- ALYFTREK™ is approved for patients 6 years
and older with at least one responsive mutation, including 31
additional mutations not responsive to other CFTR modulator
therapies -
- In head-to-head clinical trials, ALYFTREK was
non-inferior on ppFEV1 and further decreased sweat chloride
compared to TRIKAFTA® -
Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX) today
announced that the U.S. Food and Drug Administration (FDA) has
approved ALYFTREK (vanzacaftor/tezacaftor/deutivacaftor), a
once-daily next-in-class triple combination cystic fibrosis
transmembrane conductance regulator (CFTR) modulator for the
treatment of cystic fibrosis (CF) in people 6 years and older who
have at least one F508del mutation or another mutation in the CFTR
gene that is responsive to ALYFTREK. See below for Important Safety
Information, including a Boxed Warning.
“ALYFTREK is our fifth CFTR modulator to secure FDA approval and
represents another significant milestone in our journey to serially
innovate and to improve the lives of people living with cystic
fibrosis,” said Reshma Kewalramani, M.D., Chief Executive Officer
and President of Vertex. “Our north star for more than 20 years has
been to address the underlying cause of cystic fibrosis, treat more
people with this disease, and bring more people to normal levels of
CFTR function — ALYFTREK, with once-daily dosing, efficacy in 31
additional mutations, and lower sweat chloride levels than
TRIKAFTA, is another step in achieving this goal.”
This approval is based on the most comprehensive Phase 3 pivotal
program ever conducted in CF, including more than 1,000 patients
across more than 20 countries and more than 200 sites. These data
were previously released at the conclusion of the studies and
presented at the North American Cystic Fibrosis Conference in
September of this year. The Phase 3 studies in people with CF ages
12 years and older met their primary endpoint (non-inferiority on
absolute change from baseline in ppFEV1 compared to TRIKAFTA) and
all key secondary endpoints (including absolute change from
baseline in sweat chloride [SwCl] compared to TRIKAFTA). In the
Phase 3 study of children with CF ages 6-11 years, ALYFTREK
demonstrated safety, the primary endpoint. Secondary endpoints,
such as absolute change from baseline in ppFEV1 and absolute change
from baseline in SwCl, were presented, supporting the benefit of
ALYFTREK in this age group. ALYFTREK was generally well tolerated
across all studies.
“In Phase 3 clinical trials, across a broad range of genotypes,
once-daily ALYFTREK demonstrated non-inferiority to TRIKAFTA in
ppFEV1 response and statistically significant improvement in SwCl,
a welcomed advancement for the treatment of CF,” said Claire L.
Keating, M.D., Co-Director of the Gunnar Esiason Adult Cystic
Fibrosis and Lung Program at Columbia University and investigator
in the ALYFTREK clinical trial program. “ALYFTREK has the potential
to improve the care of patients with CF.”
ALYFTREK is the first, once-daily CFTR modulator. In a recent
survey, approximately 75% of physicians reported that more
convenient dosing is a very high unmet need for people with CF.
Specifically, people with CF will have the added benefit from a
once-daily dosing regimen, given the need to take CFTR modulators
with fat-containing food. ALYFTREK also offers a potentially
transformative option for approximately 150 people with CF in the
U.S. with one of 31 mutations who are now eligible for a CFTR
modulator for the first time.
ALYFTREK was also submitted to global health authorities and is
under regulatory review in the European Union, the United Kingdom,
Canada, Switzerland, Australia and New Zealand.
About Cystic Fibrosis
Cystic fibrosis (CF) is a rare, life-shortening genetic disease
affecting more than 92,000 people globally. CF is a progressive,
multi-organ disease that affects the lungs, liver, pancreas, GI
tract, sinuses, sweat glands and reproductive tract. CF is caused
by a defective and/or missing CFTR protein resulting from certain
mutations in the CFTR gene. Children must inherit two defective
CFTR genes — one from each parent — to have CF, and these mutations
can be identified by a genetic test. While there are many different
types of CFTR mutations that can cause the disease, the vast
majority of people with CF have at least one F508del mutation. CFTR
mutations lead to CF by causing CFTR protein to be defective or by
leading to a shortage or absence of CFTR protein at the cell
surface. The defective function and/or absence of CFTR protein
results in poor flow of salt and water into and out of the cells in
a number of organs. In the lungs, this leads to the buildup of
abnormally thick, sticky mucus, chronic lung infections and
progressive lung damage that eventually leads to death for many
patients. The median age of death is in the 30s, but with
treatment, projected survival is improving.
Learn more about the importance of sweat chloride (SwCl) in
cystic fibrosis.
Today Vertex CF medicines are treating over 68,000 people with
CF across more than 60 countries on six continents. This represents
2/3 of the diagnosed people with CF eligible for CFTR modulator
therapy.
