Volixibat potassium ethanolate hydrate

吉利德科学（Gilead Sciences）今天宣布，美国FDA已加速批准Livdelzi（seladelpar）与熊去氧胆酸（UDCA）联合用于治疗对UDCA应答不足的原发性胆汁性肝硬化（PBC）成人患者，或作为单药治疗对UDCA不耐受的患者，但不建议患有或发展为失代偿性肝硬化的患者使用Livdelzi。根据新闻稿，Livdelzi是在碱性磷酸酶（ALP）正常化、关键生物标志物和瘙痒控制方面，与安慰剂相比表现出统计学显著改善的首个疗法。目前英国药品和健康产品管理局（MHRA）和欧洲药品管理局（EMA）正在评估Livdelzi的上市申请。 原发性胆汁性胆管炎是一种有潜在生命危险的肝脏自身免疫性疾病。由于免疫系统持续攻击胆管，胆汁流动受阻而淤积，毒性胆汁酸在肝内留存，可发展为肝纤维化、肝硬化和肝功能衰竭。其他临床症状还包括疲劳和瘙痒。在40岁以上的女性中，有千分之一患有PBC。 这次的加速批准主要基于关键安慰剂对照3期RESPONSE研究的数据。在该研究中，62%接受每日一次口服Livdelzi的受试者在第12个月达到了综合生化应答的主要终点，而此数值在安慰剂组中只有20%。使用Livdelzi治疗后，25%的患者在第12个月时ALP值恢复正常，而安慰剂组中的患者均未出现这种变化。ALP是一种胆汁淤积标志物，可预测肝移植和死亡的风险。 第6个月时瘙痒评分相对于基线的变化是试验的关键次要终点。与安慰剂组相比，Livdelzi组患者的瘙痒症状显著减少。根据新闻稿，Livdelzi是在3期试验中，证明能够显著、持久改善瘙痒和胆汁淤积标志物的首个药物，这些标志物与疾病进展风险相关。 最常见的不良事件（≥5% Livdelzi组患者报告，且高于安慰剂组）是头痛、腹痛、恶心、腹胀和头晕，没有观察到与治疗相关的严重不良事件（SAE）。 目前为止，Livdelzi已在RESPONSE以及其他试验（包括长期开放标签ASSURE研究和之前的早期研究）中超过500名PBC患者中受检视。进行中的研究包括验证性3期AFFIRM研究，这是一项随机、安慰剂对照的验证性研究，旨在评估Livdelzi对因PBC导致的代偿性肝硬化患者的临床结果的影响。 Livdelzi为一款口服的强效选择性过氧化物酶体增殖物活化受体δ（PPAR δ）激动剂。PPARδ表达在肝脏的多种细胞类型中，临床前数据表明，它对调控胆汁酸合成、炎症、纤维化过程的多种基因有调节作用。该药物曾于2019年2月获得美国FDA授予突破性疗法认定，用以治疗PBC。该疗法原由CymaBay公司所研发，吉利德科学在2024年2月与该公司达成总金额达43亿美元的收购协议，进而囊获此款疗法。 今年6月美国FDA加速批准益普生（Ipsen）的Iqirvo（elafibranor）80毫克片剂与UDCA联合用于治疗对UDCA应答不足的成人PBC患者，或作为单药疗法治疗对UDCA不耐受的患者。Iqirvo是一种每日一次、口服、“first-in-class"的PPAR α/δ激动剂，同时靶向活化PPAR α/δ可潜在治疗PBC的炎症、胆汁淤积和纤维化。根据新闻稿，Iqirvo是近十年来首个获批用于治疗罕见肝病原发性胆汁性胆管炎的新药。 除了Livdelzi与Iqirvo，目前开发用以治疗PBC的疗法还有由GSK开发、目前处于3期阶段的回肠胆汁酸转运体（IBAT）口服小分子抑制剂linerixibat，其3期试验已募集238位患者，预计今年10月会有初步结果。而由Calliditas Therapeutics开发的NOX1/4抑制剂setanaxib也在近期完成临床2期试验，预计在今年下半年公布完整试验结果。该疗法曾获EMA与美国FDA授予孤儿药资格，并获FDA授予快速通道资格，用以治疗PBC。Mirum Pharmaceuticals也正在开发选择性ASBT小分子抑制剂volixibat用于PBC治疗，目前该疗法的2期试验正在进行患者招募，预计在明年12月会有初步结果。同样地，凯思凯迪（Cascade Pharmaceuticals）开发的FXR靶向激动剂linafexor（CS0159）的2期试验也正在招募患者，初步结果预计在今年10月公布。 参考资料： [1] Gilead’s Livdelzi (Seladelpar) Granted Accelerated Approval for Primary Biliary Cholangitis by U.S. FDA. Retrieved August 14, 2024 from https://www.gilead.com/news-and-press/press-room/press-releases/2024/8/gileads-livdelzi-seladelpar-granted-accelerated-approval-for-primary-biliary-cholangitis-by-us-fda [2] Global Linerixibat Itch Study of Efficacy and Safety in Primary Biliary Cholangitis (PBC) (GLISTEN). Retrieved August 14, 2024 from https://clinicaltrials.gov/study/NCT04950127?term=Primary%20Biliary%20Cholangitis%20%5C(PBC%5C)&intr=linerixibat&rank=2 [3] A Trial of Setanaxib in Patients With Primary Biliary Cholangitis (PBC) and Liver Stiffness (TRANSFORM). Retrieved August 14, 2024 from https://clinicaltrials.gov/study/NCT05014672?term=Primary%20Biliary%20Cholangitis%20&intr=setanaxib&rank=1 [4] A Study to Evaluate Efficacy and Safety of an Investigational Drug Named Volixibat in Patients With Itching Caused by Primary Biliary Cholangitis (VANTAGE). Retrieved August 14, 2024 from https://clinicaltrials.gov/study/NCT05050136?term=Primary%20Biliary%20Cholangitis%20&intr=volixibat%20&rank=1 [5] CS0159 in Chinese Patients With PBC (Primary Biliary Cholangitis). Retrieved August 14, 2024 from https://clinicaltrials.gov/study/NCT05896124?term=Primary%20Biliary%20Cholangitis%20&intr=CS-0159&rank=3 内容来源于网络，如有侵权，请联系删除。

