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FDA approves once-weekly ALTUVIIIO , a new class of factor VIII therapy for hemophilia A that offers significant bleed protection Paris and Stockholm

Key Takeaway: The FDA has approved ALTUVIIIO, a novel once-weekly therapy for patients with hemophilia A, offering significant improvements in bleed protection. This first-in-class therapy maintains high factor activity levels, reducing the annual bleeding rates substantially compared to prior treatments. With a simplified dosing regimen, ALTUVIIIO aims to enhance the lives of individuals living with hemophilia A, marking a significant advancement in treatment options. The drug is expected to be commercially available in the U.S. in April, with further regulatory submissions anticipated in Europe later this year.

Market Sentiment Analysis

POSITIVE FACTORS

  • FDA approval introduces a new once-weekly treatment for hemophilia A.
  • ALTUVIIIO offers significant bleed protection and improves patient quality of life.
  • Potential for transforming treatment paradigms in the hemophilia community.

CONCERNS & RISKS

  • Inhibitor formation to factor VIII is possible despite no recent reports.
  • The study results rely on data from limited trial populations and may require more extensive validation.

Full Press Release Details

FDA approves once-weekly
ALTUVIIIO , a new class of factor VIII therapy for hemophilia A that offers significant bleed protection
Paris and Stockholm February 23, 2023 The U.S. Food and Drug Administration (FDA) has approved ALTUVIIIO [Antihemophilic Factor (Recombinant), Fc-VWF-XTEN Fusion Protein-ehtl], previously referred to as efanesoctocog
alfa, a first-in-class, high-sustained factor VIII replacement therapy. ALTUVIIIO is indicated for routine prophylaxis and
on-demand treatment to control bleeding episodes, as well as perioperative management (surgery) for adults and children with hemophilia A. ALTUVIIIO is the first and only hemophilia A treatment that delivers
normal to near-normal factor activity levels (over 40%) for most of the week with once-weekly dosing, and significantly reduces bleeds compared to prior factor VIII prophylaxis.
Today s approval of ALTUVIIIO allows patients and physicians to reimagine living with
hemophilia. The high sustained factor activity levels that can be achieved with ALTUVIIIO have the potential to change the hemophilia landscape. For the first time, with a once-weekly dose, powerful bleed protection is a reality for patients.
Significant shifts in treatment paradigms that improve people s lives, like ALTUVIIIO, are what we have committed to delivering at Sanofi.
Hemophilia A is a rare, lifelong condition in which the ability of a person s blood to clot properly is impaired, leading to
excessive bleeds and spontaneous bleeds into joints that can result in joint damage and chronic pain, and potentially impact quality of life. The severity of hemophilia is determined by the level of clotting factor activity in a person s blood,
and there is a negative correlation between risk of bleeding and factor activity levels.
Medical Director of Comprehensive Center for Bleeding Disorders and Associate Investigator at The Versiti
Blood Research Institute, and Associate Professor of Medicine and Pediatrics at The Medical College of Wisconsin
This approval marks an important clinical advancement for the hemophilia community because we have an option that can
achieve higher levels of factor activity with a single simplified weekly dose. By maintaining high levels of factor activity throughout the week, patients can be confident in the bleed protection ALTUVIIIO offers.
This is the first approval of ALTUVIIIO. The FDA evaluated the application under Priority Review, which is granted to therapies that have the potential
to provide significant improvements in the treatment, diagnosis, or prevention of serious conditions. The FDA previously granted ALTUVIIIO Breakthrough Therapy designation in May 2022 the first factor VIII therapy to receive this recognition Fast Track
designation in February 2021, and Orphan Drug designation in August 2017.
Regulatory submission
in the EU is anticipated in the second half of 2023. The European Commission granted Orphan Drug designation in June 2019.
ALTUVIIIO helps elevate expectations for hemophilia A by providing protection for longer
based on data from the pivotal XTEND-1 Phase 3 study recently published in The New England Journal of Medicine. Once-weekly ALTUVIIIO
prophylaxis met the primary endpoint, providing significant bleed protection for people with severe hemophilia A with a mean
annualized bleeding rate (ABR) of 0.70 (95% CI: 0.5-1.0) and a median ABR of 0.0 (Q1, Q3: 0.0, 1.0). ALTUVIIIO met the key secondary endpoint with a
significant reduction of 77% in ABR versus prior factor prophylaxis based on an intra-patient comparison (95% CI:58%-87%).
Additional data showed prevention of joint bleeds with a median annualized joint bleeding rate of 0 (Q1, Q3: 0.0, 1.0). Treatment with ALTUVIIIO
provided 100% resolution of target joints, which are joints that have recurrent bleeds (e.g., knee, ankle, or elbow). ALTUVIIIO provided mean factor VIII activity greater than 40% for most of the week and greater than 10% at Day 7; these levels were
associated with a low bleed risk. In the study, ALTUVIIIO was well-tolerated and inhibitor development to factor VIII was not detected, although is possible following administration of ALTUVIIIO.
Additionally, interim data from XTEND-Kids showed that children younger than 12 years of age receiving once-weekly ALTUVIIIO for 26 weeks (n=23)
experienced a mean ABR of 0.5 (95% CI: 0.2-1.3) and a median ABR of 0 (Q1, Q3: 0.0, 1.3). Safety results were consistent with data from the XTEND-1 trial. The full
results from XTEND-Kids will be presented at a future medical meeting.
Across the studies, ALTUVIIIO has an established safety profile and there
were no reports of factor VIII inhibitor development, although inhibitor formation is possible following administration of ALTUVIIIO. The most common side effects (>10%) of ALTUVIIIO are headache and arthralgia.
