In this episode of The CheckRare Brief, we discuss four recent FDA approvals, including LISRAYA for dermatomyositis and Imaavy for warm autoimmune hemolytic anemia (wAIHA), Mimrylo for polycythemia vera (PV), and Rasonque for pancreatic cancer. We also examine the recent measles outbreak in Pennsylvania.
The FDA has approved Lisraya and Imaavy to treat two different autoimmune diseases – dermatomyositis and wAIHA. Historically, the standard therapy for autoimmune conditions has been steroids. While still common, advances in our understanding of the immune system and the pathophysiology of autoimmune conditions have led to a variety of treatment options. LISRAYA is a dual TYK2 and JAK1 inhibitor, while Imaavy blocks FcRn, a receptor involved in maintaining IgG antibodies in the bloodstream. Both represent newer approaches to targeting the immune system.These approvals highlight an important trend in drug development– companies are looking at how the same drug might help patients with several different diseases. For example, Imaavy was previously approved for myasthenia gravis, and now it’s approved for wAIHA. Additionally, as is the case with Lisraya, sometimes the breakthrough isn’t discovering a new drug but finding the right disease for a drug that already exists.
The FDA has also approved Mimrylo, a first-in-class hepcidin mimetic, to treat excessive red blood cell production in adults with PV. In the Phase 3 study that led to the drug’s approval, 76.9% of patients taking Mimrylo required no phlebotomies between weeks 20 and 32, compared with 32.9% of patients receiving placebo.Mimrylo was filed by Takeda but developed by Protagonist, showcasing a common collaboration between a smaller biotech company and larger pharmaceutical company when it comes to regulatory submissions and commercialization.
In our last FDA approval of the week, Rasonque has been indicated to treat patients with metastatic pancreatic adenocarcinoma who have received at least one prior systemic therapy or are not candidates for multiagent systemic therapy. Approximately 60,000 patients are diagnosed each year with pancreatic cancer, however, approximately 110,000 are living with the disease. This new medication may help increase the lifespan of patients with this cancer. Study results from the trial that led to the approval were very impressive, with median overall survival doubling from 6.7 months to over 13 months when treated with Rasonque.
Finally, a growing measles outbreak in Pennsylvania is putting the debate over vaccines back in the spotlight. The state has reported hundreds of cases this year and, this week, confirmed two measles-associated deaths for the first time in 35 years. Measles is a rare condition, but only because the majority of people have been vaccinated against it. Most measles outbreaks occur when people who choose not to take the vaccines, often due to a lack of trust in the healthcare system. This story emphasizes how fundamental trust is in physicians, science, medicine and the healthcare system as a whole.
References
FDA approves Lisraya for dermatomyositis
FDA approves drug for wAIHA
FDA approves Mimrylo (rusfertied) to treat adults with polycythemia vera
FDA approves orphan drug for Pancreatic Cancer
