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Groundbreaking CF drug recommended in Europe

Published on 25/05/12 at 12:00am

The first-in-class treatment for cystic fibrosis Kalydeco has been recommended by the EMA’s medicines committee.

Kalydeco (ivacaftor) promises to be a breakthrough drug for children who are six years or older and who have at least one copy of the G551D mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene.

The Agency’s Committee for Medicinal Products for Human Use (CHMP) reviewed Kalydeco under accelerated assessment in just 150 days, nearly half its average time. The appraisal was accelerated in recognition of it treating an unmet medical need.

The drug is the first to treat the underlying cause of CF, a rare, genetic disease caused by defective or missing CFTR proteins resulting from mutations in the CFTR gene.

An estimated 1,100 people in Europe have the G551D mutation and will be able to benefit. This represents only 4% of the total CF population, so most sufferers won’t be able to benefit from the treatment.

However researchers at Vertex and elsewhere are confident that the drug represents a significant step towards fighting the disease in all patients.

 “While there has been great progress in cystic fibrosis treatment during the last few decades, we are still only treating the symptoms and complications of the disease,” said Stuart Elborn, M.D., Kalydeco investigator and President of the European Cystic Fibrosis Society. “Kalydeco is a fundamentally different approach to the way we treat cystic fibrosis because it targets the underlying cause of the disease. In clinical trials, Kalydeco helped people with a specific genetic mutation breathe more easily, gain weight and generally feel better.”

The CHMP opinion was based on data from two global Phase III studies in which the drug demonstrated unprecedented improvements in breathing and other measures of disease for people ages six and older with this specific genetic mutation. People treated with KALYDECO experienced significant and sustained improvements in lung function, weight gain and certain quality of life measurements compared to those on placebo. In addition, people who took Kalydeco were 55% less likely to have pulmonary exacerbations, or periods of worsening in the signs and symptoms of the disease that often require treatment with antibiotics and hospital visits, than those who received placebo.

Fewer people in the Kalydeco treatment groups discontinued treatment due to adverse events than in the placebo groups. The majority of adverse events associated with Kalydeco were mild to moderate. Adverse events most commonly observed in those taking Kalydeco included headache, upper respiratory tract infection (common cold), stomach pain and diarrhoea.

The CHMP’s positive opinion will now be reviewed by the European Commission, which has the authority to approve medicines for the European Union. The European Commission generally follows the recommendation of the CHMP and typically issues marketing approval within three to four months.

Kalydeco was discovered as part of a collaboration with Cystic Fibrosis Foundation Therapeutics the non-profit drug discovery and development affiliate of the Cystic Fibrosis Foundation.

The drug was launched in February in the US, and its groundbreaking profile has been matched by an eye-catching price -  $294,000 a year per patient, putting it into the top 10 most expensive treatments on the US market.

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