ALTUVIIIO is indicated for routine prophylaxis, on-demand treatment and control of bleeding episodes, and
perioperative management of bleeding. The simple recommended dose of 50 IU/kg is intended for all patients and for different clinical scenarios.
ensure that patients have access to the improved bleed protection provided by ALTUVIIIO, Sanofi will price ALTUVIIIO at parity to the annual cost of treating a prophylaxis patient on Eloctate [Antihemophilic Factor (Recombinant), Fc Fusion Protein]. Sanofi will also provide comprehensive patient support services and resources online and at 1.855.MyALTUVIIIO (855.692.5888). In the U.S.,
ALTUVIIIO is expected to be commercially available in April.
ALTUVIIIO [Antihemophilic Factor (Recombinant), Fc-VWF-XTEN Fusion Protein-ehtl] is a novel von Willebrand Factor (VWF) independent recombinant factor VIII therapy that is designed to extend protection from bleeds with once-weekly prophylactic dosing for
adults and children with hemophilia A. ALTUVIIIO has a 3 to 4 fold longer half-life relative to standard and extended half-life factor VIII products. It is the first factor VIII therapy that has been shown to break through the von Willebrand factor
ceiling, which imposes a half-life limitation on earlier generation factor VIII therapies. ALTUVIIIO builds on the innovative Fc fusion technology by adding a region of von Willebrand factor and
XTEN polypeptides to extend its time in circulation.
About the XTEND Clinical Programs
The XTEND clinical program is comprised of two Phase 3 trials in hemophilia A: XTEND-1 in people 12 years or
older and XTEND-Kids in children younger than 12 years old. There is also an ongoing extension study (XTEND-ed).
The Phase 3 XTEND-1 study (NCT04161495) was an open-label, non-randomized interventional study assessing the safety, efficacy, and pharmacokinetics
of once-weekly ALTUVIIIO in people 12 years of age or older (n=159) with severe hemophilia A who were previously treated with factor VIII replacement therapy. The study consisted of two parallel treatment arms the prophylaxis
Arm A (n=133), in which patients who had received prior factor VIII prophylaxis were treated with once-weekly intravenous ALTUVIIIO prophylaxis (50 IU/kg) for 52 weeks, and the on-demand Arm B
(n=26), in which patients who had received prior on-demand factor VIII therapy began with 26 weeks of on-demand ALTUVIIIO (50 IU/kg), then switched
to once-weekly prophylaxis with ALTUVIIIO (50 IU/kg) for an additional 26 weeks.
The primary efficacy endpoint was the mean annualized bleeding rate (ABR) in Arm A, and the
key secondary endpoint was an intra-patient comparison of ABR during the ALTUVIIIO weekly prophylaxis treatment period versus the prior factor VIII prophylaxis ABR for a subset of participants in Arm A
who had participated in a previous observational study (Study 242HA201/OBS16221).
The XTEND-Kids study (NCT04759131) was an
open-label, non-randomized interventional study of the safety, efficacy, and pharmacokinetics of once-weekly ALTUVIIIO in previously treated patients younger than 12 years of age (n=67) with severe hemophilia
A. Patients received once-weekly ALTUVIIIO prophylaxis (50 IU/kg) for 52 weeks.
About the Sanofi and Sobi
Sobi and Sanofi collaborate on the development and commercialization of Alprolix and Elocta /Eloctate . The companies also collaborate on the development and
commercialization of efanesoctocog alfa or ALTUVIIIO in the US. Sobi has final development and commercialization rights in the Sobi territory (essentially Europe, North Africa, Russia and
most Middle Eastern markets). Sanofi has final development and commercialization rights in North America and all other regions in the world excluding the Sobi territory.
Sobi is a specialized international biopharmaceutical company transforming the lives of people with rare diseases. Providing sustainable access to
innovative medicines in the areas of haematology, immunology and specialty care, Sobi has approximately 1,600 employees across Europe, North America, the Middle East and Asia. In 2022, revenue amounted to SEK 18.8 billion. Sobi s share
(STO:SOBI) is listed on Nasdaq Stockholm. More about Sobi at sobi.com, LinkedIn and YouTube.
We are an innovative global healthcare company, driven by one purpose: we chase the miracles of science to improve people s lives.
Our team, across some 100 countries, is dedicated to transforming the practice of medicine by working to turn the impossible into the possible. We provide potentially life-changing treatment options and life-saving vaccine protection to millions of
people globally, while putting sustainability and social responsibility at the center of our ambitions.
Sanofi is listed on EURONEXT: SAN and NASDAQ:
Sandrine Guendoul | + 33 6 25 09 14 25
Sally Bain | + 1 617 834 6026
Evan Berland | +1 215 432 0234 | evan.berland@sanofi.com
Kate Conway | + 1 508 364 4931 | kate.conway@sanofi.com
Rouault | + 33 6 70 93 71 40 | victor.rouault@sanofi.com
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Tarik Elgoutni| + 1 617 710 3587 | tarik.elgoutni@sanofi.com
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For details on how to contact the Sobi Investor Relations Team, click here.
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Frequently Asked Questions

What is ALTUVIIIO approved for?

ALTUVIIIO is approved for routine prophylaxis, on-demand treatment, and perioperative management in hemophilia A patients.

How often is ALTUVIIIO administered?

ALTUVIIIO is administered once a week, providing extended bleed protection.

What are the primary benefits of ALTUVIIIO?

ALTUVIIIO offers significant bleed protection and maintains high factor activity levels.

What are common side effects of ALTUVIIIO?

Common side effects include headache and arthralgia in over 10% of patients.

When will ALTUVIIIO be commercially available?

ALTUVIIIO is expected to be commercially available in the U.S. by April.

Last updated: Feb 23, 2023