Gene therapy in rare diseases: the benefits and challenges of developing a patient-centric registry for Strimvelis in ADA-SCID
Abstract Background Strimvelis (autologous CD34+ cells transduced to express adenosine deaminase [ADA]) is the first ex vivo stem cell gene therapy approved by the European Medicines Agency (EMA), indicated as a single treatment for patients with ADA-severe combined immunodeficiency (ADA-SCID) who l...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-04-01
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| Series: | Orphanet Journal of Rare Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13023-018-0791-9 |
| _version_ | 1811210256444817408 |
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| author | Heide Stirnadel-Farrant Mahesh Kudari Nadia Garman Jessica Imrie Bikramjit Chopra Stefania Giannelli Michela Gabaldo Ambra Corti Stefano Zancan Alessandro Aiuti Maria Pia Cicalese Rohit Batta Jonathan Appleby Mario Davinelli Pauline Ng |
| author_facet | Heide Stirnadel-Farrant Mahesh Kudari Nadia Garman Jessica Imrie Bikramjit Chopra Stefania Giannelli Michela Gabaldo Ambra Corti Stefano Zancan Alessandro Aiuti Maria Pia Cicalese Rohit Batta Jonathan Appleby Mario Davinelli Pauline Ng |
| author_sort | Heide Stirnadel-Farrant |
| collection | DOAJ |
| description | Abstract Background Strimvelis (autologous CD34+ cells transduced to express adenosine deaminase [ADA]) is the first ex vivo stem cell gene therapy approved by the European Medicines Agency (EMA), indicated as a single treatment for patients with ADA-severe combined immunodeficiency (ADA-SCID) who lack a suitable matched related bone marrow donor. Existing primary immunodeficiency registries are tailored to transplantation outcomes and do not capture the breadth of safety and efficacy endpoints required by the EMA for the long-term monitoring of gene therapies. Furthermore, for extended monitoring of Strimvelis, the young age of children treated, small patient numbers, and broad geographic distribution of patients all increase the risk of loss to follow-up before sufficient data have been collected. Establishing individual investigator sites would be impractical and uneconomical owing to the small number of patients from each location receiving Strimvelis. Results An observational registry has been established to monitor the safety and effectiveness of Strimvelis in up to 50 patients over a minimum of 15 years. To address the potential challenges highlighted above, data will be collected by a single investigator site at Ospedale San Raffaele (OSR), Milan, Italy, and entered into the registry via a central electronic platform. Patients/families and the patient’s local physician will also be able to submit healthcare information directly to the registry using a uniquely designed electronic platform. Data entry will be monitored by a Gene Therapy Registry Centre (funded by GlaxoSmithKline) who will ensure that necessary information is collected and flows between OSR, the patient/family and the patient’s local healthcare provider. Conclusion The Strimvelis registry sets a precedent for the safety monitoring of future gene therapies. A unique, patient-focused design has been implemented to address the challenges of long-term follow-up of patients treated with gene therapy for a rare disease. Strategies to ensure data completeness and patient retention in the registry will help fulfil pharmacovigilance requirements. Collaboration with partners is being sought to expand from a treatment registry into a disease registry. Using practical and cost-efficient approaches, the Strimvelis registry is hoped to encourage further innovation in registry design within orphan drug development. |
| first_indexed | 2024-04-12T04:51:34Z |
| format | Article |
| id | doaj.art-a8893f1115da49d982593a6f5bd7315f |
| institution | Directory Open Access Journal |
| issn | 1750-1172 |
| language | English |
| last_indexed | 2024-04-12T04:51:34Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Orphanet Journal of Rare Diseases |
