HARMONY BIOSCIENCES RECEIVES U.S. FOOD AND DRUG ADMINISTRATION APPROVAL FOR WAKIX® (PITOLISANT) IN PEDIATRIC PATIENTS WITH NARCOLEPSY
Harmony Biosciences (Nasdaq: HRMY) has received FDA approval for its drug WAKIX® (pitolisant) to treat excessive daytime sleepiness (EDS) in pediatric patients aged 6 years and older with narcolepsy. This approval follows a Phase 3 study by Bioprojet, which also led to European Medicines Agency approval for the same use last year. While WAKIX will now be available for pediatric EDS, FDA has issued a complete response for its use in treating cataplexy in this age group. WAKIX, first approved in 2019 for adult narcolepsy, is the only FDA-approved non-scheduled treatment for this condition. The company plans to discuss further pathways for cataplexy treatment in pediatric patients with the FDA.
- FDA approval for WAKIX to treat EDS in pediatric patients, expanding its market.
- WAKIX is the first FDA-approved non-scheduled treatment for pediatric narcolepsy.
- Positive Phase 3 study results supporting FDA and European Medicines Agency approvals.
- Potential for next-generation formulations and new indications to extend the WAKIX franchise.
- FDA issued a complete response for WAKIX's use in treating cataplexy in pediatric patients.
Insights
The FDA approval of WAKIX® (pitolisant) for pediatric patients with narcolepsy is a significant milestone for Harmony Biosciences. This approval extends the use of WAKIX, already approved for adult patients, to a younger age group suffering from excessive daytime sleepiness (EDS). The pivotal Phase 3 study by Bioprojet, which led to this approval, highlights the drug's safety and efficacy in children aged 6 and above.
WAKIX's unique mechanism as a histamine 3 (H3) receptor antagonist/inverse agonist sets it apart from other treatments, which are typically controlled substances. This is particularly noteworthy for pediatric treatment, where non-scheduled options are important for long-term management. By targeting the histamine system to promote wakefulness, WAKIX represents a novel approach in combating EDS in narcolepsy patients. Furthermore, the drug's non-scheduled status eliminates concerns related to dependency, making it a safer option for children.
Clinical trials are the gold standard in verifying a drug's effectiveness and safety. The approval not only demonstrates the robustness of Bioprojet's data but also confirms the FDA's confidence in WAKIX's therapeutic potential. The focus now shifts to the next-generation formulations and potential new indications, which could bolster Harmony Biosciences' portfolio and market position.
From a financial perspective, the FDA approval for WAKIX in pediatric narcolepsy patients could have a profound impact on Harmony Biosciences' revenue streams. Historically, pediatric indications can significantly expand a drug's market, given the extended duration of treatment typical for chronic conditions like narcolepsy. The non-scheduled status of WAKIX further enhances its marketability by addressing safety concerns associated with controlled substances, potentially leading to broader adoption among pediatricians and parents.
Investors should note the strategic value of this approval. Harmony Biosciences is now positioned to tap into a new patient demographic, which could translate into substantial long-term revenue growth. Moreover, the company's commitment to developing next-generation formulations and pursuing additional indications for WAKIX reflects a forward-looking strategy aimed at consolidating its leadership in the rare sleep disorder market. This could lead to enhanced shareholder value through sustained revenue growth and market expansion.
The approval of WAKIX for pediatric use is likely to shift the market dynamics in the treatment of pediatric narcolepsy. Until now, treatment options for children have been limited and primarily dominated by controlled substances, which poses a significant barrier due to risk of addiction and regulatory restrictions. WAKIX's non-scheduled status and unique action mechanism position it as a potentially preferred option for both healthcare providers and parents.
Market penetration for pediatric medication can be challenging, but the unmet medical need in this segment, highlighted by the FDA's priority review, underscores a substantial demand. Harmony Biosciences can leverage this opportunity by educating physicians and engaging with patient advocacy groups. Additionally, the approval from the European Medicines Agency last year aligns with a global strategy, indicating a synchronized effort to capture both U.S. and international markets.
Given these factors, WAKIX could quickly gain market share and the company's ongoing discussions with the FDA for additional indications demonstrate a proactive approach to maximizing the drug's potential. Investors should watch for updates on these discussions, as successful expansion into new indications could further strengthen market positioning.
The FDA granted priority review of the sNDA based on a Phase 3 study conducted by Bioprojet, which evaluated the safety and efficacy of pitolisant in patients ages 6 to under 18 years with narcolepsy, with or without cataplexy. Based on the results of this study, Bioprojet received approval from the European Medicines Agency last year extending the indication for WAKIX to include the treatment of narcolepsy in children ages 6 years of age and older, with or without cataplexy.
