The European Medicines Agency Review of Luspatercept for the Treatment of Adult Patients With Transfusion-dependent Anemia Caused by Low-risk Myelodysplastic Syndromes With Ring Sideroblasts or Beta-thalassemia

Luspatercept is a recombinant fusion protein that selectively binds to ligands belonging to the transforming growth factor-beta superfamily, resulting in erythroid maturation and differentiation. On June 25, 2020, a marketing authorization valid through the European Union (EU) was issued for luspate...

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Main Authors: Julio Delgado, Caroline Voltz, Milena Stain, Ewa Balkowiec-Iskra, Brigitte Mueller, Johanna Wernsperger, Iwona Malinowska, Christian Gisselbrecht, Harald Enzmann, Francesco Pignatti
Format: Article
Language:English
Published: Wiley 2021-08-01
Series:HemaSphere
Online Access:http://journals.lww.com/10.1097/HS9.0000000000000616
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author Julio Delgado
Caroline Voltz
Milena Stain
Ewa Balkowiec-Iskra
Brigitte Mueller
Johanna Wernsperger
Iwona Malinowska
Christian Gisselbrecht
Harald Enzmann
Francesco Pignatti
author_facet Julio Delgado
Caroline Voltz
Milena Stain
Ewa Balkowiec-Iskra
Brigitte Mueller
Johanna Wernsperger
Iwona Malinowska
Christian Gisselbrecht
Harald Enzmann
Francesco Pignatti
author_sort Julio Delgado
collection DOAJ
description Luspatercept is a recombinant fusion protein that selectively binds to ligands belonging to the transforming growth factor-beta superfamily, resulting in erythroid maturation and differentiation. On June 25, 2020, a marketing authorization valid through the European Union (EU) was issued for luspatercept for the treatment of adult patients with transfusion-dependent anemia caused by very low-, low-, and intermediate-risk myelodysplastic syndromes (MDS) with ring sideroblasts, or those with transfusion-dependent beta thalassemia (BT). Luspatercept was evaluated in 2 separate phase 3, double-blind, placebo-controlled multicentre trials. The primary endpoints of these trials were the percentage of patients achieving transfusion independence over ≥8 weeks or longer for patients with MDS, and the percentage of patients achieving a ≥33% reduction in transfusion burden from baseline to week 13–24 for patients with BT. In the MDS trial, the percentage of responders was 37.91% versus 13.16%, P < 0.0001, for patients receiving luspatercept versus placebo, respectively. In the BT trial, the percentage of responders was 21.4% versus 4.5% (P < 0.0001) for luspatercept versus placebo, respectively. Treatment with luspatercept led to similar incidences of adverse events (AEs), but higher incidences of grade ≥3 AEs and serious AEs compared to placebo. The most frequently reported treatment-emergent AEs (≥15%) in the pooled luspatercept group were headache; back pain, bone pain, and arthralgia; diarrhea; fatigue; pyrexia; and cough. The aim of this article is to summarize the scientific review of the application, which led to the regulatory approval in the EU.
