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Zevra Therapeutics’ MIPLYFFA™ (arimoclomol) Receives U.S. FDA Approval as Treatment for Niemann-Pick Disease Type C

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Zevra Therapeutics announced FDA approval of MIPLYFFA™ (arimoclomol) as the first treatment for Niemann-Pick disease type C (NPC), an ultra-rare neurodegenerative disease. MIPLYFFA is indicated for use with miglustat to treat neurological manifestations in patients 2 years and older. The approval is based on a 12-month trial showing MIPLYFFA halted disease progression. Zevra received a rare pediatric disease priority review voucher and launched AmplifyAssist™, a patient support program.

MIPLYFFA will be commercially available in 8-12 weeks. The drug is administered orally three times daily, with dosage ranging from 47-124 mg based on body weight. Zevra estimates 900 people in the U.S. have NPC, with about one-third diagnosed. The approval marks a significant milestone for NPC patients, offering the first FDA-approved treatment option for this progressive and fatal disease.

Zevra Therapeutics ha annunciato l'approvazione della FDA per MIPLYFFA™ (arimoclomol) come il primo trattamento per la malattia di Niemann-Pick di tipo C (NPC), una malattia neurodegenerativa ultra-rara. MIPLYFFA è indicato per l'uso insieme a miglustat per trattare le manifestazioni neurologiche nei pazienti di 2 anni e più. L'approvazione si basa su uno studio di 12 mesi che ha mostrato che MIPLYFFA ha arrestato la progressione della malattia. Zevra ha ricevuto un voucher per la revisione prioritaria delle malattie pediatriche rare e ha lanciato AmplifyAssist™, un programma di supporto per i pazienti.

MIPLYFFA sarà disponibile commercialmente in 8-12 settimane. Il farmaco è somministrato per via orale tre volte al giorno, con un dosaggio che varia da 47 a 124 mg in base al peso corporeo. Zevra stima che 900 persone negli Stati Uniti soffrano di NPC, con circa un terzo già diagnosticato. L'approvazione segna una tappa significativa per i pazienti affetti da NPC, offrendo la prima opzione di trattamento approvata dalla FDA per questa malattia progressiva e fatale.

Zevra Therapeutics anunció la aprobación de la FDA de MIPLYFFA™ (arimoclomol) como el primer tratamiento para la enfermedad de Niemann-Pick tipo C (NPC), una enfermedad neurodegenerativa ultra-rara. MIPLYFFA está indicado para su uso con miglustat para tratar las manifestaciones neurológicas en pacientes de 2 años o más. La aprobación se basa en un ensayo de 12 meses que mostró que MIPLYFFA detuvo la progresión de la enfermedad. Zevra recibió un voucher de revisión prioritaria para enfermedades pediátricas raras y lanzó AmplifyAssist™, un programa de apoyo al paciente.

MIPLYFFA estará disponible comercialmente en 8-12 semanas. El medicamento se administra por vía oral tres veces al día, con una dosis que varía de 47 a 124 mg según el peso corporal. Zevra estima que 900 personas en los EE. UU. tienen NPC, con aproximadamente un tercio diagnosticado. La aprobación marca un hito significativo para los pacientes de NPC, ofreciendo la primera opción de tratamiento aprobada por la FDA para esta enfermedad progresiva y fatal.

Zevra TherapeuticsMIPLYFFA™ (아리모클로몰)의 FDA 승인을 발표했습니다. 이는 니만-픽병 C형 (NPC)에 대한 최초의 치료제입니다. NPC는 극히 드문 신경퇴행성 질환입니다. MIPLYFFA는 2세 이상의 환자들에게 신경학적 증상을 치료하기 위해 미글루스타트와 함께 사용하도록 권장됩니다. 이번 승인은 MIPLYFFA가 질병의 진행을 멈춘 12개월 임상시험 결과에 기반합니다. Zevra는 희귀 소아 질환 우선 검토 바우처를 받았으며, 환자 지원 프로그램인 AmplifyAssist™를 시작했습니다.

