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Pharma Tech Outlook | Tuesday, July 27, 2021
This is the first time a treatment option for these rare genetic obesity diseases has been authorized in the European Union.
FREMONT, CA: Rhythm Pharmaceuticals, Inc., a commercial-stage biopharmaceutical company dedicated to transforming the care of people living with rare genetic obesity diseases, declares that the European Commission (EC) has approved IMCIVREE (setmelanotide) for the treatment of obesity and the control of hunger in the European Union (EU).
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“Rhythms Phase 3 trials confirmed that treatment with IMCIVREE may deliver clinically meaningful impacts on obesity and severe hunger or hyperphagia. Many patients enrolled in these studies experienced weight loss of a magnitude that is unprecedented in the natural history of rare genetic diseases of obesity,” says Martin Wabitsch, M.D., professor of medicine and head of the Division of Pediatric Endocrinology and Diabetes at Ulm University Medical Center in Germany. “With this authorization, we are reminded of the importance of genetic testing, so that we can identify and properly diagnose patients with POMC, PCSK1 or LEPR deficiency obesity and offer eligible patients IMCIVREE, a pharmacological therapy designed to address the underlying cause of their disease.”
Obesity caused by POMC, PCSK1, or LEPR deficiency is a sporadic disease caused by variants in the POMC, PCSK1 or LEPR genes that impair the MC4R pathway, a pathway in the hypothalamus that regulates hunger, energy expenditure, and thus body weight. Individuals who are obese due to POMC, PCSK1, or LEPR deficiency experience severe, insatiable appetite from an early age, resulting in early-onset, severe obesity. IMCIVREE was developed as an MC4R agonist to restore impaired MC4R pathway activity caused by genetic deficiencies upstream of the MC4 receptor.
The European Commission approves IMCIVREE based on the most extensive studies in obesity caused by POMC, PCSK1, or LEPR deficiency. v After one year of treatment with IMCIVREE, 80 percent of ten patients with obesity due to POMC or PCSK1 deficit lost more than ten percent of their body weight, and 45.5 percent of eleven patients with obesity due to LEPR deficiency lost more than ten percent of their body weight. Additionally, both studies demonstrated significant body mass index (BMI) reductions in patients aged 6 to 17 years at baseline (n=14).
IMCIVREE was generally well tolerated in clinical trials. The most frequently reported adverse events were injection site reaction, hyper pigmentation of the skin, and nausea. Disruption of sexual arousal, depression and suicidal ideation, skin pigmentation and darkening of pre-existing nevi are all warnings and precautions.
Indications for IMCIVREE (setmelanotide)
To treat obesity caused by pro-opiomelanocortin (POMC), proprotein convertase subtilisin/Kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency, IMCIVREE is approved in the United States. Obesity and hunger control are associated with genetically confirmed loss-of-function biallelic pro-opiomelanocortin (POMC) deficiency, including PCSK1 lack, or biallelic leptin receptor (LEPR) deficiency, are treated with IMCIVREE in the EU. IMCIVREE should be prescribed and monitored by an expert in obesity with genetic aetiology. Genetic testing demonstrating pathogenic, likely pathogenic, or uncertain significance variants in POMC, PCSK1, or LEPR genes is required (VOUS).
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