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spelling doaj.art-a3006b67091a4eebbe6f6aaeeadc8c602024-03-02T11:11:41ZengWileyHemaSphere2572-92412021-08-0158e61610.1097/HS9.0000000000000616202108000-00011The European Medicines Agency Review of Luspatercept for the Treatment of Adult Patients With Transfusion-dependent Anemia Caused by Low-risk Myelodysplastic Syndromes With Ring Sideroblasts or Beta-thalassemiaJulio Delgado0Caroline Voltz1Milena Stain2Ewa Balkowiec-Iskra3Brigitte Mueller4Johanna Wernsperger5Iwona Malinowska6Christian Gisselbrecht7Harald Enzmann8Francesco Pignatti91 Oncology and Haematology Office, European Medicines Agency, Amsterdam, The Netherlands1 Oncology and Haematology Office, European Medicines Agency, Amsterdam, The Netherlands3 Bundesamt fur Sicherheit im Gesundheitswesen, Vienna, Austria4 Committe for Medicinal Products for Human Use, European Medicines Agency, Amsterdam, The Netherlands3 Bundesamt fur Sicherheit im Gesundheitswesen, Vienna, Austria3 Bundesamt fur Sicherheit im Gesundheitswesen, Vienna, Austria5 Urząd Rejestracji Produktów Leczniczych, Wyrobow Medycznych i Produktów Biobójczych, Warsaw, Poland8 Department of Haematology, Hopital Saint Louis, Paris, France4 Committe for Medicinal Products for Human Use, European Medicines Agency, Amsterdam, The Netherlands1 Oncology and Haematology Office, European Medicines Agency, Amsterdam, The NetherlandsLuspatercept is a recombinant fusion protein that selectively binds to ligands belonging to the transforming growth factor-beta superfamily, resulting in erythroid maturation and differentiation. On June 25, 2020, a marketing authorization valid through the European Union (EU) was issued for luspatercept for the treatment of adult patients with transfusion-dependent anemia caused by very low-, low-, and intermediate-risk myelodysplastic syndromes (MDS) with ring sideroblasts, or those with transfusion-dependent beta thalassemia (BT). Luspatercept was evaluated in 2 separate phase 3, double-blind, placebo-controlled multicentre trials. The primary endpoints of these trials were the percentage of patients achieving transfusion independence over ≥8 weeks or longer for patients with MDS, and the percentage of patients achieving a ≥33% reduction in transfusion burden from baseline to week 13–24 for patients with BT. In the MDS trial, the percentage of responders was 37.91% versus 13.16%, P < 0.0001, for patients receiving luspatercept versus placebo, respectively. In the BT trial, the percentage of responders was 21.4% versus 4.5% (P < 0.0001) for luspatercept versus placebo, respectively. Treatment with luspatercept led to similar incidences of adverse events (AEs), but higher incidences of grade ≥3 AEs and serious AEs compared to placebo. The most frequently reported treatment-emergent AEs (≥15%) in the pooled luspatercept group were headache; back pain, bone pain, and arthralgia; diarrhea; fatigue; pyrexia; and cough. The aim of this article is to summarize the scientific review of the application, which led to the regulatory approval in the EU.http://journals.lww.com/10.1097/HS9.0000000000000616
spellingShingle Julio Delgado
Caroline Voltz
Milena Stain
Ewa Balkowiec-Iskra
Brigitte Mueller
Johanna Wernsperger
Iwona Malinowska
Christian Gisselbrecht
Harald Enzmann
Francesco Pignatti
The European Medicines Agency Review of Luspatercept for the Treatment of Adult Patients With Transfusion-dependent Anemia Caused by Low-risk Myelodysplastic Syndromes With Ring Sideroblasts or Beta-thalassemia
HemaSphere
title The European Medicines Agency Review of Luspatercept for the Treatment of Adult Patients With Transfusion-dependent Anemia Caused by Low-risk Myelodysplastic Syndromes With Ring Sideroblasts or Beta-thalassemia
title_full The European Medicines Agency Review of Luspatercept for the Treatment of Adult Patients With Transfusion-dependent Anemia Caused by Low-risk Myelodysplastic Syndromes With Ring Sideroblasts or Beta-thalassemia
title_fullStr The European Medicines Agency Review of Luspatercept for the Treatment of Adult Patients With Transfusion-dependent Anemia Caused by Low-risk Myelodysplastic Syndromes With Ring Sideroblasts or Beta-thalassemia
title_full_unstemmed The European Medicines Agency Review of Luspatercept for the Treatment of Adult Patients With Transfusion-dependent Anemia Caused by Low-risk Myelodysplastic Syndromes With Ring Sideroblasts or Beta-thalassemia
title_short The European Medicines Agency Review of Luspatercept for the Treatment of Adult Patients With Transfusion-dependent Anemia Caused by Low-risk Myelodysplastic Syndromes With Ring Sideroblasts or Beta-thalassemia
title_sort european medicines agency review of luspatercept for the treatment of adult patients with transfusion dependent anemia caused by low risk myelodysplastic syndromes with ring sideroblasts or beta thalassemia
url http://journals.lww.com/10.1097/HS9.0000000000000616
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