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WAINZUA (eplontersen) recommended for approval in the EU by CHMP for the treatment of adults with polyneuropathy associated with hereditary transthyretin-mediated amyloidosis

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Ionis Pharmaceuticals announced that WAINZUA (eplontersen), developed with AstraZeneca, has been recommended for approval by the CHMP in the EU for treating hereditary transthyretin-mediated amyloidosis in adult patients with stage 1 or 2 polyneuropathy (ATTRv-PN). If approved, WAINZUA will be the only EU-approved medicine for ATTRv-PN that can be self-administered monthly via an auto-injector.

The recommendation is based on the positive NEURO-TTRansform Phase 3 trial results, showing consistent and sustained benefits in serum TTR concentration, neuropathy impairment, and quality of life through 66 weeks. WAINZUA demonstrated a favorable safety and tolerability profile throughout the trial.

WAINZUA was approved in the U.S. in December 2023 and is gaining approvals worldwide. Ionis and AstraZeneca are commercializing it in the U.S. and seeking approvals globally. The drug is also being evaluated for ATTR-CM in the CARDIO-TTRansform Phase 3 study.

Ionis Pharmaceuticals ha annunciato che WAINZUA (eplontersen), sviluppato con AstraZeneca, è stato raccomandato per l'approvazione dal CHMP nell'UE per il trattamento dell'amiloidosi ereditaria mediata da transtiretina in pazienti adulti con polineuropatia di stadio 1 o 2 (ATTRv-PN). Se approvato, WAINZUA sarà l'unico farmaco approvato nell'UE per ATTRv-PN che può essere auto-somministrato mensilmente tramite un auto-iniettore.

La raccomandazione si basa sui risultati positivi della fase 3 dello studio NEURO-TTRansform, che mostrano benefici coerenti e sostenuti nelle concentrazioni sieriche di TTR, nel deterioramento della neuropatia e nella qualità della vita per 66 settimane. WAINZUA ha dimostrato un profilo di sicurezza e tollerabilità favorevole durante tutto lo studio.

WAINZUA è stato approvato negli Stati Uniti nel dicembre 2023 e sta ottenendo approvazioni in tutto il mondo. Ionis e AstraZeneca lo stanno commercializzando negli Stati Uniti e cercando approvazioni a livello globale. Il farmaco è anche in fase di valutazione per l'ATTR-CM nello studio CARDIO-TTRansform di fase 3.

Ionis Pharmaceuticals anunció que WAINZUA (eplontersen), desarrollado junto con AstraZeneca, ha sido recomendado para aprobación por el CHMP en la UE para el tratamiento de amiloidosis mediada por transtirretina hereditaria en pacientes adultos con polineuropatía de etapa 1 o 2 (ATTRv-PN). Si se aprueba, WAINZUA será el único medicamento aprobado en la UE para ATTRv-PN que puede autoadministrarse mensualmente mediante un autoinyector.

La recomendación se basa en los resultados positivos del ensayo de fase 3 NEURO-TTRansform, que muestran beneficios consistentes y sostenidos en la concentración sérica de TTR, en la discapacidad neuropática y en la calidad de vida a través de 66 semanas. WAINZUA mostró un perfil de seguridad y tolerabilidad favorable durante todo el ensayo.

WAINZUA fue apurado en EE. UU. en diciembre de 2023 y está obteniendo aprobaciones en todo el mundo. Ionis y AstraZeneca lo están comercializando en EE. UU. y buscando aprobaciones a nivel global. El fármaco también está siendo evaluado para ATTR-CM en el estudio CARDIO-TTRansform de fase 3.

아이오니스 제약은 아스트라제네카와 공동 개발한 WAINZUA (에플론테르센)가 EU의 CHMP에서 승인 권장을 받았으며, 유전성 트랜스티레틴 매개 아밀로이드증 치료를 위해 성인 환자의 1단계 또는 2단계 다발신경병증(ATTRv-PN)에 적합하다고 발표했습니다. 만약 승인된다면 WAINZUA는 매달 자가 투여가 가능한 ATTRv-PN을 위한 EU 승인 약물이 될 것입니다.

이 권장 사항은 NEURO-TTRansform 3상 시험 결과의 긍정적인 결론을 바탕으로 하며, 혈청 TTR 농도, 신경병증 손상, 그리고 66주 동안의 삶의 질에서 일관되고 지속적인 혜택을 보여줍니다. WAINZUA는 시험 기간 동안 안전성과 내약성 프로필이 우수하였습니다.

WAINZUA는 2023년 12월 미국에서 승인을 받았으며, 전세계적으로 승인을 받고 있습니다. 아이오니스와 아스트라제네카는 미국에서 이를 상업화하고 있으며 전 세계적으로 승인을 요청하고 있습니다. 이 약물은 CARDIO-TTRansform 3상 연구에서 ATTR-CM에 대해서도 평가되고 있습니다.

