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Voice of the Patient Report for Spinal Muscular Atrophy
V OICE OF THE PATIENT REPORT A summary report resulting from an Externally-Led Patient Focused Drug Development Meeting reflecting the U.S. Food and Drug Administration (FDA) Patient-Focused Drug Development Initiative Spinal Muscular Atrophy (SMA) Externally Led Public Meeting: April 18, 2017 Report Date: January 10, 2018 Title of Resource: The Voice of the Patient Report for Spinal Muscular Atrophy Authors: Contributors to the collection of the information and development of the document are: Cure SMA: Rosangel Cruz, Megan Lenz, Lisa Belter, Kenneth Hobby, Jill Jarecki Medical Writer: Theo Smart Cruz, Lenz, Belter, Hobby, and Jarecki are all employees of Cure SMA and have no disclosures. Cure SMA has received funding from certain companies for work on projects unrelated to the Patient-Focused Drug Development meeting. Funding Received: The report was funded by grants received from the SMA Industry Collaboration to support Cure SMA’s production and execution of the Externally-Led Patient-Focused Drug Development initiative for SMA and the engagement of an outside medical writing professional to assist in the development, editing, and production of The Voice of the Patient report for SMA. The members of the SMA Industry Collaboration are Astellas Pharmaceuticals, AveXis, Inc., Biogen, Genentech/Roche Pharmaceuticals, Cytokinetics Inc., Novartis Pharmaceuticals, and Ionis Pharmaceuticals, Inc. Version Date: January 10, 2018 Revision Statement: This resource document has not been revised and/or modified in any way after January 10, 2018. Statement of Use: Cure SMA has the necessary permissions to submit the “The Voice of the Patient for SMA” report to the U.S. FDA. -
Neuromyelitis Optica Spectrum Disorder
© Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 | Fax 503-947-2596 Drug Class Review with New Drug Evaluation: Biologics for Autoimmune Disorders-Neuromyelitis Optica Spectrum Disorder Date of Review: April 2021 Date of Last Review: n/a Dates of Literature Search: 1/1/1996 – 1/20/2021 Generic Name: Brand Name (Manufacturer): Eculizumab Soliris® (Alexion Pharmaceuticals) Inebilizumab-cdon Uplizna™ (Viela Bio) Satralizumab-mwge Enspryng™ (Genentech/Roche) Dossiers Received: Yes Current Status of PDL Class: See Appendix 1. Purpose for Class Update: To define place in therapy for 3 immunosuppressive agents, eculizumab, inebilizumab-cdon, and satralizumab-mwge, recently approved by the Food and Drug Administration (FDA) for the treatment adults with neuromyelitis optica spectrum disorder (NMOSD). Research Questions: 1. What is the effectiveness of eculizumab, inebilizumab, and satralizumab in reducing time to relapse in adult patients with NMOSD who are anti-aquaporin-4 (AQP4) antibody positive? 2. What are the harms of eculizumab, inebilizumab-cdon and satralizumab in adults with NMOSD? 3. Is there comparative evidence that eculizumab, inebilizumab, and satralizumab differ in efficacy or harms for management of NMOSD? 4. Are there certain sub-populations (based on age, gender, ethnicity, comorbidities, disease duration or severity) in which eculizumab, inebilizumab, or satralizumab may be beneficial -
Neuromyelitis Optica News
Neuromyelitis Optica News Gloria von Geldern, MD Assistant Professor of Neurology University of Washington Multiple Sclerosis Center Multiple Sclerosis Regional Summit June 13, 2020 Disclosures ▪ No conflict of interest ▪ Off-label treatments will be mentioned Current research funding Patient-Centered Outcomes Research Institute (PCORI) What is New in NMO? Natalia Rost, MD Chair scientific committee AAN Neuromyelitis Optica (NMO) Neuromyelitis Optica Spectrum Disease (NMOSD) ▪ Inflammatory disorder of the central nervous system ▪ Predominantly involving optic nerves and spinal cord ▪ Severe demyelination and axonal damage ▪ Rare disease: 0.5-10/100,000, ~8,000 patients in the US ▪ Black > Asian > White ▪ Female > Male Flanagan et al., 2016 Bukhari et al. 2017 Hor et al. 2018 (Guthy-Jackson Charitable Foundation) Multiple Sclerosis vs NMO Pittock and Lucchinetti 2016 History 1894: Clinical case descriptions 2004: AQP4 antibody identified by Devic and Gault by