"Following the FDA's decision to grant priority review, we are very pleased with the Agency's timely review and approval of WAKIX for pediatric narcolepsy patients with excessive daytime sleepiness," said Jeffrey M. Dayno, M.D.,
WAKIX was first approved by the FDA in August 2019 for the treatment of EDS in adult patients with narcolepsy, followed by FDA approval for the treatment of cataplexy in adult patients with narcolepsy in October 2020. A first-in-class treatment with a novel mechanism of action, WAKIX functions as a selective histamine 3 (H₃) receptor antagonist/inverse agonist that is believed to target the histamine system to promote wakefulness.
Dayno added, "The unique mechanism of action of WAKIX and its non-scheduled status are especially important for a pediatric population that has had limited treatment options, all of which are controlled substances. The unique features of pitolisant present an exciting opportunity, and we are currently working on the next-generation formulations that could potentially offer additional benefits to patients, such as greater efficacy and new indications, extend the WAKIX franchise, and strengthen our leadership position in the treatment of rare sleep disorders."
"We plan to discuss with the Agency a path forward for a cataplexy indication in pediatric narcolepsy patients based on the strength of the existing data from Bioprojet's Phase 3 trial," said Kumar Budur, M.D., M.S., Chief Medical and Scientific Officer of Harmony Biosciences. "We appreciate the FDA's recognition of the unmet medical need in this patient population and their approval of the EDS indication, making WAKIX available to every appropriate pediatric patient 6 years and older living with narcolepsy."
"As a parent of a son who was diagnosed with narcolepsy in childhood, who continues to work in advocacy for all people living with narcolepsy of all ages, I applaud the FDA for approving WAKIX in pediatric patients 6 years of age and older," said Monica Gow, Co-Founder and Executive Director of Wake Up Narcolepsy. "This new approval offers a promising non-scheduled treatment option for children with narcolepsy, marking an important step forward in addressing the unmet medical needs of these children."
About Narcolepsy
Narcolepsy is a rare, chronic, debilitating neurological disease of sleep-wake state instability that impacts approximately 170,000 Americans and is primarily characterized by its cardinal symptom excessive daytime sleepiness (EDS), with or without cataplexy – along with other manifestations of REM sleep dysregulation (hallucinations and sleep paralysis), which intrude into wakefulness. EDS is the inability to stay awake and alert during the day and is the symptom that is present in all people living with narcolepsy. In most patients, narcolepsy is caused by the loss of hypocretin/orexin, a neuropeptide in the brain that supports sleep-wake state stability. This disease affects men and women equally, with typical symptom onset in adolescence or young adulthood; however, it can take up to a decade to be properly diagnosed.
About WAKIX® (pitolisant) Tablets
WAKIX, a first-in-class medication, is approved by the U.S. Food and Drug Administration for the treatment of excessive daytime sleepiness (EDS) or cataplexy in adult patients with narcolepsy and for the treatment of EDS in pediatric patients 6 years of age and older with narcolepsy. It was granted orphan drug designation for the treatment of narcolepsy in 2010, and breakthrough therapy designation for the treatment of cataplexy in 2018. WAKIX is a selective histamine 3 (H₃) receptor antagonist/inverse agonist. The mechanism of action of WAKIX is unclear; however, its efficacy could be mediated through its activity at H₃ receptors, thereby increasing the synthesis and release of histamine, a wake promoting neurotransmitter. WAKIX was designed and developed by Bioprojet (
INDICATIONS AND USAGE
WAKIX is indicated for the treatment of excessive daytime sleepiness (EDS) or cataplexy in adult patients with narcolepsy and for the treatment of excessive daytime sleepiness (EDS) in pediatric patients 6 years of age and older with narcolepsy.
IMPORTANT SAFETY INFORMATION
Contraindications
WAKIX is contraindicated in patients with known hypersensitivity to pitolisant or any component of the formulation. Anaphylaxis has been reported. WAKIX is also contraindicated in patients with severe hepatic impairment.
Warnings and Precautions
WAKIX prolongs the QT interval. Avoid use of WAKIX in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval. Avoid use in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval.
The risk of QT prolongation may be greater in patients with hepatic or renal impairment due to higher concentrations of pitolisant; monitor these patients for increased QTc. Dosage modification is recommended in patients with moderate hepatic impairment and moderate or severe renal impairment. WAKIX is contraindicated in patients with severe hepatic impairment and not recommended in patients with end-stage renal disease (ESRD).
Adverse Reactions
In the placebo-controlled clinical trials conducted in adult patients with narcolepsy with or without cataplexy, the most common adverse reactions (≥
In the placebo-controlled phase of the clinical trial conducted in pediatric patients 6 years and older with narcolepsy with or without cataplexy, the most common adverse reactions (≥
Drug Interactions
Concomitant administration of WAKIX with strong CYP2D6 inhibitors increases pitolisant exposure by 2.2-fold. Reduce the dose of WAKIX by half.