| spelling | doaj.art-a8893f1115da49d982593a6f5bd7315f2022-12-22T03:47:17ZengBMCOrphanet Journal of Rare Diseases1750-11722018-04-0113111010.1186/s13023-018-0791-9Gene therapy in rare diseases: the benefits and challenges of developing a patient-centric registry for Strimvelis in ADA-SCIDHeide Stirnadel-Farrant0Mahesh Kudari1Nadia Garman2Jessica Imrie3Bikramjit Chopra4Stefania Giannelli5Michela Gabaldo6Ambra Corti7Stefano Zancan8Alessandro Aiuti9Maria Pia Cicalese10Rohit Batta11Jonathan Appleby12Mario Davinelli13Pauline Ng14GlaxoSmithKlineGlaxoSmithKlineGlaxoSmithKlineGlaxoSmithKlineGlaxoSmithKlineSan Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific InstituteSan Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific InstituteSan Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific InstituteSan Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific InstituteSan Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific InstituteSan Raffaele Telethon Institute for Gene Therapy (SR-TIGET), San Raffaele Scientific InstituteGlaxoSmithKlineGlaxoSmithKlinePharmaceuticals Product DevelopmentGlaxoSmithKlineAbstract Background Strimvelis (autologous CD34+ cells transduced to express adenosine deaminase [ADA]) is the first ex vivo stem cell gene therapy approved by the European Medicines Agency (EMA), indicated as a single treatment for patients with ADA-severe combined immunodeficiency (ADA-SCID) who lack a suitable matched related bone marrow donor. Existing primary immunodeficiency registries are tailored to transplantation outcomes and do not capture the breadth of safety and efficacy endpoints required by the EMA for the long-term monitoring of gene therapies. Furthermore, for extended monitoring of Strimvelis, the young age of children treated, small patient numbers, and broad geographic distribution of patients all increase the risk of loss to follow-up before sufficient data have been collected. Establishing individual investigator sites would be impractical and uneconomical owing to the small number of patients from each location receiving Strimvelis. Results An observational registry has been established to monitor the safety and effectiveness of Strimvelis in up to 50 patients over a minimum of 15 years. To address the potential challenges highlighted above, data will be collected by a single investigator site at Ospedale San Raffaele (OSR), Milan, Italy, and entered into the registry via a central electronic platform. Patients/families and the patient’s local physician will also be able to submit healthcare information directly to the registry using a uniquely designed electronic platform. Data entry will be monitored by a Gene Therapy Registry Centre (funded by GlaxoSmithKline) who will ensure that necessary information is collected and flows between OSR, the patient/family and the patient’s local healthcare provider. Conclusion The Strimvelis registry sets a precedent for the safety monitoring of future gene therapies. A unique, patient-focused design has been implemented to address the challenges of long-term follow-up of patients treated with gene therapy for a rare disease. Strategies to ensure data completeness and patient retention in the registry will help fulfil pharmacovigilance requirements. Collaboration with partners is being sought to expand from a treatment registry into a disease registry. Using practical and cost-efficient approaches, the Strimvelis registry is hoped to encourage further innovation in registry design within orphan drug development.http://link.springer.com/article/10.1186/s13023-018-0791-9Adenosine deaminase deficiencySevere combined immunodeficiencyGene therapyHaematopoietic stem cell transplantationTransplantationAutologous |
| spellingShingle | Heide Stirnadel-Farrant Mahesh Kudari Nadia Garman Jessica Imrie Bikramjit Chopra Stefania Giannelli Michela Gabaldo Ambra Corti Stefano Zancan Alessandro Aiuti Maria Pia Cicalese Rohit Batta Jonathan Appleby Mario Davinelli Pauline Ng Gene therapy in rare diseases: the benefits and challenges of developing a patient-centric registry for Strimvelis in ADA-SCID Orphanet Journal of Rare Diseases Adenosine deaminase deficiency Severe combined immunodeficiency Gene therapy Haematopoietic stem cell transplantation Transplantation Autologous |
| title | Gene therapy in rare diseases: the benefits and challenges of developing a patient-centric registry for Strimvelis in ADA-SCID |
| title_full | Gene therapy in rare diseases: the benefits and challenges of developing a patient-centric registry for Strimvelis in ADA-SCID |
| title_fullStr | Gene therapy in rare diseases: the benefits and challenges of developing a patient-centric registry for Strimvelis in ADA-SCID |
| title_full_unstemmed | Gene therapy in rare diseases: the benefits and challenges of developing a patient-centric registry for Strimvelis in ADA-SCID |
| title_short | Gene therapy in rare diseases: the benefits and challenges of developing a patient-centric registry for Strimvelis in ADA-SCID |
| title_sort | gene therapy in rare diseases the benefits and challenges of developing a patient centric registry for strimvelis in ada scid |
| topic | Adenosine deaminase deficiency Severe combined immunodeficiency Gene therapy Haematopoietic stem cell transplantation Transplantation Autologous |
| url | http://link.springer.com/article/10.1186/s13023-018-0791-9 |
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