Ionis Pharmaceuticals a annoncé que WAINZUA (éplontersène), développé avec AstraZeneca, a été recommandé pour approbation par le CHMP dans l'UE pour le traitement de l'amylose héréditaire médiée par transthyretine chez les patients adultes atteints de polynévropathie de stade 1 ou 2 (ATTRv-PN). Si approuvé, WAINZUA sera le seul médicament approuvé dans l'UE pour l'ATTRv-PN pouvant être auto-administré mensuellement via un auto-injecteur.

La recommandation est basée sur les résultats positifs de l'essai de phase 3 NEURO-TTRansform, montrant des avantages cohérents et durables en termes de concentration de TTR sérique, d'atteinte neuropathique et de qualité de vie sur 66 semaines. WAINZUA a démontré un profil de sécurité et de tolérabilité favorable tout au long de l'essai.

WAINZUA a été approuvé aux États-Unis en décembre 2023 et obtient des approbations dans le monde entier. Ionis et AstraZeneca le commercialisent aux États-Unis et recherchent des approbations à l'échelle mondiale. Le médicament est également évalué pour l'ATTR-CM dans l'étude CARDIO-TTRansform de phase 3.

Ionis Pharmaceuticals hat angekündigt, dass WAINZUA (Eplontersen), das gemeinsam mit AstraZeneca entwickelt wurde, vom CHMP in der EU zur Genehmigung empfohlen wurde zur Behandlung von erblicher transthyretinvermittelter Amyloidose bei erwachsenen Patienten mit Polyneuropathie der Stufen 1 oder 2 (ATTRv-PN). Wenn es genehmigt wird, wird WAINZUA das einzige in der EU zugelassene Medikament für ATTRv-PN sein, das monatlich selbst verabreicht werden kann über einen Autoinjektor.

Die Empfehlung basiert auf den positiven Ergebnissen der Phase-3-Studie NEURO-TTRansform, die konsistente und nachhaltige Vorteile in der Serum-TTR-Konzentration, der Beeinträchtigung durch Neuropathie und der Lebensqualität über 66 Wochen hinweg zeigt. WAINZUA zeigte während der gesamten Studie ein günstiges Sicherheits- und Verträglichkeitsprofil.

WAINZUA wurde im Dezember 2023 in den USA genehmigt und erhält weltweit Genehmigungen. Ionis und AstraZeneca vermarkten es in den USA und streben globale Genehmigungen an. Das Medikament wird auch im CARDIO-TTRansform Phase-3-Studie für ATTR-CM evaluiert.

Positive
  • WAINZUA recommended for approval by CHMP in the EU for ATTRv-PN treatment
  • Potential to be the only EU-approved self-administered monthly treatment for ATTRv-PN
  • Positive Phase 3 trial results showing consistent and sustained benefits
  • Already approved in the U.S. and gaining approvals worldwide
  • Large-scale Phase 3 study ongoing for ATTR-CM indication
Negative
  • None.

Insights

This CHMP recommendation for WAINZUA (eplontersen) is a significant milestone for Ionis Pharmaceuticals and AstraZeneca in the treatment of ATTRv-PN. The positive Phase 3 results demonstrating consistent and sustained benefits in neuropathy impairment and quality of life are compelling. Key points to consider:

  • WAINZUA could become the only EU-approved, self-administered monthly treatment for ATTRv-PN via auto-injector
  • The drug showed efficacy in reducing serum TTR concentration and improving neuropathy impairment (mNIS+7) over 66 weeks
  • A favorable safety and tolerability profile was maintained throughout the trial

For investors, this represents a potential expansion of Ionis' market reach in Europe and strengthens its partnership with AstraZeneca. The orphan drug designation in both the U.S. and EU also suggests potential for market exclusivity and premium pricing. The ongoing CARDIO-TTRansform study for ATTR-CM indicates further growth opportunities in related indications.

This CHMP recommendation is a positive catalyst for Ionis Pharmaceuticals (IONS). Key financial implications include:

  • Market Expansion: Potential EU approval opens a significant new market for WAINZUA, complementing its U.S. approval
  • Revenue Growth: As the only self-administered monthly treatment in the EU, if approved, WAINZUA could capture a substantial market share
  • Partnership Value: The AstraZeneca collaboration enhances commercialization potential and may lead to milestone payments
  • Pipeline Strength: Success in ATTRv-PN bodes well for the larger ATTR-CM trial, potentially expanding the addressable market

With a market cap of $6.16 billion, IONS could see meaningful revenue growth from WAINZUA. Investors should monitor the final EU approval decision and subsequent launch strategy. The orphan drug status may also provide pricing power, potentially leading to higher profit margins.