Lennon, Weinshenker et al. Eugene Devic (1858–1930) Lancet2004; 364: 2106–12; Journal of Neuroinflammation 2013, 10:8 Diagnostic Criteria Wingerchuk et al. 2015 Myelin Oligodendrocyte (MOG) Antibody ▪ More common in men and whites ▪ Bilateral optic neuritis, caudal myelitis ▪ Better recovery compared to AQP4-Ab pos NMO ▪ MRI brain without NMO findings ▪ Assay now commercially available at Mayo Sato et al. 2014; van Pelt et al. 2016 Auto-Antibody to Aquaporin 4 Water channel protein in ▪ Astrocytic foot processes at the blood-brain barrier ▪ Spinal cord grey matter ▪ Periaqueductal and periventricular regions ▪ Mueller cells in the retina Amiry-Moghaddam and Otterson 2003 Bystander Oligodendrocyte Injury Tradtrantip et al 2017 Pathology Extensive demyelination Perivascular & parenchymal Complement activation Axonal injury, necrosis eosinophils & granulocytes rosette and rim pattern Jacob et al. -
Spinal Muscular Atrophy
Spinal Muscular Atrophy U.S. DEPARTMENT OF HEALTHAND HUMAN SERVICES National Institutes of Health Spinal Muscular Atrophy What is spinal muscular atrophy? pinal muscular atrophy (SMA) is a group Sof hereditary diseases that progressively destroys motor neurons—nerve cells in the brain stem and spinal cord that control essential skeletal muscle activity such as speaking, walking, breathing, and swallowing, leading to muscle weakness and atrophy. Motor neurons control movement in the arms, legs, chest, face, throat, and tongue. When there are disruptions in the signals between motor neurons and muscles, the muscles gradually weaken, begin wasting away and develop twitching (called fasciculations). What causes SMA? he most common form of SMA is caused by Tdefects in both copies of the survival motor neuron 1 gene (SMN1) on chromosome 5q. This gene produces the survival motor neuron (SMN) protein which maintains the health and normal function of motor neurons. Individuals with SMA have insufficient levels of the SMN protein, which leads to loss of motor neurons in the spinal cord, producing weakness and wasting of the skeletal muscles. This weakness is often more severe in the trunk and upper leg and arm muscles than in muscles of the hands and feet. 1 There are many types of spinal muscular atrophy that are caused by changes in the same genes. Less common forms of SMA are caused by mutations in other genes including the VAPB gene located on chromosome 20, the DYNC1H1 gene on chromosome 14, the BICD2 gene on chromosome 9, and the UBA1 gene on the X chromosome. The types differ in age of onset and severity of muscle weakness; however, there is overlap between the types. -
HY 2021 Results
Roche HY 2021 results Basel, 22 July 2021 This presentation contains certain forward-looking statements. These forward-looking statements may be identified by words such as ‘believes’, ‘expects’, ‘anticipates’, ‘projects’, ‘intends’, ‘should’, ‘seeks’, ‘estimates’, ‘future’ or similar expressions or by discussion of, among other things, strategy, goals, plans or intentions. Various factors may cause actual results to differ materially in the future from those reflected in forward-looking statements contained in this presentation, among others: 1 pricing and product initiatives of competitors; 2 legislative and regulatory developments and economic conditions; 3 delay or inability in obtaining regulatory approvals or bringing products to market; 4 fluctuations in currency exchange rates and general financial market conditions; 5 uncertainties in the discovery, development or marketing of new products or new uses of existing products, including without limitation negative results of clinical trials or research projects, unexpected side-effects of pipeline or marketed products; 6 increased government pricing pressures; 7 interruptions in production; 8 loss of or inability to obtain adequate protection for intellectual property rights; 9 litigation; 10 loss of key executives or other employees; and 11 adverse publicity and news coverage. Any statements regarding earnings per share growth is not a profit forecast and should not be interpreted to mean that Roche’s earnings or earnings per share for this year or any subsequent period will necessarily match or exceed the historical published earnings or earnings per share of Roche. For marketed products discussed in this presentation, please see full prescribing information on our website www.roche.com All mentioned trademarks are legally protected. -
