Vestronidase alfa, sold under brand name Mepsevii, is a drug for the treatment of
Sly syndrome
Sly syndrome, also called mucopolysaccharidosis type VII (MPS-VII), is an autosomal recessive lysosomal storage disease caused by a deficiency of the enzyme β-glucuronidase. This enzyme is responsible for breaking down large sugar molecules calle ...
.
It is a recombinant form of the human enzyme
beta-glucuronidase
Beta-glucuronidases are members of the glycosidase family of enzymes that catalyze breakdown of complex carbohydrates. Human β-glucuronidase is a type of glucuronidase (a member of glycosidase Family 2) that catalyzes hydrolysis of β-D-glucur ...
. It was approved in the United States in November 2017, to treat children and adults with an inherited metabolic condition called mucopolysaccharidosis type VII (MPS VII), also known as Sly syndrome.
[ ] MPS VII is an extremely rare, progressive condition that affects most tissues and organs.
[ ]
The most common side effects after treatment with vestronidase alfa include infusion site reactions,
diarrhea
Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin wi ...
, rash (
urticaria
Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. Hives may burn or sting. The patches of rash may appear on different body parts, with variable duration from minutes to days, and does not leave any long-lasti ...
) and
anaphylaxis
Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follow ...
(sudden, severe allergic reaction).
The U.S.
Food and Drug Administration
The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA) considers it to be a
first-in-class medication A first-in-class medication is a pharmaceutical that uses a "new and unique mechanism of action" to treat a particular medical condition. While the Food and Drug Administration's Center for Drug Evaluation and Research tracks first-in-class medicat ...
.
It was approved for use in the European Union in August 2018.
[ Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.]
Medical uses
Mepsevii is indicated for the treatment of non-neurological manifestations of Mucopolysaccharidosis VII (MPS VII; Sly syndrome).
History
The safety and efficacy of vestronidase alfa were established in a clinical trial and expanded access protocols enrolling a total of 23 participants ranging from five months to 25 years of age.
Participants received treatment with vestronidase alfa at doses up to 4mg/kg once every two weeks for up to 164 weeks.
Efficacy was primarily assessed via the six-minute walk test in ten participants who could perform the test.
After 24 weeks of treatment, the mean difference in distance walked relative to placebo was 18 meters.
Additional follow-up for up to 120 weeks suggested continued improvement in three participants and stabilization in the others.
Two participants in the vestronidase alfa development program experienced marked improvement in pulmonary function.
Overall, the results observed would not have been anticipated in the absence of treatment.
The effect of vestronidase alfa on the central nervous system manifestations of MPS VII has not been determined.
The FDA approved vestronidase alfa-vjbk based primarily on evidence from one clinical trial (NCT02230566) of 12 participants with mucopolysaccharidosis VII. The trial was conducted at four sites in the United States.
The benefit and side effects of vestronidase alfa were based primarily on one trial.
Participants were randomly assigned to four groups.
Three groups of participants received placebo treatment before starting vestronidase alfa treatment and one group received vestronidase alfa only.
vestronidase alfa or placebo were given once every two weeks as intravenous (IV) infusions.
Neither participants nor healthcare providers knew which treatment was given until after the trial was competed.
The benefit of 24 weeks of vestronidase alfa treatment was primarily evaluated by the 6-minute walking test (6MWT) and compared to placebo treatment in ten participants who could perform the test.
The 6MWT measured the distance a patient could walk on a flat surface in 6 minutes.
An additional follow-up using 6MWT was done for up to 120 weeks.
The application for vestronidase alfa was granted fast track designation, orphan drug designation, and a rare pediatric disease priority review voucher.
This was the twelfth rare pediatric disease priority review voucher issued.
The U.S.
Food and Drug Administration
The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA) granted approval of Mepsevii to
Ultragenyx Pharmaceutical, Inc,
and required the manufacturer to conduct a post-marketing study to evaluate the long-term safety of the product.
References
External links
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