- Recommendation based on NEURO-TTRansform Phase 3 results showing WAINZUA demonstrated consistent and sustained benefit improving neuropathy impairment and quality of life versus placebo

CARLSBAD, Calif., Oct. 21, 2024  /PRNewswire/ -- Ionis Pharmaceuticals, Inc. (Nasdaq: IONS) announced today that Ionis' and AstraZeneca's WAINZUA (eplontersen) has been recommended for approval by the Committee for Medicinal Products for Human Use (CHMP) in the European Union (EU) for the treatment of hereditary transthyretin-mediated amyloidosis in adult patients with stage 1 or stage 2 polyneuropathy, commonly referred to as hATTR-PN or ATTRv-PN. If approved by the European Commission, WAINZUA will be the only approved medicine in the EU for the treatment of ATTRv-PN that can be self-administered monthly via an auto-injector.

The CHMP based its opinion on the positive NEURO-TTRansform Phase 3 trial which showed that through 66 weeks, patients treated with WAINZUA demonstrated consistent and sustained benefit on the co-primary endpoints of serum transthyretin (TTR) concentration and neuropathy impairment measured by modified Neuropathy Impairment Score +7 (mNIS+7), and key secondary endpoint of quality of life (QoL) on the Norfolk Quality of Life Questionnaire-Diabetic Neuropathy (Norfolk QoL-DN) versus external placebo. WAINZUA continued to demonstrate a favorable safety and tolerability profile throughout the NEURO-TTRansform trial.

ATTRv-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. WAINZUA is a once-monthly RNA-targeted medicine designed to reduce the production of TTR protein at its source.

"Hereditary transthyretin-mediated amyloidosis with polyneuropathy remains a progressive and debilitating disease in Europe and other parts of the world, despite currently available medicines," said Brett P. Monia, Ph.D., chief executive officer, Ionis. "The CHMP recommendation is an important step toward making WAINZUA available in Europe, which, if approved, will be the only medicine in the EU for the treatment of transthyretin-mediated amyloidosis with polyneuropathy that can be self-administered monthly via an auto-injector. We are proud to partner with AstraZeneca whose global leadership and expertise positions our alliance to rapidly and effectively bring WAINZUA to many people living with hereditary transthyretin-mediated amyloidosis with polyneuropathy in Europe, pending the EMA's decision."

In December 2023, eplontersen was approved in the U.S. for the treatment of ATTRv-PN, under the brand name WAINUA™ (eplontersen). WAINUA is now gaining approvals in additional countries worldwide, including Canada. As part of a global development and commercialization agreement, AstraZeneca and Ionis are commercializing WAINUA in the U.S. The companies are seeking regulatory approval in Europe and other parts of the world where AstraZeneca has exclusive rest of world commercialization and development rights. Eplontersen has also been granted Orphan Drug Designation in the U.S. and in the EU for the treatment of transthyretin-mediated amyloidosis (ATTR).

Eplontersen is also currently being evaluated in the global CARDIO-TTRansform Phase 3 study for the treatment of adults with ATTR-CM. The trial is fully enrolled with more than 1,400 patients – making it the largest, most comprehensive study to date in this patient population. More information on the CARDIO-TTRansform study (NCT04136171) is available at www.clinicaltrials.gov.

About TTR Amyloidosis

ATTR is caused by the accumulation of liver-derived misfolded TTR protein in tissues, such as the heart and the peripheral nerves, causing organ damage and failure. ATTR then causes complications, leading to cardiovascular, neurological and renal diseases such as heart failure and chronic kidney disease. There are both hereditary (ATTRv) and non-hereditary (wild-type) forms of ATTR. ATTR is a rapidly progressive and fatal disease that requires timely recognition of symptoms. ATTR has several phenotypes including ATTR-cardiomyopathy (CM), which predominantly impacts the heart, potentially leading to heart failure, ATTR-polyneuropathy (PN), which predominantly affects the peripheral nervous system and mixed phenotype, where patients experience symptoms of both. Worldwide, there are an estimated 300,000 – 500,000 patients with ATTR-CM and about 10,000 – 40,000 patients with ATTRv-PN.

About NEURO-TTRansform

NEURO-TTRansform is a global, open-label, randomized trial evaluating the efficacy and safety of eplontersen in patients with ATTRv-PN at week 35, week 66 and week 85. The final analysis comparing eplontersen to an external placebo group was completed at week 66. All patients were then followed on treatment until week 85 and evaluated four weeks after the last dose in an end-of-trial assessment. Following treatment and the end-of-trial assessments, patients were eligible to enter an open-label extension study to continue receiving eplontersen once every four weeks or enter a 20-week post-treatment evaluation period, which is still ongoing. Full results from the NEURO-TTRansform trial were published in The Journal of the American Medical Association (JAMA) demonstrating the benefit of eplontersen across the spectrum of ATTRv-PN at 35, 66 and 85 weeks of treatment.