Biologic Immunomodulators Pa Summary
GEORGIA MEDICAID FEE-FOR-SERVICE BIOLOGIC IMMUNOMODULATORS PA SUMMARY Preferred Non-Preferred Arcalyst (rilonacept) Actemra Subcutaneous (tocilizumab) Benlysta subcutaneous (belimumab) Cimzia (certolizumab) Enbrel (etanercept) Cosentyx (secukinumab) Humira (adalimumab) Dupixent (dupilumab) Ilaris (canakinumab) Enspryng (satralizumab-mwge) Xeljanz (tofacitinib) Fasenra Pen (benralizumab autoinjector) Xeljanz XR (tofacitinib extended-release) Kevzara (sarilumab) Kineret (anakinra) Nucala Pen (mepolizumab autoinjector) Olumiant (baricitinib) Orencia Subcutaneous (abatacept) Otezla (apremilast) Rinvoq (upadacitinib) Siliq (brodalumab) Simponi (golimumab) Stelara (ustekinumab) Skyrizi (risankizumab) Taltz (ixekizumab) Tremfya (guselkumab) The drug names above include all available oral or subcutaneous formulations under the same primary name. LENGTH OF AUTHORIZATION: Varies NOTES: ▪ All preferred and non-preferred products require prior authorization. Intravenous (IV) formulations of the biologic immunomodulators are not covered under Pharmacy Services. ▪ The criteria details below are for the outpatient pharmacy program. If a medication is being administered in a physician’s office or clinic, then the medication must be billed through the DCH physician services program and not the outpatient pharmacy program. Information regarding the physician services program is located at www.mmis.georgia.gov. PA CRITERIA: Actemra Subcutaneous ❖ Approvable for members 2 years of age or older with a diagnosis of moderately to severely active polyarticular -
CDER Breakthrough Therapy Designation Approvals Data As of December 31, 2020 Total of 190 Approvals
CDER Breakthrough Therapy Designation Approvals Data as of December 31, 2020 Total of 190 Approvals Submission Application Type and Proprietary Approval Use Number Number Name Established Name Applicant Date Treatment of patients with previously BLA 125486 ORIGINAL-1 GAZYVA OBINUTUZUMAB GENENTECH INC 01-Nov-2013 untreated chronic lymphocytic leukemia in combination with chlorambucil Treatment of patients with mantle cell NDA 205552 ORIGINAL-1 IMBRUVICA IBRUTINIB PHARMACYCLICS LLC 13-Nov-2013 lymphoma (MCL) Treatment of chronic hepatitis C NDA 204671 ORIGINAL-1 SOVALDI SOFOSBUVIR GILEAD SCIENCES INC 06-Dec-2013 infection Treatment of cystic fibrosis patients age VERTEX PHARMACEUTICALS NDA 203188 SUPPLEMENT-4 KALYDECO IVACAFTOR 21-Feb-2014 6 years and older who have mutations INC in the CFTR gene Treatment of previously untreated NOVARTIS patients with chronic lymphocytic BLA 125326 SUPPLEMENT-60 ARZERRA OFATUMUMAB PHARMACEUTICALS 17-Apr-2014 leukemia (CLL) for whom fludarabine- CORPORATION based therapy is considered inappropriate Treatment of patients with anaplastic NOVARTIS lymphoma kinase (ALK)-positive NDA 205755 ORIGINAL-1 ZYKADIA CERITINIB 29-Apr-2014 PHARMACEUTICALS CORP metastatic non-small cell lung cancer (NSCLC) who have progressed on or are intolerant to crizotinib Treatment of relapsed chronic lymphocytic leukemia (CLL), in combination with rituximab, in patients NDA 206545 ORIGINAL-1 ZYDELIG IDELALISIB GILEAD SCIENCES INC 23-Jul-2014 for whom rituximab alone would be considered appropriate therapy due to other co-morbidities -
ASAH1 Variant Causing a Mild SMA Phenotype with No Myoclonic Epilepsy: a Clinical, Biochemical and Molecular Study
European Journal of Human Genetics (2016) 24, 1578–1583 & 2016 Macmillan Publishers Limited, part of Springer Nature. All rights reserved 1018-4813/16 www.nature.com/ejhg ARTICLE ASAH1 variant causing a mild SMA phenotype with no myoclonic epilepsy: a clinical, biochemical and molecular study Massimiliano Filosto*,1, Massimo Aureli2, Barbara Castellotti3, Fabrizio Rinaldi1, Domitilla Schiumarini2, Manuela Valsecchi2, Susanna Lualdi4, Raffaella Mazzotti4, Viviana Pensato3, Silvia Rota1, Cinzia Gellera3, Mirella Filocamo4 and Alessandro Padovani1 ASAH1 gene encodes for acid ceramidase that is involved in the degradation of ceramide into sphingosine and free fatty acids within