FOSTER CITY, Calif.--( BUSINESS WIRE )--Mirum Pharmaceuticals, Inc. (Nasdaq: MIRM) today announced that the U.S. Food and Drug Administration (FDA) has approved a label expansion for LIVMARLI® (maralixibat) oral solution for the treatment of cholestatic pruritus in patients with progressive familial intrahepatic cholestasis (PFIC). The expanded label includes use in PFIC patients 12 months and older as well as the higher concentration formulation of LIVMARLI evaluated in the MARCH Phase 3 study. “The launch of LIVMARLI in PFIC is going well and we are thrilled that it will now be available for patients 12 months and older,” said Chris Peetz, chief executive officer at Mirum. “PFIC is generally diagnosed when children are young, and initiating treatment quickly after diagnosis will help to ensure they have fewer days suffering from pruritus associated with this rare liver disease.” About LIVMARLI® (maralixibat) oral solution LIVMARLI® (maralixibat) oral solution is an orally administered, once-daily, ileal bile acid transporter (IBAT) inhibitor approved by the U.S. Food and Drug Administration for two pediatric cholestatic liver diseases. It is approved for the treatment of cholestatic pruritus in patients with Alagille syndrome (ALGS) in the U.S. three months of age and older and in Europe for patients two months of age and older. It is also approved in the U.S. for the treatment of cholestatic pruritus in patients with progressive familial intrahepatic cholestasis (PFIC) 12 months of age and older and in Europe for the treatment of PFIC in patients three months of age and older. For more information for U.S. residents, please visit LIVMARLI.com . LIVMARLI has received Breakthrough Therapy designation for ALGS and PFIC type 2 and orphan designation for ALGS and PFIC. To learn more about ongoing clinical trials with LIVMARLI, please visit Mirum’s clinical trials section on the company’s website. IMPORTANT SAFETY INFORMATION Limitation of Use : LIVMARLI is not for use in PFIC type 2 patients who have a severe defect in the bile salt export pump (BSEP) protein. LIVMARLI can cause side effects, including: Liver injury . Changes in certain liver tests are common in patients with Alagille syndrome and PFIC but can worsen during treatment. These changes may be a sign of liver injury. In PFIC, this can be serious or may lead to liver transplant or death. Your healthcare provider should do blood tests and physical exams before starting and during treatment to check your liver function. Tell your healthcare provider right away if you get any signs or symptoms of liver problems, including nausea or vomiting, skin or the white part of the eye turns yellow, dark or brown urine, pain on the right side of the stomach (abdomen), bloating in your stomach area, loss of appetite or bleeding or bruising more easily than normal. Stomach and intestinal (gastrointestinal) problems. LIVMARLI can cause stomach and intestinal problems, including diarrhea and stomach pain. Your healthcare provider may advise you to monitor for new or worsening stomach problems including stomach pain, diarrhea, blood in your stool or vomiting. Tell your healthcare provider right away if you have any of these symptoms more often or more severely than normal for you. A condition called Fat Soluble Vitamin (FSV) Deficiency caused by low levels of certain vitamins (vitamin A, D, E, and K) stored in body fat is common in patients with Alagille syndrome and PFIC but may worsen during treatment. Your healthcare provider should do blood tests before starting and during treatment and may monitor for bone fractures and bleeding which have been reported as common side effects. US Prescribing Information EU SmPC Canadian Product Monograph About Mirum Pharmaceuticals, Inc. Mirum Pharmaceuticals, Inc. is a biopharmaceutical company dedicated to transforming the treatment of rare diseases affecting children and