MIPLYFFA는 8-12주 안에 상업적으로 이용 가능할 것입니다. 이 약물은 하루 세 번 경구로 투여되며, 체중에 따라 47-124 mg의 용량 범위를 가집니다. Zevra는 미국에서 NPC 환자가 900명 있을 것으로 추정하며, 그 중 약 3분의 1이 진단을 받았다고 합니다. 이번 승인은 NPC 환자에게 중요한 이정표가 되며, 이 진행성 치명적인 질환에 대한 FDA 승인 치료 옵션을 제공합니다.

Zevra Therapeutics a annoncé l'approbation par la FDA de MIPLYFFA™ (arimoclomol) en tant que premier traitement pour la maladie de Niemann-Pick de type C (NPC), une maladie neurodégénérative ultra-rare. MIPLYFFA est indiqué pour être utilisé avec le miglustat pour traiter les manifestations neurologiques chez les patients de 2 ans et plus. L'approbation repose sur un essai de 12 mois montrant que MIPLYFFA a stoppé la progression de la maladie. Zevra a reçu un coupon de révision prioritaire pour les maladies pédiatriques rares et a lancé AmplifyAssist™, un programme de soutien aux patients.

MIPLYFFA sera disponible commercialement dans 8 à 12 semaines. Le médicament est administré par voie orale trois fois par jour, avec une posologie allant de 47 à 124 mg en fonction du poids corporel. Zevra estime que 900 personnes aux États-Unis souffrent de NPC, avec environ un tiers d'entre elles diagnostiquées. Cette approbation marque une étape significative pour les patients atteints de NPC, offrant la première option de traitement approuvée par la FDA pour cette maladie progressive et fatale.

Zevra Therapeutics hat die FDA-Zulassung für MIPLYFFA™ (Arimoclomol) als erste Behandlung für die Niemann-Pick-Krankheit Typ C (NPC) angekündigt, eine äußerst seltene neurodegenerative Erkrankung. MIPLYFFA ist zur Anwendung in Kombination mit Miglustat zur Behandlung neurologischer Manifestationen bei Patienten ab 2 Jahren angezeigt. Die Genehmigung basiert auf einer 12-monatigen Studie, die gezeigt hat, dass MIPLYFFA das Fortschreiten der Krankheit stoppt. Zevra erhielt einen Voucher für die priorisierte Prüfung seltener pädiatrischer Krankheiten und startete AmplifyAssist™, ein Unterstützungsprogramm für Patienten.

MIPLYFFA wird in 8-12 Wochen kommerziell verfügbar sein. Das Medikament wird dreimal täglich oral eingenommen, mit einer Dosierung von 47-124 mg, je nach Körpergewicht. Zevra schätzt, dass 900 Menschen in den USA an NPC leiden, von denen etwa ein Drittel diagnostiziert wurde. Die Genehmigung stellt einen bedeutenden Meilenstein für NPC-Patienten dar, da sie die erste von der FDA genehmigte Behandlungsoption für diese fortschreitende und tödliche Erkrankung bietet.

Positive
  • First FDA-approved treatment for Niemann-Pick disease type C (NPC)
  • Received rare pediatric disease priority review voucher
  • Clinical trial showed MIPLYFFA halted disease progression
  • Launching AmplifyAssist™ patient support program
  • Estimated 900 people living with NPC in the U.S., providing a potential market
Negative
  • Commercial availability delayed by 8-12 weeks post-approval
  • patient population due to ultra-rare disease status
  • MIPLYFFA must be used in combination with miglustat, potentially increasing treatment complexity

Insights

The FDA approval of MIPLYFFA for Niemann-Pick disease type C (NPC) is a significant breakthrough in rare disease treatment. As the first FDA-approved therapy for NPC, it addresses a critical unmet need for this ultra-rare neurodegenerative disorder. The drug's efficacy in halting disease progression, demonstrated by a 0.2% decrease in clinical severity scores compared to a 1.9% increase with standard care, is remarkable. This approval could dramatically improve patient outcomes and quality of life for the estimated 900 NPC patients in the U.S. The additional 48-month open-label extension study data further supports MIPLYFFA's long-term benefits, potentially altering the disease trajectory for NPC patients.

