Rhythm Pharmaceuticals Announces FDA Acceptance for Priority Review of Supplemental New Drug Application for IMCIVREE® (setmelanotide) in Patients as Young as 2 years old

Rhea-AI Summary

Rhythm Pharmaceuticals announced that the FDA has accepted their supplemental New Drug Application (sNDA) for IMCIVREE® (setmelanotide) with Priority Review. The sNDA aims to expand the label to treat obesity due to Bardet-Biedl syndrome (BBS) or POMC/LEPR deficiency in children as young as 2 years old. The FDA set a PDUFA goal date of December 26, 2024.

The sNDA is based on data from a Phase 3 trial in patients aged 2 to 6 years. Results showed a 3.04 mean reduction in BMI-Z score and 18.4% mean reduction in BMI. In July 2024, the European Commission expanded IMCIVREE's marketing authorization for children as young as 2 years old with these conditions.

Positive

• FDA acceptance of sNDA with Priority Review for IMCIVREE
• Potential label expansion to treat children as young as 2 years old
• Phase 3 trial showed 3.04 mean reduction in BMI-Z score and 18.4% mean reduction in BMI
• European Commission already expanded marketing authorization for children as young as 2 years old

Negative

• None.

Pharmaceutical Industry Analyst

The FDA's acceptance of Rhythm Pharmaceuticals' sNDA for IMCIVREE with Priority Review is a significant development for the company. This potential label expansion to include children as young as 2 years old could substantially increase the addressable market for IMCIVREE.

The PDUFA date of December 26, 2024, suggests a relatively quick review process, which is positive for Rhythm. The company's focus on rare genetic obesity disorders positions it in a niche market with competition. If approved, treating younger patients could lead to better long-term outcomes and potentially increased lifetime value per patient.

Investors should note the positive Phase 3 trial results, with a 3.04 mean reduction in BMI-Z score and 18.4% mean reduction in BMI. These results, coupled with the recent European Commission approval for the same age group, strengthen the likelihood of FDA approval.

Pediatric Endocrinologist

The potential approval of IMCIVREE for children as young as 2 years old with rare genetic obesity disorders is a significant medical advancement. Early intervention in these conditions is crucial, as hyperphagia and severe obesity can manifest early in life, leading to lifelong health complications.

The 3.04 mean reduction in BMI-Z score observed in the Phase 3 trial is clinically meaningful for this patient population. It suggests that IMCIVREE could effectively manage weight in very young children with these rare genetic conditions, potentially altering the course of their disease.

However, it's important to consider the long-term effects of MC4R agonist use in developing children. While the benefits seem substantial, ongoing monitoring for potential side effects or developmental impacts will be important if the drug is approved for this younger age group.

Market Access Specialist

The potential label expansion for IMCIVREE to include younger children represents a significant market opportunity for Rhythm Pharmaceuticals. Rare disease treatments often command premium pricing and expanding the eligible patient population could boost revenue potential.

The Priority Review status and recent EC approval for the same indication increase the likelihood of FDA approval. This could lead to faster market access and uptake in the U.S. for this expanded indication.

However, investors should consider potential challenges in market access for very young patients. Payers may require additional evidence of long-term benefits and safety in this age group. The orphan drug status of IMCIVREE for these indications could provide some pricing power and market exclusivity, but negotiations with payers for coverage in this younger population will be important for commercial success.

-- Label expansion sought to treat younger children with Bardet-Biedl syndrome or POMC/LEPR deficiency --

-- FDA sets PDUFA goal date of December 26, 2024 --

BOSTON, Aug. 26, 2024 (GLOBE NEWSWIRE) -- Rhythm Pharmaceuticals, Inc. (Nasdaq: RYTM), a global commercial-stage biopharmaceutical company focused on transforming the lives of patients living with rare neuroendocrine diseases, today announced that the U.S. Food and Drug Administration (FDA) has accepted the company’s supplemental New Drug Application (sNDA) for IMCIVREE^® (setmelanotide), a melanocortin-4 receptor (MC4R) agonist, for the treatment of obesity due to Bardet-Biedl syndrome (BBS) or pro-opiomelanocortin (POMC), including proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency obesity in children as young as 2 years old. The FDA has granted Priority Review of the sNDA and assigned a Prescription Drug User Fee Act (PDUFA) goal date of December 26, 2024. 

“This milestone brings us another step closer to offering a precision therapy for young patients in the U.S. experiencing hyperphagia – a pathological hunger that leads to aberrant food-seeking behaviors – and severe obesity caused by rare MC4R pathway diseases,” said David Meeker, M.D., Chairman, Chief Executive Officer and President of Rhythm. “IMCIVREE has been approved for more than two years and prescribed to hundreds of patients 6 years old and older, and we believe that treating patients at an even earlier age will positively affect the lives of these children and their families.”

