we are not confident will help.
3. It is not FDA-approved for PH2, thus, paye...