Zevra Therapeutics' MIPLYFFA approval is a game-changer for the company's financial outlook. As the first-mover in the NPC market, Zevra has a significant competitive advantage. The rare pediatric disease priority review voucher received with the approval is a valuable asset, potentially worth $100-$200 million if sold. With an estimated 900 NPC patients in the U.S., even with conservative pricing and adoption rates, MIPLYFFA could generate substantial revenue. The launch of AmplifyAssist program demonstrates a strategic approach to market penetration. Investors should watch for initial sales figures and adoption rates in the coming quarters to gauge the drug's commercial success and potential impact on Zevra's financials.

The approval of MIPLYFFA opens up a new market segment in rare disease therapeutics. With no previous FDA-approved treatments for NPC, Zevra has the opportunity to establish market dominance. The combination therapy approach with miglustat could lead to synergistic partnerships or potential M&A activity in the rare disease space. The AmplifyAssist program is a smart market strategy, addressing access barriers and potentially accelerating adoption. However, the ultra-rare nature of NPC (0.0003% of the U.S. population) may limit market size. The success of MIPLYFFA could pave the way for Zevra to expand its rare disease portfolio, potentially attracting investor interest in this niche but high-value market segment.

MIPLYFFA is the first FDA-approved treatment for Niemann-Pick disease type C (NPC), an ultra-rare and progressive neurodegenerative disease

MIPLYFFA is indicated for use in combination with miglustat for the treatment of neurological manifestations of NPC in adults and pediatric patients 2 years of age and older

Zevra receives rare pediatric disease priority review voucher in conjunction with approval

Company launches AmplifyAssist™ patient support program

Conference call and webcast set for 8:00 a.m. EDT on Monday, Sept. 23, 2024

CELEBRATION, Fla., Sept. 20, 2024 (GLOBE NEWSWIRE) -- Zevra Therapeutics, Inc. (NasdaqGS: ZVRA) (Zevra, or the Company), a commercial-stage rare disease therapeutics company, today announced that the U.S. Food and Drug Administration (FDA) has approved MIPLYFFA™ (MY-PLY-FAH) (arimoclomol) capsules as an orally delivered treatment for Niemann-Pick disease type C (NPC). The first NPC drug approved by the FDA, MIPLYFFA is indicated for use in combination with miglustat for the treatment of neurological manifestations of NPC in adult and pediatric patients 2 years of age and older. In addition, the Company announced that it has received a rare pediatric disease priority review voucher (PRV) in conjunction with the approval.

“NPC is an ultra-rare, relentlessly progressive, degenerative, and fatal disease for which there were no FDA-approved treatment options until today,” said Neil F. McFarlane, President and Chief Executive Officer of Zevra Therapeutics, Inc. “The approval of MIPLYFFA is a monumental milestone for NPC patients and their family members in the U.S. We are immensely grateful for the unwavering support we have received over the years from the families and individuals impacted by NPC as well as the collaborative efforts of advocacy groups, researchers, and clinicians.”

In the U.S., it is estimated that 900 people are living with NPC, of which approximately one-third have been diagnosed with this ultra-rare, relentlessly progressive, and fatal neurodegenerative disease.i Both children and adults can be affected by NPC with varying clinical presentations. Characteristically, those living with NPC experience progressive physical and cognitive limitations, with key neurological impairments presenting in speech, cognition, swallowing, ambulation, and fine motor skills.

