Biology:Valoctocogene roxaparvovec
| Gene therapy | |
|---|---|
| Target gene | F8 |
| Vector | AAV5 |
| Nucleic acid type | DNA |
| Delivery method | IV |
| Clinical data | |
| Trade names | Roctavian |
| Other names | BMN-270, Valrox |
| Routes of administration | Intravenous |
| Drug class | Antihemorrhagics |
| ATC code |
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| Legal status | |
| Legal status | |
| Identifiers | |
| CAS Number | |
| DrugBank | |
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Valoctocogene roxaparvovec, sold under the brand name Roctavian, is a gene therapy for the treatment of hemophilia A.[1] It was developed by BioMarin Pharmaceutical.[2][3][4] Valoctocogene roxaparvovec is made of a virus (AAV5) that has been modified to contain the gene for factor VIII, which is lacking in patients with haemophilia A.[1] It is given by intravenous infusion.[1]
The most common side effects include increased levels of the liver enzymes alanine aminotransferase and aspartate aminotransferase (signs of possible liver problems), increased levels of the enzyme lactate dehydrogenase (sign of possible tissue damage), nausea (feeling sick) and headache.[1]
Valoctocogene roxaparvovec was approved for medical use in the European Union in August 2022.[1][2]
Medical uses
Valoctocogene roxaparvovec is indicated for the treatment of severe haemophilia A (congenital factor VIII deficiency) in adults without a history of factor VIII inhibitors and without detectable antibodies to adeno-associated virus serotype 5 (AAV5).[1]
Mechanism of action
Valoctocogene roxaparvovec is a gene therapy that uses an adeno-associated virus 5 (AAV5) that codes for human Factor VIII, together with a human liver-specific promoter that encourages translation in hepatocytes, not liver endothelial and sinusoidal cells, where Factor VIII is ordinarily synthesised.[5][6]
History
The US Food and Drug Administration granted valoctocogene roxaparvovec orphan drug status in 2016,[7] and breakthrough therapy designation in 2017.[8]
However, in late August 2020, BioMarin received a Complete Response Letter from the FDA, indicating that its Biologics License Application (which would have made valoctocogene roxaparvovec the first gene therapy to be approved for a bleeding disorder) would not be approved.[9] The regulator was concerned that differences between results from the phase I/II trials (the 270-201 study)[10] and the phase III trial (the 270-301 study)[11] were too dissimilar with regard to durability, the latter suggesting that the protective effect of valoctocogene roxaparvovec wore off after approx. 12-18 months.[12]
Society and culture
Legal status
On 23 June 2022, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a conditional marketing authorization for the medicinal product Roctavian, intended for the treatment of severe haemophilia A.[13][3] As Roctavian is an advanced therapy medicinal product, the CHMP positive opinion is based on an assessment by the Committee for Advanced Therapies.[3] The applicant for this medicinal product is BioMarin International Limited.[3] Valoctocogene roxaparvovec was approved for medical use in the European Union in August 2022.[1][2]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 "Roctavian EPAR". 20 June 2022. https://www.ema.europa.eu/en/medicines/human/EPAR/roctavian-0. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
- ↑ 2.0 2.1 2.2 2.3 "Roctavian Product information". 25 August 2022. https://ec.europa.eu/health/documents/community-register/html/h1668.htm.
- ↑ 3.0 3.1 3.2 3.3 "Roctavian: Pending EC decision". 23 June 2022. https://www.ema.europa.eu/en/medicines/human/summaries-opinion/roctavian. Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.
- ↑ "Roctavian (formerly Valrox/BMN 270)". BioNews Services, LLC. https://hemophilianewstoday.com/bmn-270/.
- ↑ "Gene Therapy with BMN 270 Results in Therapeutic Levels of FVIII in Mice and Primates and Normalization of Bleeding in Hemophilic Mice". Molecular Therapy 26 (2): 496–509. February 2018. doi:10.1016/j.ymthe.2017.12.009. PMID 29292164.
- ↑ "Activity of transgene-produced B-domain-deleted factor VIII in human plasma following AAV5 gene therapy". Blood 136 (22): 2524–2534. November 2020. doi:10.1182/blood.2020005683. PMID 32915950.
- ↑ "BioMarin Receives Orphan Drug Designation From FDA for First AAV-Factor VIII Gene Therapy, BMN 270, for Patients With Hemophilia A" (Press release). BioMarin Pharmaceutical Inc. 1 March 2016. Archived from the original on 9 July 2021. Retrieved 1 July 2021 – via GlobeNewswire.
- ↑ "FDA Grants Breakthrough Therapy Designation for BioMarin's Valoctocogene Roxaparvovec (formerly BMN 270), an Investigational Gene Therapy for Hemophilia A". BioMarin Investors (Press release). Archived from the original on 23 June 2021. Retrieved 1 July 2021.
- ↑ "BioMarin Receives Complete Response Letter (CRL) from FDA for Valoctocogene Roxaparvovec Gene Therapy for Severe Hemophilia A". https://www.biospace.com/article/biomarin-receives-complete-response-letter-crl-from-fda-for-valoctocogene-roxaparvovec-gene-therapy-for-severe-hemophilia-a/.
- ↑ BioMarin Pharmaceutical (20 January 2021). "Gene Therapy Study in Severe Haemophilia A Patients (270-201)". ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02576795. Retrieved 1 July 2021.
- ↑ BioMarin Pharmaceutical (15 January 2021). A Phase 3 Open-Label, Single-Arm Study To Evaluate The Efficacy and Safety of BMN 270, an Adeno-Associated Virus Vector-Mediated Gene Transfer of Human Factor VIII in Hemophilia A Patients With Residual FVIII Levels ≤ 1 IU/dL Receiving Prophylactic FVIII Infusions. https://clinicaltrials.gov/ct2/show/NCT03370913. Retrieved 1 July 2021.
- ↑ "FDA gets out its red pen again, rejecting BioMarin's gene therapy valrox amid durability worries". 19 August 2020. https://www.fiercebiotech.com/biotech/fda-gets-out-its-red-pen-again-rejecting-biomarin-s-gene-therapy-valrox-amid-durability.
- ↑ "First gene therapy to treat severe haemophilia A". European Medicines Agency (EMA) (Press release). 24 June 2022. Archived from the original on 26 June 2022. Retrieved 26 June 2022.
External links
- "Valoctocogene roxaparvovec". Drug Information Portal. U.S. National Library of Medicine. https://druginfo.nlm.nih.gov/drugportal/name/valoctocogene%20roxaparvovec.
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