△至2020年,美國(guó)的濕性AMD(年齡相關(guān)性黃斑變性)患者很可能超過(guò)150萬(wàn)人,而AMD是工業(yè)化國(guó)家致盲的主要原因 △此次申報(bào)數(shù)據(jù)主要是來(lái)自于Brolucizumab的HAWK和HARRIER III期研究的數(shù)據(jù) △諾華使用了優(yōu)先審查通路獲得了Brolucizumab在美國(guó)的快速評(píng)審。若獲得FDA批準(zhǔn),預(yù)計(jì)該藥將于2019年底上市 昨日,諾華公司在巴塞爾宣布,美國(guó)食品藥品監(jiān)督管理局(FDA)已接受諾華公司用于治療濕性年齡相關(guān)性黃斑變性(AMD)的brolucizumab(RTH258)的生物藥許可證申請(qǐng)(BLA)。該種AMD亦稱(chēng)為新生血管性AMD(nAMD)。為加速brolucizumab上市,諾華公司使用了優(yōu)先審查通路以期獲得快速審評(píng)。若得到FDA的批準(zhǔn),諾華預(yù)計(jì)將于2019年底上市brolucizumab。 據(jù)估計(jì),至2020年,美國(guó)將有150萬(wàn)至175萬(wàn)人罹患濕性AMD,而濕性AMD是全球致盲的主要原因,也是一個(gè)日益嚴(yán)峻的公共衛(wèi)生問(wèn)題1。隨著病情發(fā)展,患者可能會(huì)失去中心視力,導(dǎo)致無(wú)法進(jìn)行日?;顒?dòng)。若不治療,視力會(huì)迅速惡化,可致失明2。 諾華制藥(美國(guó))總裁Fabrice Chouraqui認(rèn)為:“我們致力于重塑濕性AMD患者及其照護(hù)者的治療歷程。實(shí)現(xiàn)這一里程碑是其中重要一步。濕性AMD患者需要面對(duì)視力下降導(dǎo)致的巨大身心困擾,我們希望能夠?yàn)榛颊咛峁┬碌闹委熯x擇。” “濕性AMD剝奪了人們的寶貴視力,對(duì)數(shù)百萬(wàn)人的生活造成了巨大負(fù)擔(dān)。這些人不僅面臨視力喪失,而且還要承受對(duì)頻繁眼內(nèi)注射藥物的痛苦,”視力支持基金會(huì)執(zhí)行主任Dawn Prall George認(rèn)為,“我們對(duì)這種前景光明的新治療方案十分期待,希望它們能幫助患者更好地控制這種嚴(yán)重?fù)p害性疾病?!?/p> Brolucizumab(RTH258)是一種人源化單鏈抗體片段(scFv),是目前達(dá)到開(kāi)發(fā)階段的臨床上最先進(jìn)的人源化單鏈抗體片段。由于單鏈抗體片段體積小、組織滲透性強(qiáng)、從全身循環(huán)里快速清除及其藥物釋放特性,brolucizumab在藥物開(kāi)發(fā)中受到高度關(guān)注7-9。 該專(zhuān)利創(chuàng)新結(jié)構(gòu)使得藥物分子更小(26kDa),對(duì)所有血管內(nèi)皮生長(zhǎng)因子VEGF-A異構(gòu)體有強(qiáng)大抑制作用及高度親和力7-10。臨床前研究中,brolucizumab通過(guò)阻止配體-受體相互作用,抑制VEGF受體的激活7,9,10。VEGF信號(hào)通路增強(qiáng)的信號(hào)轉(zhuǎn)導(dǎo)與病理性眼部血管生成及視網(wǎng)膜水腫有關(guān)11。抑制VEGF通路已被證明能抑制脈絡(luò)膜視網(wǎng)膜血管疾病患者的新生血管病灶的生長(zhǎng),緩解視網(wǎng)膜水腫,改善視力12。 nAMD是北美、歐洲、澳大利亞和亞洲65歲以上人群嚴(yán)重失明和法定盲的主要原因,全球患者約2000萬(wàn)至2500萬(wàn)人2,13。nAMD是由異常血管形成于黃斑(視網(wǎng)膜中負(fù)責(zé)敏銳的中央視力的區(qū)域)下方所導(dǎo)致的。這些血管非常脆弱,有漏液現(xiàn)象,會(huì)破壞正常視網(wǎng)膜結(jié)構(gòu),最終導(dǎo)致黃斑的損害1,14,15。 nAMD的早期癥狀包括視物扭曲變形以及清晰視物的困難16。及時(shí)診斷及干預(yù)至關(guān)重要。隨著疾病發(fā)展,細(xì)胞損傷增加,視力進(jìn)一步下降。如此下去,可致中央視力的完全喪失,使患者無(wú)法閱讀、駕駛或識(shí)別熟悉面孔14。若不治療,視力會(huì)迅速惡化2。 *Brolucizumab(RTH258)尚未在中國(guó)遞交新藥審批 Disclaimer This press release contains forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements can generally be identified by words such as “potential,” “can,” “will,” “plan,” “expect,” “anticipate,” “l(fā)ook forward,” “believe,” “committed,” “investigational,” “pipeline,” “l(fā)aunch,” or similar terms, or by express or implied discussions regarding potential marketing approvals, new indications or labeling for the investigational or approved products described in this press release, or regarding potential future revenues from such products. You should not place undue reliance on these statements. Such forward-looking statements are based on our current beliefs and expectations regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forth in the forward-looking statements. There can be no guarantee that the investigational or approved products described in this press release will be submitted or approved for sale or for any additional indications or labeling in any market, or at any particular time. Nor can there be any guarantee that such products will be commercially successful in the future. In particular, our expectations regarding such products could be affected by, among other things, the uncertainties inherent in research and development, including clinical trial results and additional analysis of existing clinical data; regulatory actions or delays or government regulation generally; global trends toward health care cost containment, including government, payor and general public pricing and reimbursement pressures and requirements for increased pricing transparency; our