“Until now, those living with NPC have had no FDA-approved treatment to combat this devastating disease,” said Laurie Turner, Family Services Manager, National Niemann-Pick Disease Foundation (NNPDF). “For more than 30 years, NNPDF and the community have been working to find treatments for NPC, and we are grateful for the diligence and commitment of the researchers, clinicians, families and Zevra for making this approval possible.”

“The FDA approval of MIPLYFFA marks a significant moment for those living with NPC and the global NPC community,” stated Dr. Elizabeth Berry-Kravis, Professor, Departments of Pediatrics, Neurological Sciences, Anatomy and Cell Biology, Director, RUSH Pediatric Neurosciences F.A.S.T. Center for Translational Research at Rush University Medical Center, “Effective management of NPC requires multiple treatment options due to the complexity of the disease. Until today, there were no approved therapies in the U.S. for NPC. With this labeled indication, patients will now have more access to treatments to tackle this devastating disease.”

The approval of MIPLYFFA for the treatment of NPC is based on the totality of the data in the New Drug Application (NDA), which included additional evidence supporting trial endpoints, FDA-preferred analyses, and additional confirmatory evidence, both clinical and nonclinical. The safety and effectiveness of MIPLYFFA were studied in a 12-month multicenter, randomized, double-blind, placebo-controlled trial in patients with NPC between two and 19 years of age. In this trial, 76% of patients in the MIPLYFFA group and 81% of those in the placebo group received miglustat as part of their routine care. The effectiveness of MIPLYFFA was evaluated using the rescored 4-domain NPC Clinical Severity Scale (R4DNPCCSS). Results from this trial demonstrated:

  • MIPLYFFA, in combination with miglustat, halted disease progression through 12 months of treatment, as demonstrated by a decrease of 0.2 points from baseline on the R4DNPCCSS compared to 1.9 points of progression for patients treated with miglustat alone.

Additional confirmatory evidence included data from a 48-month open-label extension study which suggested improved outcomes when compared to a matched National Institutes of Health NPC natural history cohort.

MIPLYFFA is administered orally, three times a day with or without food, with the exact dosage ranging from 47 mg to 124 mg dependent on body weight, by appropriate patients or caregivers with follow-up from a healthcare provider. Healthcare providers and patients/caregivers should refer to the Full and Instructions for Use for information on the proper administration of MIPLYFFA.

Zevra will immediately initiate its launch activities for MIPLYFFA, which is expected to be commercially available in the U.S. in eight to 12 weeks.

Launch of AmplifyAssist™ — Comprehensive Support for Patients

Zevra is committed to assisting those whose lives are affected by NPC to overcome the barriers and challenges that may impact their treatment journey. The Company today launched AmplifyAssist, Zevra’s comprehensive patient support program. The mission of the program is to support the individual needs of eligible patients and those who care for them. Available resources include personalized insurance coverage education and support, copay and alternate funding identification assistance for eligible patients, product needs, disease state information and therapy management counseling, and ongoing interactions to address barriers while facilitating timely prescription refills. Information about the program is available at MIPLYFFA.com or via telephone. The AmplifyAssist team can be reached toll-free at (888) 668-4198 from 8 a.m. CT to 6 p.m. CT Monday through Friday. Healthcare providers who want to submit prescriptions can visit MIPLYFFA.com to complete the prescription enrollment form that initiates the process for accessing the treatment.

Conference Call and Webcast Information

Zevra Therapeutics, Inc. will host a conference call and audio webcast at 8 a.m. ET on Monday, September 23, 2024, to discuss FDA approval of MIPLYFFA. A link to the audio webcast will be accessible via the Investor Relations section of the Company’s website, https://investors.zevra.com/. To join the meeting by conference call, use the dial-in information below:

(800) 267-6316 (U.S.)
+1 (203) 518- 9783 (International)
Conference ID: ZVRA0923

An archive of the webcast will be available for ninety (90) days beginning at approximately 9 a.m. ET, on September 23, 2024, at https://investors.zevra.com/.

