Eplontersen granted Orphan Drug Designation in the US for transthyretin amyloidosis
Eplontersen has received Orphan Drug Designation from the FDA for treating transthyretin-mediated amyloidosis, a serious progressive condition. Also known as IONIS-TTR-LRx, Eplontersen is undergoing Phase III trials for ATTR-CM and ATTR-PN. The FDA grants this status to drugs for rare diseases affecting less than 200,000 people in the U.S. AstraZeneca and Ionis Pharmaceuticals will jointly develop Eplontersen, with regulatory approval expected for hereditary ATTR-PN by late 2022, signaling promising advancements in treatment options for patients.
- Eplontersen granted FDA Orphan Drug Designation, highlighting its potential for treating a rare, progressive disease.
- Joint development and commercialization with Ionis Pharmaceuticals could enhance market reach and resource sharing.
- Potential to file a new drug application by the end of 2022, indicating a clear regulatory pathway.
- None.
Eplontersen, formerly known as IONIS-TTR-LRx, is a ligand-conjugated antisense (LICA) investigational medicine currently in Phase III clinical trials for amyloid transthyretin cardiomyopathy (ATTR-CM) and amyloid transthyretin polyneuropathy (ATTR-PN). It is designed to reduce the production of transthyretin (TTR protein) to treat both hereditary and non-hereditary forms of TTR amyloidosis (ATTR).
ATTR-CM is a systemic, progressive and fatal condition that leads to progressive heart failure and death within four years from diagnosis.1 It remains underdiagnosed and its prevalence is thought to be underestimated due to a lack of disease awareness and the heterogeneity of symptoms.2,3 Hereditary ATTR-PN is a debilitating disease that leads to peripheral nerve damage with motor disability within five years of diagnosis and, without treatment, is generally fatal within a decade.3
The FDA grants ODD status to medicines and potential new medicines intended for the treatment, diagnosis or prevention of rare diseases or disorders that affect fewer than 200,000 people in the US.
As part of a global development and commercialization agreement with Ionis Pharmaceuticals, Inc. (Ionis) eplontersen will be jointly developed and commercialized by both companies in the US, and will be developed and commercialized in the rest of the world, except in
Hereditary ATTR-PN is expected to be the first indication for which the companies will seek regulatory approval for eplontersen, with the potential to file a new drug application with the
Notes
TTR Amyloidosis (ATTR)
Cardiomyopathy and polyneuropathy due to ATTR are caused by aging or genetic mutations resulting in misfolded TTR protein and accumulation as amyloid fibrils in the cardiac myocardium and peripheral nerves, respectively. In patients with ATTR, both the mutant and wild type TTR protein builds up as fibrils in tissues, such as the peripheral nerves, heart, gastrointestinal system, eyes, kidneys, central nervous system, thyroid and bone marrow.2 The presence of TTR fibrils interferes with the normal functions of these tissues. As the TTR protein fibrils enlarge, more tissue damage occurs and the disease worsens, resulting in poor quality of life and eventually death. Worldwide, there are an estimated 300,000 - 500,000 patients with ATTR-CM4,5 and 10,000 - 40,000 patients with ATTR-PN.2
Eplontersen
Eplontersen is a ligand-conjugated antisense (LICA) investigational medicine designed to reduce the production of transthyretin, or TTR protein, to treat all types of ATTR, a systemic, progressive and fatal disease.
Cardiovascular, Renal and Metabolism (CVRM), part of BioPharmaceuticals, forms one of AstraZeneca’s three disease areas and is a key growth driver for the Company. By following the science to understand more clearly the underlying links between the heart, kidneys and pancreas,
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References
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Lauppe RE, et al. Nationwide prevalence and characteristics of transthyretin amyloid cardiomyopathy in
Sweden . Open Heart. 2021 Oct;8(2):e001755. doi: 10.1136/openhrt-2021-001755. - González-Duarte A, et al. Impact of non-cardiac clinicopathologic characteristics on survival in transthyretin amyloid polyneuropathy. Neurol Ther. 2020;9(1):135-149. doi:10.1007/s40120-020-00183-7.
- Cortese A, et al. Diagnostic challenges in hereditary transthyretin amyloidosis with polyneuropathy: avoiding misdiagnosis of a treatable hereditary neuropathy. J Neurol Neurosurg Psychiatry. 2017 May;88(5):457-458. doi: 10.1136/jnnp-2016-315262.
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Mohamed-Salem L , et al. Prevalence of wild type ATTR assessed as myocardial uptake in bone scan in the elderly population. Int J Cardiol. 2018Nov 1 ;270:192-196. doi: 10.1016/j.ijcard.2018.06.006. -
Cuscaden C, et al. Estimation of prevalence of transthyretin (ATTR) cardiac amyloidosis in an Australian subpopulation using bone scans with echocardiography and clinical correlation. J Nucl Cardiol. 2020
May 8 . doi: 10.1007/s12350-020-02152-x
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