ALYFTREK U.S. INDICATIONS
ALYFTREK is indicated for the treatment of cystic fibrosis (CF)
in patients aged 6 years and older who have at least one F508del
mutation or another responsive mutation in the cystic fibrosis
transmembrane conductance regulator (CFTR) gene.
If the patient’s genotype is unknown, an FDA-cleared CF mutation
test should be used to confirm the presence of at least one
indicated mutation.
IMPORTANT SAFETY INFORMATION
BOXED WARNING: DRUG-INDUCED LIVER INJURY AND LIVER
FAILURE
Elevated transaminases have been observed in patients treated
with ALYFTREK. Cases of serious and potentially fatal drug-induced
liver injury and liver failure were reported in patients taking a
fixed-dose combination drug containing elexacaftor, tezacaftor, and
ivacaftor, which contains the same or similar active ingredients as
ALYFTREK. Liver injury has been reported within the first month of
therapy and up to 15 months following initiation of
elexacaftor/tezacaftor/ivacaftor.
Assess liver function tests (ALT, AST, alkaline phosphatase,
and bilirubin) in all patients prior to initiating ALYFTREK, every
month during the first 6 months of treatment, every 3 months for
the next 12 months, and at least annually thereafter. Consider more
frequent monitoring for patients with a history of liver disease or
elevated liver function tests (LFTs) at baseline.
Interrupt ALYFTREK for significant elevations in LFTs or in
the event of signs or symptoms of liver injury. Consider referral
to a hepatologist. Follow patients closely with clinical and
laboratory monitoring until abnormalities resolve. If resolved,
resume treatment only if benefit is expected to outweigh risk.
Closer monitoring is advised after resuming ALYFTREK.
ALYFTREK should not be used in patients with severe hepatic
impairment (Child-Pugh Class C). ALYFTREK is not recommended in
patients with moderate hepatic impairment (Child-Pugh Class B) and
should only be considered when there is a clear medical need, and
benefit outweighs risk. If used, monitor patients closely.
WARNINGS AND PRECAUTIONS
Drug-Induced Liver Injury and Liver Failure
- Elevated transaminases have been observed in patients treated
with ALYFTREK. Cases of serious and potentially fatal drug-induced
liver injury and liver failure have been reported in patients with
and without a history of liver disease taking a fixed-dose
combination drug containing elexacaftor, tezacaftor, and ivacaftor
(ELX/TEZ/IVA), which contains the same or similar active
ingredients as ALYFTREK. Liver injury has been reported within the
first month of therapy and up to 15 months following initiation of
ELX/TEZ/IVA
- Assess LFTs (ALT, AST, alkaline phosphatase, and bilirubin) in
all patients prior to initiating ALYFTREK, every month during the
first 6 months of treatment, every 3 months for the next 12 months,
and at least annually thereafter. Consider more frequent monitoring
in patients with a history of liver disease, elevated LFTs at
baseline, or a history of elevated LFTs with drugs containing ELX,
TEZ, and/or IVA
- Interrupt ALYFTREK in the event of signs or symptoms of liver
injury, which may include:
- Significant elevations in LFTs (e.g., ALT or AST >5x the
upper limit or normal (ULN) or ALT or AST >3x ULN with bilirubin
>2x ULN)
- Clinical signs or symptoms suggestive of liver injury (e.g.,
jaundice, right upper quadrant pain, nausea, vomiting, altered
mental status, ascites)
- Consider referral to a hepatologist and follow patients closely
with clinical and laboratory monitoring until abnormalities
resolve. If resolved and if benefit is expected to outweigh risk,
resume ALYFTREK with close monitoring
- ALYFTREK should not be used in patients with severe hepatic
impairment. ALYFTREK is not recommended in patients with moderate
hepatic impairment and should only be considered when there is a
clear medical need and benefit outweighs risk. If used, monitor
patients closely
Hypersensitivity Reactions, Including Anaphylaxis
- Hypersensitivity reactions, including cases of anaphylaxis,
have been reported in the postmarketing setting of drugs containing
ELX, TEZ, and/or IVA (same or similar active ingredients in
ALYFTREK). If signs or symptoms of serious hypersensitivity
reactions develop during ALYFTREK treatment, discontinue ALYFTREK
and institute appropriate therapy. Consider benefits and risks for
the individual patient to determine whether to resume ALYFTREK
Patients Who Discontinued or Interrupted Elexacaftor-,
Tezacaftor-, or Ivacaftor-Containing Drugs Due to Adverse
Reactions
- There are no available safety data for ALYFTREK in patients who
previously discontinued or interrupted treatment with drugs
containing ELX/TEZ/IVAr due to adverse reactions. Consider the
benefits and risks before using ALYFTREK in these patients. If
ALYFTREK is used in these patients, closely monitor for adverse
reactions as clinically appropriate
Reduced Effectiveness with Concomitant Use With CYP3A
Inducers
