Biology:Vestronidase alfa-vjbk

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Vestronidase alfa-vjbk
Clinical data
Trade namesMepsevii
Other namesVestronidase alfa
AHFS/Drugs.comMonograph
License data
Routes of
administration
Injection
ATC code
Legal status
Legal status
Identifiers
CAS Number
UNII
KEGG
Chemical and physical data
FormulaC3308H4996N874O940S16
Molar mass72562.49 g·mol−1

Vestronidase alfa-vjbk (trade name Mepsevii) is a drug for the treatment of Sly syndrome. It is a recombinant form of the human enzyme beta-glucuronidase. In the United States, it was approved in November 2017 to treat pediatric and adult patients with an inherited metabolic condition called mucopolysaccharidosis type VII (MPS VII), also known as Sly syndrome.[1][2] MPS VII is an extremely rare, progressive condition that affects most tissues and organs.[1]

The most common side effects after treatment with vestronidase alfa-vjbk include infusion site reactions, diarrhea, rash and anaphylaxis.[1]

The safety and efficacy of vestronidase alfa-vjbk were established in clinical trial and expanded access protocols enrolling a total of 23 patients ranging from five months to 25 years of age.[1] Patients received treatment with vestronidase alfa-vjbk at doses up to 4 mg/kg once every two weeks for up to 164 weeks.[1] Efficacy was primarily assessed via the six-minute walk test in ten patients who could perform the test.[1] After 24 weeks of treatment, the mean difference in distance walked relative to placebo was 18 meters.[1] Additional follow-up for up to 120 weeks suggested continued improvement in three patients and stabilization in the others.[1] Two patients in the vestronidase alfa-vjbk development program experienced marked improvement in pulmonary function.[1] Overall, the results observed would not have been anticipated in the absence of treatment.[1] The effect of vestronidase alfa-vjbk on the central nervous system manifestations of MPS VII has not been determined.[1]

The FDA approved vestronidase alfa-vjbk based primarily on evidence from one clinical trial (NCT02230566) of 12 patients with mucopolysaccharidosis VII. The trial was conducted at four sites in the United States.[2]

The benefit and side effects of vestronidase alfa-vjbk were based primarily on one trial.[2] Patients were randomly assigned to four groups.[2] Three groups of patients received placebo treatment before starting vestronidase alfa-vjbk treatment and one group received vestronidase alfa-vjbk only.[2] vestronidase alfa-vjbk or placebo were given once every two weeks as intravenous (IV) infusions.[2] Neither patients nor healthcare providers knew which treatment was given until after the trial was competed.[2]

The benefit of 24 weeks of vestronidase alfa-vjbk treatment was primarily evaluated by the 6-minute walking test (6MWT) and compared to placebo treatment in ten patients who could perform the test.[2] The 6MWT measured the distance a patient could walk on a flat surface in 6 minutes.[2] An additional follow-up using 6MWT was done for up to 120 weeks.[2]

The application for vestronidase alfa-vjbk was granted fast track designation, orphan drug designation, and a rare pediatric disease priority review voucher.[1] This was the twelfth rare pediatric disease priority review voucher issued.[1]

The U.S. Food and Drug Administration (FDA) granted approval of Mepsevii to Ultragenyx Pharmaceutical, Inc,[1] and required the manufacturer to conduct a post-marketing study to evaluate the long-term safety of the product.[1]

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 "FDA approves treatment for rare genetic enzyme disorder" (Press release). U.S. Food and Drug Administration (FDA). 15 November 2017. Archived from the original on 10 December 2019. Retrieved 9 December 2019. This article incorporates text from this source, which is in the public domain.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 "Drug Trial Snapshot: Mepsevii". 4 December 2017. https://www.fda.gov/drugs/drug-trial-snapshot-mepsevii.  This article incorporates text from this source, which is in the public domain.

External links