adults. Mirum has three approved medications: LIVMARLI® (maralixibat) oral solution , CHOLBAM® (cholic acid) capsules, and CHENODAL® (chenodiol) tablets. LIVMARLI, an IBAT inhibitor, is approved for the treatment of two rare liver diseases affecting children and adults. It is approved for the treatment of cholestatic pruritus in patients with Alagille syndrome in the U.S. (three months and older), in Europe (two months and older), and in other regions globally. It is also approved in the U.S. in cholestatic pruritus in PFIC patients 12 months of age and older; in Europe, it is approved for patients with PFIC three months of age and older. CHOLBAM is FDA-approved for the treatment of bile acid synthesis disorders due to single enzyme deficiencies and adjunctive treatment of peroxisomal disorders in patients who show signs or symptoms or liver disease. CHENODAL has received medical necessity recognition by the FDA to treat patients with cerebrotendinous xanthomatosis (CTX). Mirum’s late-stage pipeline includes two investigational treatments for debilitating liver diseases. Volixibat, an IBAT inhibitor, is being evaluated in two potentially registrational studies including the Phase 2 VISTAS study for primary sclerosing cholangitis (PSC) and Phase 2b VANTAGE study for primary biliary cholangitis. Lastly, chenodiol, has been evaluated in a Phase 3 clinical study, RESTORE, to treat patients with CTX, with positive topline results reported in 2023. Mirum has submitted a new drug application with the FDA for the approval of chenodiol to treat CTX in the U.S. To learn more about Mirum, visit mirumpharma.com and follow Mirum on Facebook , LinkedIn , Instagram and Twitter (X) . Forward-Looking Statements Statements contained in this press release regarding matters that are not historical facts are “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Such forward-looking statements include statements regarding, among other things, the potential benefits of LIVMARLI in PFIC patients older than 12 years of age, the commercial success of LIVMARLI in PFIC generally, and the impact of the higher concentration formula of LIVMARLI. Because such statements are subject to risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. Words such as “will,” “could,” “would,” “potential” and similar expressions are intended to identify forward-looking statements. These forward-looking statements are based upon Mirum’s current expectations and involve assumptions that may never materialize or may prove to be incorrect. Actual results could differ materially from those anticipated in such forward-looking statements as a result of various risks and uncertainties, which include, without limitation, risks and uncertainties associated with Mirum’s business in general and the other risks described in Mirum’s filings with the Securities and Exchange Commission. All forward-looking statements contained in this press release speak only as of the date on which they were made and are based on management’s assumptions and estimates as of such date. Mirum undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made, except as required by law. A further description of risks and uncertainties can be found in Mirum’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023 and in its subsequent reports on Form 10-Q, including in the sections thereof captioned “Risk Factors,” as well as in its subsequent reports on Form 8-K, all of which are filed with the U.S. Securities and Exchange Commission and available at www.sec.gov .