lysosomes. ASAH1 variants cause both the severe and early-onset Farber disease and rare cases of spinal muscular atrophy (SMA) with progressive myoclonic epilepsy (SMA-PME), phenotypically characterized by childhood onset of proximal muscle weakness and atrophy due to spinal motor neuron degeneration followed by occurrence of severe and intractable myoclonic seizures and death in the teenage years. We studied two subjects, a 30-year-old pregnant woman and her 17-year-old sister, affected with a very slowly progressive non-5q SMA since childhood. No history of seizures or myoclonus has been reported and EEG was unremarkable. The molecular study of ASAH1 gene showed the presence of the homozygote nucleotide variation c.124A4G (r.124a4g) that causes the amino acid substitution p.Thr42Ala. Biochemical evaluation of cultured fibroblasts showed both reduction in ceramidase activity and accumulation of ceramide compared with the normal control. This study describes for the first time the association between ASAH1 variants and an adult SMA phenotype with no myoclonic epilepsy nor death in early age, thus expanding the phenotypic spectrum of ASAH1-related SMA. -
Spinal Muscular Atrophy Resources About Integrated Genetics Atrophy SMA Carrier Screening
Spinal Muscular Informed Consent/Decline for Spinal Muscular Atrophy Resources About Integrated Genetics Atrophy SMA Carrier Screening (Continued from other side) Claire Altman Heine Foundation Integrated Genetics has been 1112 Montana Avenue a leader in genetic testing My signature below indicates that I have read, Suite 372 and counseling services for or had read to me, the above information and I Santa Monica, CA 90403 over 25 years. understand it. I have also read or had explained to (310) 260-3262 me the specific disease(s) or condition(s) tested www.clairealtmanheinefoundation.org This brochure is provided for, and the specific test(s) I am having, including by Integrated Genetics as the test descriptions, principles and limitations. Families of Spinal Muscular Atrophy an educational service for 925 Busse Road physicians and their patients. Elk Grove Village, IL 60007 For more information on I have had the opportunity to discuss the purposes (800) 886-1762 our genetic testing and and possible risks of this testing with my doctor or www.fsma.org someone my doctor has designated. I know that counseling services, genetic counseling is available to me before and National Society of Genetic Counselors please visit our web sites: after the testing. I have all the information I want, 401 N. Michigan Avenue www.mytestingoptions.com and all my questions have been answered. Chicago, IL 60611 www.integratedgenetics.com (312) 321-6834 I have decided that: www.nsgc.org References: 1) Prior TW. ACMG Practice Guidelines: Carrier screening for spinal muscular I want SMA carrier testing. Genetic Alliance atrophy. Genet Med 2008; 10:840-842. -
Deletions Causing Spinal Muscular Atrophy Do Not Predispose to Amyotrophic Lateral Sclerosis
ORIGINAL CONTRIBUTION Deletions Causing Spinal Muscular Atrophy Do Not Predispose to Amyotrophic Lateral Sclerosis Jillian S. Parboosingh, MSc; Vincent Meininger, MD; Diane McKenna-Yasek; Robert H. Brown, Jr, MD; Guy A. Rouleau, MD Background: Amyotrophic lateral sclerosis (ALS) is a ing neurodegeneration in spinal muscular atrophy are rapidly progressive, invariably lethal disease resulting present in patients with ALS in whom the copper/zinc from the premature death of motor neurons of the superoxide dismutase gene is not mutated. motor cortex, brainstem, and spinal cord. In approxi- mately 15% of familial ALS cases, the copper/zinc super- Patients and Methods: Patients in whom ALS oxide dismutase gene is mutated; a juvenile form of was diagnosed were screened for mutations in the familial ALS has been linked to chromosome 2. No SMN and NAIP genes by single strand conformation cause has been identified in the remaining familial ALS analysis. cases or in sporadic cases and the selective neurodegen- erative mechanism remains unknown. Deletions in 2 Results: We found 1 patient with an exon 7 deletion in genes on chromosome 5q, SMN (survival motor neuron the SMN gene; review of clinical status confirmed the mo- gene) and NAIP (neuronal apoptosis inhibitory protein lecular diagnosis of spinal muscular atrophy. No muta- gene), have been identified in spinal muscular atrophy, a tions were found in the remaining patients. disease also characterized by the loss of motor neurons. These genes are implicated in the regulation of apopto- Conclusion: The SMN and NAIP gene mutations are spe- sis, a mechanism that may explain the cell loss found in cific for spinal muscular atrophy and do not predispose the brains and spinal cords of patients with ALS. -
