The Mercury News

U.S. approves new drug to manage sickle cell disease

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U.S. regulators on Friday approved a new medicine that can help reduce extremely painful sickle cell disease flare-ups.

The Food and Drug Administra­tion approved Novartis AG’s Adakveo for patients 16 and older. The monthly infusion, which halves occurrence­s of sickle cell pain episodes, will carry a list price of roughly $85,000 to $113,000 per year, depending on dosing. Insured patients generally will pay less.

Sickle cell disease is one of the most common inherited blood disorders, affecting about 100,000 Americans, most of them black, and about 300 million people worldwide.

Its hallmark is periodic episodes in which red blood cells stick together, blocking blood from reaching organs and small blood vessels. That causes intense pain and cumulative organ damage that shortens the lives of people with the disease.

“The duration and severity of these pain crises worsens with aging. Often patients die during one of these crises,” said Dr. Biree Andemariam, chief medical officer of the Sickle Cell Disease Associatio­n of America.

Andemariam, a former Novartis advisory board member, said the drug appears to work better the longer patients receive it.

The Swiss drugmaker is continuing patient testing to determine whether Adakveo, also known as crizanlizu­mab, lengthens patients’ lives, said Ameet Mallik, the company’s head of U.S. oncology and blood disorders.

He said severe pain episodes send U.S. patients to emergency department­s about 200,000 times per year. About 85% are hospitaliz­ed for days to a week, running up big bills.

The debilitati­ng condition also causes anemia, delayed growth, vision damage and painful swelling in hands and feet, making it hard for some people to maintain jobs or attend school.

Current treatments include a 21-year-old cancer drug called hydroxyure­a and Endari, approved in 2017.

In patient studies, Endari reduced frequency of pain episodes about 25% and hydroxyure­a reduced them by half. Hydroxyure­a can have serious side effects and requires weekly blood tests. Both drugs have complicate­d dosing and don’t work — or stop working — in some patients.

In a one-year study of 198 patients, those getting the higher of two Adakveo doses averaged 1.6 pain episodes over that year and 36% had none. A comparison group on placebo averaged three pain episodes that year and 17% had none. Adakveo’s side effects included influenza and high fever.

 ?? NOVARTIS VIA AP ?? U.S. regulators have approved the use of the new sickle cell disease medicine Adakveo, above.
NOVARTIS VIA AP U.S. regulators have approved the use of the new sickle cell disease medicine Adakveo, above.

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