About WAINZUA / WAINUA™ (eplontersen)

Eplontersen is a once-monthly RNA-targeted medicine that provides upstream suppression of transthyretin (TTR) production and is designed to precisely target and reduce the production of TTR protein at its source in the liver.

WAINZUA has been approved in the U.S. and Canada under the brand name WAINUA™ (eplontersen) for the treatment of the polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults, commonly referred to as hATTR-PN or ATTRv-PN. Please see link for full U.S. Prescribing Information. WAINZUA is not yet approved for any indication in Europe.

U.S. INDICATION for WAINUA™ (eplontersen)

WAINUA injection for subcutaneous use 45 mg is indicated for treatment of the polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults.

IMPORTANT SAFETY INFORMATION for WAINUA™ (eplontersen)

WARNINGS AND PRECAUTIONS

Reduced Serum Vitamin A Levels and Recommended Supplementation WAINUA leads to a decrease in serum vitamin A levels. Supplement with recommended daily allowance of vitamin A. Refer patient to an ophthalmologist if ocular symptoms suggestive of vitamin A deficiency occur.

ADVERSE REACTIONS

Most common adverse reactions (≥9% in WAINUA-treated patients) were vitamin A decreased (15%) and vomiting (9%).

Please see link to U.S. Full Prescribing Information for WAINUA. 

About Ionis Pharmaceuticals, Inc.

For three decades, Ionis has invented medicines that bring better futures to people with serious diseases. Ionis currently has five marketed medicines and a leading pipeline in neurology, cardiology, and other areas of high patient need. As the pioneer in RNA-targeted medicines, Ionis continues to drive innovation in RNA therapies in addition to advancing new approaches in gene editing. A deep understanding of disease biology and industry-leading technology propels our work, coupled with a passion and urgency to deliver life-changing advances for patients. To learn more about Ionis, visit Ionis.com and follow us on X (Twitter) and LinkedIn.

Ionis Forward-looking Statements

This press release includes forward-looking statements regarding eplontersen, Ionis' business, and the therapeutic and commercial potential of Ionis' commercial medicines, additional medicines in development and technologies. Any statement describing Ionis' goals, expectations, financial or other projections, intentions, or beliefs is a forward-looking statement and should be considered an at-risk statement. Such statements are subject to certain risks and uncertainties, including but not limited to those related to our commercial products and the medicines in our pipeline, and particularly those inherent in the process of discovering, developing and commercializing medicines that are safe and effective for use as human therapeutics, and in the endeavor of building a business around such medicines. Ionis' forward-looking statements also involve assumptions that, if they never materialize or prove correct, could cause its results to differ materially from those expressed or implied by such forward-looking statements. Although Ionis' forward-looking statements reflect the good faith judgment of its management, these statements are based only on facts and factors currently known by Ionis. Except as required by law, we undertake no obligation to update any forward-looking statements for any reason. As a result, you are cautioned not to rely on these forward-looking statements. These and other risks concerning Ionis' programs are described in additional detail in Ionis' annual report on Form 10-K for the year ended Dec. 31, 2023, and most recent Form 10-Q, which are on file with the SEC. Copies of these and other documents are available at www.Ionis.com.

Ionis Pharmaceuticals® is a registered trademark of Ionis Pharmaceuticals, Inc. WAINUA™ is a trademark of AstraZeneca plc.

Ionis Investor Contact:
D. Wade Walke, Ph.DD.
IR@ionis.com 760-603-2331

Ionis Media Contact:
Daria Binder
media@ionis.com 760-603-4679

 

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SOURCE Ionis Pharmaceuticals, Inc.

FAQ

What is WAINZUA (eplontersen) recommended for in the EU?

WAINZUA (eplontersen) is recommended for approval in the EU for the treatment of hereditary transthyretin-mediated amyloidosis in adult patients with stage 1 or stage 2 polyneuropathy (ATTRv-PN).

What makes WAINZUA unique for ATTRv-PN treatment in the EU?

If approved, WAINZUA will be the only EU-approved medicine for ATTRv-PN that can be self-administered monthly via an auto-injector.

What clinical trial supported WAINZUA's recommendation in the EU?

The CHMP recommendation is based on the positive results from the NEURO-TTRansform Phase 3 trial, which showed consistent and sustained benefits through 66 weeks.

When was WAINZUA approved in the United States for IONS?

WAINZUA (eplontersen) was approved in the U.S. in December 2023 for the treatment of ATTRv-PN.

What other indication is WAINZUA being studied for by IONS?

Eplontersen is currently being evaluated in the CARDIO-TTRansform Phase 3 study for the treatment of adults with ATTR-CM (transthyretin-mediated amyloidosis with cardiomyopathy).

Ionis Pharmaceuticals, Inc.

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