The sNDA submission is based on data from Rhythm’s multi-center, one-year, open-label Phase 3 trial in patients (N=12) between 2 and younger than 6 years old with obesity due to biallelic POMC/PCSK1 or LEPR deficiency or a clinical diagnosis of BBS. The hyperphagia and severe obesity of rare genetically-caused MC4R pathway diseases can present early in life, and these data showed potential efficacy in patients younger than 6 years of age. Treatment with setmelanotide achieved the primary endpoint with a 3.04 mean reduction in BMI-Z score (a measure of body mass index deviations from what is considered normal) and 18.4 percent mean reduction in BMI. 

In July 2024, the European Commission (EC) expanded the marketing authorization for IMCIVREE to include children as young as 2 years old with obesity due to BBS or POMC/PCSK1, or LEPR deficiency. In the United States, IMCIVREE is currently indicated for chronic weight management in adult and pediatric patients 6 years of age and older with monogenic or syndromic obesity due to POMC, PCSK1 or LEPR deficiency as determined by an FDA-approved test demonstrating variants in POMC, PCSK1 or LEPR genes that are interpreted as pathogenic, likely pathogenic, or of uncertain significance (VUS), and BBS. 

About Rhythm Pharmaceuticals
Rhythm is a commercial-stage biopharmaceutical company committed to transforming the lives of patients and their families living with rare neuroendocrine diseases. Rhythm’s lead asset, IMCIVREE^® (setmelanotide), an MC4R agonist designed to treat hyperphagia and severe obesity, is approved by the U.S. Food and Drug Administration (FDA) for chronic weight management in adult and pediatric patients 6 years of age and older with monogenic or syndromic obesity due to pro-opiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1) or leptin receptor (LEPR) deficiency confirmed by genetic testing, or patients with a clinical diagnosis of Bardet-Biedl syndrome (BBS). Both the European Commission (EC) and the UK’s Medicines & Healthcare Products Regulatory Agency (MHRA) have authorized setmelanotide for the treatment of obesity and the control of hunger associated with genetically confirmed BBS or genetically confirmed loss-of-function biallelic POMC, including PCSK1, deficiency or biallelic LEPR deficiency in adults and children 6 years of age and above. The EC has also authorized setmelanotide for control of hunger and treatment of obesity in children as young as 2 years old, living with BBS or POMC, PCSK1, or LEPR deficiency. Additionally, Rhythm is advancing a broad clinical development program for setmelanotide in other rare diseases, as well as investigational MC4R agonists LB54640 and RM-718, and a preclinical suite of small molecules for the treatment of congenital hyperinsulinism. Rhythm’s headquarters is in Boston, MA.

Setmelanotide Indication
In the United States, setmelanotide is indicated for chronic weight management in adult and pediatric patients 6 years of age and older with monogenic or syndromic obesity due to POMC, PCSK1 or LEPR deficiency as determined by an FDA-approved test demonstrating variants in POMC, PCSK1 or LEPR genes that are interpreted as pathogenic, likely pathogenic, or of uncertain significance (VUS) or BBS.

In the European Union, setmelanotide is indicated for the treatment of obesity and the control of hunger associated with genetically confirmed BBS or loss-of-function biallelic POMC, including PCSK1, deficiency or biallelic LEPR deficiency in adults and children 2 years of age and above. In Europe, setmelanotide should be prescribed and supervised by a physician with expertise in obesity with underlying genetic etiology.

Limitations of Use
Setmelanotide is not indicated for the treatment of patients with the following conditions as setmelanotide would not be expected to be effective:

• Obesity due to suspected POMC, PCSK1 or LEPR deficiency with POMC, PCSK1 or LEPR variants classified as benign or likely benign.
• Other types of obesity not related to POMC, PCSK1 or LEPR deficiency, or BBS, including obesity associated with other genetic syndromes and general (polygenic) obesity.

Contraindication
Prior serious hypersensitivity to setmelanotide or any of the excipients in IMCIVREE. Serious hypersensitivity reactions (e.g., anaphylaxis) have been reported.

WARNINGS AND PRECAUTIONS

Skin Pigmentation and Darkening of Pre-Existing Nevi: Generalized increased skin pigmentation and darkening of pre-existing nevi have occurred because of its pharmacologic effect. Full body skin examinations prior to initiation and periodically during treatment should be conducted to monitor pre-existing and new pigmentary lesions.

Heart rate and blood pressure monitoring: In Europe, heart rate and blood pressure should be monitored as part of standard clinical practice at each medical visit (at least every 6 months) for patients treated with setmelanotide.

Disturbance in Sexual Arousal: Spontaneous penile erections in males and sexual adverse reactions in females have occurred. Patients who have an erection lasting longer than 4 hours should seek emergency medical attention.