ability to obtain or maintain proprietary intellectual property protection; the particular prescribing preferences of physicians and patients; general political and economic conditions; safety, quality or manufacturing issues; potential or actual data security and data privacy breaches, or disruptions of our information technology systems, and other risks and factors referred to in Novartis AG’s current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise. References 1. American Academy of Ophthalmology. Age-related macular degeneration preferred practice patterns. Available at: https://www.aao.org/preferred-practice-pattern/age-related-macular-degeneration-ppp-2015. Accessed March 2019. 2. van Lookeren Campagne M, et al. Mechanisms of age-related macular degeneration and therapeutic opportunities. J Pathol. 2014; 232(2):151-64. doi: 10.1002/path.4266. 3. ClinicalTrials.gov. Identifier NCT02307682. Available at https://clinicaltrials.gov/ct2/show/NCT02307682 (link is external). Accessed January 2019. 4. ClinicalTrials.gov. Identifier NCT02434328. Available at https://clinicaltrials.gov/ct2/show/NCT02434328 (link is external). Accessed January 2019. 5. Dugel P, et al. HAWK & HARRIER: 48-week results of 2 multi-centered, randomized, double-masked trials of brolucizumab versus aflibercept for neovascular AMD. Presented at: The American Academy of Ophthalmology 2017 Annual Meeting on November 10, 2017, New Orleans. 6. Dugel P, et al. Phase 3, randomized, double-masked, multi-center trials of brolucizumab versus aflibercept for neovascular AMD: 96-week results from the HAWK and HARRIER studies. Presented at: The American Academy of Ophthalmology on October 27, 2018, Chicago. 7. Escher D, et al. Single-chain antibody fragments in ophthalmology. Oral presentation at EURETINA congress. 2015. Abstract. 8. Nimz EL, et al. Intraocular and systemic pharmacokinetics of brolucizumab (RTH258) in nonhuman primates. The Association for Research in Vision and Ophthalmology (ARVO) annual meeting. 2016. Abstract 4996. 9. Gaudreault J, et al. Preclinical pharmacology and safety of ESBA1008, a single-chain antibody fragment, investigated as potential treatment for age related macular degeneration. ARVO Annual Meeting abstract. Invest Ophthalmol Vis Sci 2012;53:3025. http://iovs.arvojournals.org/article.aspx?articleid=2354604 (link is external). Accessed January 2019. 10. Tietz J, et al. Affinity and Potency of RTH258 (ESBA1008), a Novel Inhibitor of Vascular Endothelial Growth Factor A for the Treatment of Retinal Disorders. IOVS. 2015; 56(7):1501. 11. Qazi Y, et al. Mediators of ocular angiogenesis. J. Genet. 2009;88(4):495-515. 12. Kim R. Introduction, mechanism of action and rationale for anti-vascular endothelial growth factor drugs in age-related macular degeneration. Indian J Ophthalmol. 2007;55(6):413-415. 13. Wong, W.L. et al. Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and met analysis. Lancet Glob Health. 2014 Feb;2 (2):e106-16. 14. World Health Organization. Priority eye diseases: Age-related macular degeneration. Available at http://www.who.int/blindness/causes/priority/en/index7.html (link is external). Accessed January 2019. 15. NHS Choices. Macular Degeneration. Available at http://www.nhs.uk/Conditions/Macular-degeneration/Pages/Introduction.aspx (link is external). Accessed January 2019. 16. NHS Choices. Macular Degeneration - Symptoms. Available at http://www.nhs.uk/Conditions/Macular-degeneration/Pages/Symptoms.aspx (link is external). Accessed January 2019. |
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