Concomitant use of WAKIX with strong CYP3A4 inducers decreases exposure of pitolisant by
H1 receptor antagonists that cross the blood-brain barrier may reduce the effectiveness of WAKIX. Patients should avoid centrally acting H1 receptor antagonists.
WAKIX is a borderline/weak inducer of CYP3A4. WAKIX may reduce the effectiveness of sensitive CYP3A4 substrates, including hormonal contraceptives. Patients using hormonal contraception should be advised to use an alternative non-hormonal contraceptive method during treatment with WAKIX and for at least 21 days after discontinuing treatment.
Use in Specific Populations
There is a pregnancy exposure registry that monitors pregnancy outcomes in women who are exposed to WAKIX during pregnancy. Patients should be encouraged to enroll in the WAKIX pregnancy registry if they become pregnant. To enroll or obtain information from the registry, patients can call 1-800-833-7460.
The safety and effectiveness of WAKIX have not been established for treatment of excessive daytime sleepiness in pediatric patients less than 6 years of age with narcolepsy.
The safety and effectiveness of WAKIX have not been established for treatment of cataplexy in pediatric patients with narcolepsy.
WAKIX is extensively metabolized by the liver. WAKIX is contraindicated in patients with severe hepatic impairment. Dosage adjustment is recommended in patients with moderate hepatic impairment.
WAKIX is not recommended in patients with end-stage renal disease. Dosage adjustment of WAKIX is recommended in patients with eGFR <60 mL/minute/1.73 m2.
Dosage reduction is recommended in patients known to be poor CYP2D6 metabolizers; these patients have higher concentrations of WAKIX than normal CYP2D6 metabolizers.
Please see the Full Prescribing Information for WAKIX for more information.
To report suspected adverse reactions, contact Harmony Biosciences at 1-800-833-7460 or the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
About Harmony Biosciences
At Harmony Biosciences, we specialize in developing and delivering treatments for rare neurological diseases that others often overlook. We believe that where empathy and innovation meet, a better life can begin for people living with neurological diseases. Established by Paragon Biosciences, LLC, in 2017 and headquartered in Plymouth Meeting, PA, our team of experts from a wide variety of disciplines and experiences is driven by our shared conviction that innovative science translates into therapeutic possibilities for our patients, who are at the heart of everything we do. For more information, please visit www.harmonybiosciences.com.
Forward Looking Statement
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements contained in this press release that do not relate to matters of historical fact should be considered forward-looking statements, including statements regarding our product WAKIX. These statements are neither promises nor guarantees, but involve known and unknown risks, uncertainties and other important factors that may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements, including, but not limited to, the following: our commercialization efforts and strategy for WAKIX; the rate and degree of market acceptance and clinical utility of WAKIX, pitolisant in additional indications, if approved, and any other product candidates we may develop or acquire, if approved; our research and development plans, including our plans to explore the therapeutic potential of pitolisant in additional indications; our ongoing and planned clinical trials; our ability to expand the scope of our license agreements with Bioprojet Société Civile de Recherche ("Bioprojet"); the availability of favorable insurance coverage and reimbursement for WAKIX; the timing of and our ability to obtain regulatory approvals for pitolisant for other indications as well as any other product candidates; our estimates regarding expenses, future revenue, capital requirements and additional financing needs; our ability to identify, acquire and integrate additional products or product candidates with significant commercial potential that are consistent with our commercial objectives; our commercialization, marketing and manufacturing capabilities and strategy; significant competition in our industry; our intellectual property position; loss or retirement of key members of management; failure to successfully execute our growth strategy, including any delays in our planned future growth; our failure to maintain effective internal controls; the impact of government laws and regulations; volatility and fluctuations in the price of our common stock; the significant costs and required management time as a result of operating as a public company; the fact that the price of Harmony's common stock may be volatile and fluctuate substantially; statements related to our intended share repurchases and repurchase timeframe and the significant costs and required management time as a result of operating as a public company. These and other important factors discussed under the caption "Risk Factors" in our Annual Report on Form 10-K filed with the Securities and Exchange Commission (the "SEC") on February 22, 2024, and our other filings with the SEC could cause actual results to differ materially from those indicated by the forward-looking statements made in this press release. Any such forward-looking statements represent management's estimates as of the date of this press release. While we may elect to update such forward-looking statements at some point in the future, we disclaim any obligation to do so, even if subsequent events cause our views to change.
Harmony Biosciences Investor Contact:
Brennan Doyle
484-539-9700
bdoyle@harmonybiosciences.com
Harmony Biosciences Media Contact:
Cate McCanless
202-641-6086
cmccanless@harmonybiosciences.com
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