About MIPLYFFA™ (arimoclomol)

MIPLYFFA (arimoclomol) increases the activation of the transcription factors EB (TFEB) and E3 (TFE3) resulting in the upregulation of coordinated lysosomal expression and regulation (CLEAR) genes. MIPLYFFA has also been shown to reduce unesterified cholesterol in the lysosomes of human NPC fibroblasts. The clinical significance of these findings is not fully understood. MIPLYFFA was granted Breakthrough Therapy designation, Rare Pediatric Disease designation, Orphan Drug designation, and Fast Track designation by the FDA for the treatment of NPC. MIPLYFFA was further granted Orphan Medicinal Product designation by the European Medicines Agency (EMA) for the treatment of NPC.

INDICATIONS AND USAGE

MIPLYFFA is indicated for use in combination with miglustat for the treatment of neurological manifestations of Niemann-Pick disease type C (NPC) in adult and pediatric patients 2 years of age and older.

IMPORTANT SAFETY INFORMATION

Hypersensitivity Reactions:

Hypersensitivity reactions such as urticaria and angioedema have been reported in patients treated with MIPLYFFA during Trial 1: two patients reported both urticaria and angioedema (6%) and one patient (3%) experienced urticaria alone within the first two months of treatment. Discontinue MIPLYFFA in patients who develop severe hypersensitivity reactions. If a mild or moderate hypersensitivity reaction occurs, stop MIPLYFFA and treat promptly. Monitor the patient until signs and symptoms resolve.

Embryofetal Toxicity:

MIPLYFFA may cause embryofetal harm when administered during pregnancy based on findings from animal reproduction studies. Advise pregnant females of the potential risk to the fetus and consider pregnancy planning and prevention for females of reproductive potential.

Increased Creatinine without Affecting Glomerular Function:
Across clinical trials of MIPLYFFA, mean increases in serum creatinine of 10% to 20% compared to baseline were reported. These increases occurred mostly in the first month of MIPLYFFA treatment and were not associated with changes in glomerular function.

During MIPLYFFA treatment, use alternative measures that are not based on creatinine to assess renal function. Increases in creatinine reversed upon MIPLYFFA discontinuation.

The most common adverse reactions in Trial 1 (≥15%) in MIPLYFFA-treated patients who also received miglustat were upper respiratory tract infection, diarrhea, and decreased weight.

Three (6%) of the MIPLYFFA-treated patients had the following adverse reactions that led to withdrawal from Trial 1: increased serum creatinine (one patient), and progressive urticaria and angioedema (two patients). Serious adverse reactions reported in MIPLYFFA-treated patients were hypersensitivity reactions including urticaria and angioedema.

To report SUSPECTED ADVERSE REACTIONS, contact Zevra Therapeutics, Inc. at toll-free phone 1-844-600-2237 or FDA at 1800-FDA-1088 or www.fda.gov/medwatch.

Drug Interaction(s):
Arimoclomol is an inhibitor of the organic cationic transporter 2 (OCT2) transporter and may increase the exposure of drugs that are OCT2 substrates. When MIPLYFFA is used concomitantly with OCT2 substrates, monitor for adverse reactions and reduce the dosage of the OCT2 substrate.

Use in Females and Males of Reproductive Potential:
Based on animal findings, MIPLYFFA may impair fertility and may increase post-implantation loss and reduce maternal, placental, and fetal weights.

Renal Impairment:
The recommended dosage of MIPLYFFA, in combination with miglustat, in patients with an eGFR ≥15 mL/minute to <50 mL/minute is lower than the recommended dosage (less frequent dosing) in patients with normal renal function.

MIPLYFFA capsules for oral use are available in the following strengths: 47 mg, 62 mg, 93 mg, and 124 mg.