An Interleukin-6 Receptor-Blocking Therapy for Neuromyelitis Optica Spectrum Disorder
Review Neuroimmunology Satralizumab: An Interleukin-6 Receptor-blocking Therapy for Neuromyelitis Optica Spectrum Disorder Norio Chihara,1 Riki Matsumoto1 and Takashi Yamamura2 1. Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan; 2. Department of Immunology, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan euromyelitis optica spectrum disorder (NMOSD) is a relapsing inflammatory disease of the central nervous system in which even a single disease flare may result in persistent neurological disability. The core group of patients with NMOSD, characterized by Nprominent astrocyte pathology, has high levels of autoantibodies reactive to aquaporin-4 (AQP4), a water channel expressed on astrocytes. In these patients, activation of autoreactive T and B cells, production of AQP4 autoantibody (AQP4-Ab) and AQP4-Ab-mediated complement-dependent destruction of astrocytes are presumed be the critical events in the pathology. Recent clinical trials have shown the efficacy of therapeutic antibodies targeting complement C5, interleukin-6 receptor (IL-6R) and CD19+ B cells in patients with NMOSD, particularly those with AQP4-Ab seropositivity. Regarding the pathogenesis of NMOSD, prior studies have indicated that IL-6 promotes the activation of autoreactive T cells, prolongs the survival of AQP4-Ab-producing B cells and inhibits blood–brain barrier integrity. The results of two pivotal clinical trials showing the efficacy of satralizumab have firmly established the role of IL-6 and IL-6R signalling in the pathogenesis of AQP4-Ab-positive NMOSD. This review aims to evaluate the involvement of IL-6 in NMOSD and the potential of satralizumab, a humanized antibody against IL-6R, in the current and future practice of NMOSD. -
CHMP Agenda of the 19-22 April 2021 Meeting
28 July 2021 EMA/CHMP/220334/2021 Corr.11 Human Medicines Division Committee for medicinal products for human use (CHMP) Agenda for the meeting on 19-22 April 2021 Chair: Harald Enzmann – Vice-Chair: Bruno Sepodes 19 April 2021, 09:00 – 19:30, virtual meeting/ room 1C 20 April 2021, 08:30 – 19:30, virtual meeting/ room 1C 21 April 2021, 08:30 – 19:30, virtual meeting/ room 1D 22 April 2021, 08:30 – 19:00, virtual meeting/ room 1C Disclaimers Some of the information contained in this agenda is considered commercially confidential or sensitive and therefore not disclosed. With regard to intended therapeutic indications or procedure scopes listed against products, it must be noted that these may not reflect the full wording proposed by applicants and may also vary during the course of the review. Additional details on some of these procedures will be published in the CHMP meeting highlights once the procedures are finalised and start of referrals will also be available. Of note, this agenda is a working document primarily designed for CHMP members and the work the Committee undertakes. Note on access to documents Some documents mentioned in the agenda cannot be released at present following a request for access to documents within the framework of Regulation (EC) No 1049/2001 as they are subject to on- going procedures for which a final decision has not yet been adopted. They will become public when adopted or considered public according to the principles stated in the Agency policy on access to documents (EMA/127362/2006). 1 Correction in section 8.1.1 Official address Domenico Scarlattilaan 6 ● 1083 HS Amsterdam ● The Netherlands Address for visits and deliveries Refer to www.ema.europa.eu/how-to-find-us Send us a question Go to www.ema.europa.eu/contact Telephone +31 (0)88 781 6000 An agency of the European Union © European Medicines Agency, 2021.