- Following concomitant use of strong or moderate CYP3A inducers
with ALYFTREK, exposures of vanzacaftor, tezacaftor, and
deutivacaftor were decreased, which may reduce ALYFTREK
effectiveness. Concomitant use with strong or moderate CYP3A
inducers is not recommended
Adverse Reactions with Concomitant Use With CYP3A
Inhibitors
- Following concomitant use of strong or moderate CYP3A
inhibitors with ALYFTREK, exposures of vanzacaftor, tezacaftor, and
deutivacaftor were increased, which may increase the risk of
adverse reactions associated with ALYFTREK. Reduce the ALYFTREK
dosage with concomitant use of strong or moderate CYP3A
inhibitors
Cataracts
- Non-congenital lens opacities have been reported in pediatric
patients treated with drugs containing ivacaftor (similar to an
active ingredient in ALYFTREK). Baseline and follow-up
ophthalmological examinations are recommended in pediatric patients
treated with ALYFTREK
ADVERSE REACTIONS
Serious Adverse Reactions
- Serious adverse reactions that occurred more frequently with
ALYFTREK than with ELX/TEZ/IVA in 2 or more patients (≥0.4%) were
influenza (1.5%), increased AST (0.4%), increased GGT (0.4%),
depression (0.4%), and syncope (0.4%)
Most Common Adverse Reactions
- The most common adverse reactions to ALYFTREK (≥5% of patients
and at a frequency higher than ELX/TEZ/IVA by ≥1%) were cough,
nasopharyngitis, upper respiratory tract infection, headache,
oropharyngeal pain, influenza, fatigue, increased ALT, rash,
increased AST, and sinus congestion
USE IN SPECIFIC POPULATIONS
Pediatric Use
- The safety and effectiveness of ALYFTREK in patients <6
years of age have not been established
Please click here to see the full U.S. Prescribing
Information, including Boxed WARNING for ALYFTREK.
About Vertex
Vertex is a global biotechnology company that invests in
scientific innovation to create transformative medicines for people
with serious diseases. The company has approved medicines that
treat the underlying causes of multiple chronic, life-shortening
genetic diseases — cystic fibrosis, sickle cell disease and
transfusion-dependent beta thalassemia — and continues to advance
clinical and research programs in these diseases. Vertex also has a
robust clinical pipeline of investigational therapies across a
range of modalities in other serious diseases where it has deep
insight into causal human biology, including acute and neuropathic
pain, APOL1-mediated kidney disease, IgA nephropathy, primary
membranous nephropathy, autosomal dominant polycystic kidney
disease, type 1 diabetes and myotonic dystrophy type 1.
Vertex was founded in 1989 and has its global headquarters in
Boston, with international headquarters in London. Additionally,
the company has research and development sites and commercial
offices in North America, Europe, Australia, Latin America and the
Middle East. Vertex is consistently recognized as one of the
industry's top places to work, including 15 consecutive years on
Science magazine's Top Employers list and one of Fortune’s 100 Best
Companies to Work For. For company updates and to learn more about
Vertex's history of innovation, visit www.vrtx.com or follow us on
LinkedIn, Facebook, Instagram, YouTube and X.
Special Note Regarding Forward-Looking Statements
This press release contains forward-looking statements as
defined in the Private Securities Litigation Reform Act of 1995,
including, without limitation, statements made by Reshma
Kewalramani, M.D., and Claire L. Keating, M.D., in this press
release, statements regarding the eligible patient population for
ALYFTREK, expectations for ALYFTREK regulatory submissions to
global health authorities, and statements regarding the potential
benefits of ALYFTREK, including for patients eligible for a CFTR
modulator for the first time. While Vertex believes the
forward-looking statements contained in this press release are
accurate, these forward-looking statements represent the company's
beliefs only as of the date of this press release and there are a
number of factors that could cause actual events or results to
differ materially from those indicated by such forward-looking
statements. Those risks and uncertainties include risks listed
under the heading “Risk Factors” in Vertex's annual report and in
subsequent filings filed with the Securities and Exchange
Commission and available through the company's website at
www.vrtx.com and www.sec.gov. You should not place undue reliance
on these statements. Vertex disclaims any obligation to update the
information contained in this press release as new information
becomes available.
(VRTX-GEN)
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Vertex Pharmaceuticals Incorporated Investors:
InvestorInfo@vrtx.com Susie Lisa, CFA: +1 617-341-6108 or Manisha
Pai: +1 617-961-1899
Media: mediainfo@vrtx.com or U.S.: 617-341-6992 Heather
Nichols: +1 617-839-3607 or International: +44 20 3204 5275
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