Shire secures FDA approval for primary immunodeficiency drug

CUVITRU is a treatment for patients with primary immunodeficiency (PI), a group of more than 300 genetic disorders in which part of the body’s immune system is missing or functions improperly; it affects up to six million people worldwide.

With the approval of CUVITRU, Shire now has the broadest portfolio of intravenous and subcutaneous immunoglobulin (IG) products, including the only once-a-month subcutaneous treatment option.

CUVITRU is the only 20% subcutaneous IG treatment option without proline and with the ability to infuse up to 60 mL (12 grams) per site and 60 mL per hour, per site as tolerated, resulting in fewer infusion sites and shorter infusion durations compared to other conventional subcutaneous IG treatments.

Regardless of infusion rate or volume per site, CUVITRU was generally associated with a low incidence of local adverse and systemic reactions (0.022/infusion and 0.042/infusion, respectively) in the North American clinical study.

Richard L. Wasserman, M.D., Ph.D., Medical Director of Pediatric Allergy and Immunology at Medical City Children's Hospital, said: “In the clinical study, primary immunodeficiency patients tolerated CUVITRU favorably despite the use of higher infusion site volumes and more rapid infusion rates than have been routine in the past.

“The availability of CUVITRU as a high concentration, subcutaneous IG provides primary immunodeficiency patients with the dosing flexibility that allows them to customize their therapy to best fit their individual needs."

Marcia Boyle, President and Founder of the Immune Deficiency Foundation, said: “As the national patient organization dedicated to people with primary immunodeficiency, the Immune Deficiency Foundation is delighted to see new treatment options that can address patients’ clinical priorities as well as their personal preferences, particularly in terms of dosing and administration.

“We commend Shire’s focus on innovation and continued commitment to supporting the PI community.”

The approval follows the recent publication of a Phase II/III study of CUVITRU among North American patients in the Journal of Clinical Immunology.

Shire expects to launch CUVITRU in the U.S. in the coming weeks. CUVITRU was approved in 17 European countries in June of 2016. The company expects to initiate additional global regulatory submissions for CUVITRU in late 2016 and 2017.

Perry Sternberg, Head of U.S. Commercial, Shire, “As CUVITRU is now approved in the U.S. following European approval earlier this year, Shire’s broad IG treatment portfolio offers a wide range of options to help physicians tailor treatment regimens to meet the priorities of their patients managing these life-long disorders.

“We look forward to making CUVITRU available to the community this fall.”

About Primary Immunodeficiency

Primary immunodeficiencies (PI) are a group of more than 300 disorders in which part of the body's immune system is missing or does not function properly. Normally, the immune system protects the body from pathogenic microorganisms like bacteria, viruses, and fungi, which can cause infectious diseases.

When any part of a person's immune system is absent or dysfunctional, the individuals are susceptible to infections, and it may take longer to recover from infections. When a defect in the immune system is inherited and genetically determined, it is called primary immune deficiency. It is estimated that as many as six million children and adults may be affected by PI worldwide.

About CUVITRU [Immune Globulin Subcutaneous (Human), 20% Solution]

CUVITRU is an Immune Globulin Subcutaneous (Human) (IGSC), 20% Solution indicated as replacement therapy for primary humoral immunodeficiency (PI) in adult and pediatric patients two years of age and older.

CUVITRU is for subcutaneous infusion only.

Detailed Important Risk Information

BOXED WARNING: THROMBOSIS

Thrombosis may occur with immune globulin products, including CUVITRU. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, history of venous or arterial thrombosis, use of estrogens, indwelling vascular catheters, hyperviscosity and cardiovascular risk factors.

For patients at risk of thrombosis, administer CUVITRU at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration.  Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk of hyperviscosity.

CONTRAINDICATIONS

CUVITRU is contraindicated in patients who have had an anaphylactic or severe systemic hypersensitivity reaction to the subcutaneous administration of human immune globulin and in IgA-deficient patients with antibodies against IgA and a history of hypersensitivity to human immune globulin treatment.

WARNINGS and PRECAUTIONS

Hypersensitivity:  Severe hypersensitivity reactions may occur, even in patients who have tolerated previous treatment with human immune globulin.  IgA-deficient patients with antibodies to IgA are at greater risk of developing potentially severe hypersensitivity and anaphylactic reactions.

Renal Dysfunction/Failure:  Monitor renal function and urine output and consider lower, more frequent dosing in patients who are at risk of developing renal dysfunction because of pre-existing renal insufficiency or predisposition to acute renal failure.

Thrombosis: Monitor for signs and symptoms of thrombosis and assess blood viscosity for those at risk for hyperviscosity.

Aseptic Meningitis Syndrome (AMS):  Monitor for clinical signs and symptoms of AMS.

Hemolysis:  Monitor for clinical signs and symptoms of hemolysis and delayed hemolytic anemia.

Transfusion-Related Acute Lung Injury (TRALI):  Monitor for pulmonary adverse reactions associated with TRALI.

Transmittable Infectious Agents:  Because CUVITRU is made from human plasma, it may carry a risk of transmitting infectious agents, such as viruses and other pathogens. 

No confirmed cases of transmission of viral diseases or variant Creutzfeldt-Jakob disease (vCJD) have been associated with CUVITRU.

Interference with Laboratory Tests:  False positive serological test results, with the potential for misleading interpretation, may occur as the result of passively transferred antibodies.

ADVERSE REACTIONS

The most common adverse reactions observed in clinical trials in ≥ 5% of patients were:  local adverse reactions, systemic adverse reactions including headache, nausea, fatigue, diarrhea, and vomiting.