Depression and Suicidal Ideation: Depression and suicidal ideation have occurred. Patients should be monitored for new onset or worsening depression or suicidal thoughts or behaviors. Consideration should be given to discontinuing setmelanotide if patients experience suicidal thoughts or behaviors, or clinically significant or persistent depression symptoms occur.

Hypersensitivity Reactions: Serious hypersensitivity reactions (e.g., anaphylaxis) have been reported. If suspected, advise patients to promptly seek medical attention and discontinue setmelanotide.

Pediatric Population: The prescribing physician should periodically assess response to setmelanotide therapy. In growing children, the impact of weight loss on growth and maturation should be evaluated. In Europe, the prescribing physician should monitor growth (height and weight) using age- and sex-appropriate growth curves.

Risk of Serious Adverse Reactions Due to Benzyl Alcohol Preservative in Neonates and Low Birth Weight Infants: Setmelanotide is not approved for use in neonates or infants. Serious and fatal adverse reactions including “gasping syndrome” can occur in neonates and low birth weight infants treated with benzyl alcohol-preserved drugs.

ADVERSE REACTIONS

Most common adverse reactions (incidence ≥20%) included skin hyperpigmentation, injection site reactions, nausea, headache, diarrhea, abdominal pain, vomiting, depression, and spontaneous penile erection.

USE IN SPECIFIC POPULATIONS

Lactation: Not recommended when breastfeeding.
To report SUSPECTED ADVERSE REACTIONS, contact Rhythm Pharmaceuticals at +1 (833) 789-6337 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. See section 4.8 of the Summary of Product Characteristics for information on reporting suspected adverse reactions in Europe.

Please see the full U.S. Prescribing Information and EU Summary of Product Characteristics for additional Important Safety Information.

Forward-looking Statements

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 without limitation statements regarding the potential, safety, efficacy, and regulatory and clinical progress, potential regulatory submissions, approvals and timing thereof of setmelanotide and other product candidates, including the PDUFA goal date of our sNDA discussed herein, the potential benefits of any of the Company’s products or product candidates for any specific disease indication or at any dosage, including the potential benefits of setmelanotide for pediatric patients with BBS or POMC, PCSK1, or LEPR deficiency; expectations surrounding potential regulatory submissions and approvals, including within the United States, the EU and other regions; business strategy and plans, including regarding commercialization of setmelanotide in the United States, the EU and other regions; and the timing of any of the foregoing . Statements using words such as “expect”, “anticipate”, “believe”, “may”, “will” and similar terms are also forward-looking statements. Such statements are subject to numerous risks and uncertainties, including, but not limited to, our ability to enroll patients in clinical trials, the design and outcome of clinical trials, the impact of competition, the ability to achieve or obtain necessary regulatory approvals, risks associated with data analysis and reporting, our ability to successfully commercialize setmelanotide, our liquidity and expenses, our ability to retain our key employees and consultants, and to attract, retain and motivate qualified personnel, and general economic conditions, and the other important factors discussed under the caption “Risk Factors” in Rhythm’s Quarterly Report on Form 10-Q for the three months ended June 30, 2024 and other filings with the Securities and Exchange Commission. Except as required by law, we undertake no obligations to make any revisions to the forward-looking statements contained in this release or to update them to reflect events or circumstances occurring after the date of this release, whether as a result of new information, future developments or otherwise.

Corporate Contact:
David Connolly
Head of Investor Relations and Corporate Communications
Rhythm Pharmaceuticals, Inc.
857-264-4280
dconnolly@rhythmtx.com

Media Contact:
Adam Daley
Berry & Company Public Relations
212-253-8881
adaley@berrypr.com

FAQ

What is the PDUFA date for Rhythm Pharmaceuticals' IMCIVREE sNDA (RYTM)?

The FDA has set a PDUFA goal date of December 26, 2024 for Rhythm Pharmaceuticals' supplemental New Drug Application for IMCIVREE.

What conditions does the IMCIVREE sNDA aim to treat in younger children (RYTM)?

The sNDA aims to expand IMCIVREE's label to treat obesity due to Bardet-Biedl syndrome (BBS) or POMC/LEPR deficiency in children as young as 2 years old.

What were the key results from the Phase 3 trial for IMCIVREE in young children (RYTM)?

The Phase 3 trial showed a 3.04 mean reduction in BMI-Z score and an 18.4% mean reduction in BMI in children aged 2 to 6 years with obesity due to BBS or POMC/LEPR deficiency.

Has IMCIVREE received approval for younger children in any other regions (RYTM)?

Yes, in July 2024, the European Commission expanded the marketing authorization for IMCIVREE to include children as young as 2 years old with obesity due to BBS or POMC/PCSK1, or LEPR deficiency.