About Niemann-Pick Disease Type C (NPC)

Niemann-Pick disease type C (NPC) is an ultra-rare, progressive, and neurodegenerative lysosomal storage disorder characterized by an inability of the body to transport cholesterol and other lipids within the cell, leading to an accumulation of these substances in various cell types, including neurons. The disease is caused by mutations in the NPC1 or NPC2 genes, which are responsible for making the NPC1 and NPC2 lysosomal proteins. Both children and adults can be affected by NPC with varying clinical presentations. Those living with NPC can lose independence due to physical and cognitive limitations, with key neurological impairments presenting in speech, cognition, swallowing, ambulation, and fine motor skills. Disease diagnosis can often take years, with disease progression being irreversible and often leading to early mortality.

About Zevra Therapeutics, Inc.

Zevra Therapeutics, Inc. is a commercial-stage rare disease company combining science, data, and patient needs to create transformational therapies for diseases with limited or no treatment options. Our mission is to bring life-changing therapeutics to people living with rare diseases. With unique, data-driven development and commercialization strategies, the Company is overcoming complex drug development challenges to make new therapies available to the rare disease community.

Expanded access programs are made available by Zevra Therapeutics, Inc. and its affiliates and are subject to the Company's Expanded Access Program (EAP) policy, as published on its website. Participation in these programs is subject to the laws and regulations of each jurisdiction under which each respective program is operated. Eligibility for participation in any such program is at the treating physician's discretion.

For more information, please visit www.zevra.com or follow us on X (formerly Twitter) and LinkedIn.

Cautionary Note Concerning Forward-Looking Statements

This press release may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include all statements that do not relate solely to historical or current facts, including without limitation statements regarding upcoming events or Zevra’s participation at such events. Forward-looking statements are based on information currently available to Zevra and its current plans or expectations. They are subject to several known and unknown uncertainties, risks, 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. These and other important factors are described in detail in the "Risk Factors" section of Zevra’s Annual Report on Form 10-K for the year ended December 31, 2023, Zevra’s quarterly report for the three months ended June 30, 2024, and Zevra’s other filings with the Securities and Exchange Commission. While we may elect to update such forward-looking statements at some point in the future, except as required by law, we disclaim any obligation to do so, even if subsequent events cause our views to change. Although we believe the expectations reflected in such forward-looking statements are reasonable, we cannot assure that such expectations will prove correct. These forward-looking statements should not be relied upon as representing our views as of any date after the date of this press release.
_____________________________________________

  1. Burton et.al., Molecular Genetics and Metabolism Volume 134, Issues 1–2, September–October 2021, Pages 182-187

Zevra Contact

Nichol Ochsner
+1 (732) 754-2545
nochsner@zevra.com

Russo Partners Contacts

David Schull
+1 (858) 717-2310
david.schull@russopartnersllc.com

Ignacio Guerrero-Ros, Ph.D.
+1 (646) 942-5604
ignacio.guerrero-ros@russopartnersllc.com 


FAQ

What is MIPLYFFA and what was it approved for?

MIPLYFFA (arimoclomol) is the first FDA-approved treatment for Niemann-Pick disease type C (NPC), indicated for use with miglustat to treat neurological manifestations in patients 2 years and older.

When will MIPLYFFA (ZVRA) be commercially available?

Zevra Therapeutics (ZVRA) expects MIPLYFFA to be commercially available in the U.S. within 8 to 12 weeks following FDA approval on September 20, 2024.

What is the estimated market size for MIPLYFFA (ZVRA)?

Zevra Therapeutics (ZVRA) estimates that approximately 900 people in the U.S. are living with NPC, with about one-third diagnosed, representing the potential market for MIPLYFFA.

What support program is Zevra (ZVRA) offering for MIPLYFFA patients?

Zevra Therapeutics (ZVRA) has launched AmplifyAssist™, a comprehensive patient support program offering insurance coverage education, copay assistance, and therapy management counseling for eligible MIPLYFFA patients.

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