Overview
Ivacaftor (also known as Kalydeco or VX-770) is a drug used for the management of Cystic Fibrosis (CF). It is manufactured and distributed by Vertex Pharmaceuticals. It was approved by the Food and Drug Administration on January 31, 2012, and by Health Canada in late 2012. Ivacaftor is administered as a monotherapy and also administered in combination with other drugs for the management of CF. Cystic Fibrosis is an autosomal recessive disorder caused by one of several different mutations in the gene for the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) protein, an ion channel involved in the transport of chloride and sodium ions across cell membranes. CFTR is active in epithelial cells of organs such as of the lungs, pancreas, liver, digestive system, and reproductive tract. Alterations in the CFTR gene result in altered production, misfolding, or function of the protein and consequently abnormal fluid and ion transport across cell membranes. As a result, CF patients produce thick, sticky mucus that clogs the ducts of organs where it is produced making patients more susceptible to complications such as infections, lung damage, pancreatic insufficiency, and malnutrition. Prior to the development of ivacaftor, management of CF primarily involved therapies for the control of infections, nutritional support, clearance of mucus, and management of symptoms rather than improvements in the underlying disease process or lung function (FEV1). Notably, ivacaftor was the first medication approved for the management of the underlying causes of CF (abnormalities in CFTR protein function) rather than control of symptoms.
Indication
When used as monotherapy as the product Kalydeco, ivacaftor is indicated for the treatment of cystic fibrosis (CF) in patients aged one month and older who have one mutation in the CFTR gene that is responsive to ivacaftor potentiation based on clinical and/or in vitro assay data. When used in combination with the drug lumacaftor as the product Orkambi, ivacaftor is indicated for the management of CF in patients aged one year and older who are homozygous for the F508del mutation in the CFTR gene. If the patient’s genotype is unknown, an FDA-cleared CF mutation test should be used to detect the presence of the F508del mutation on both alleles of the CFTR gene. When used in combination with tezacaftor in the product Symdeko, it is used to manage CF in patients 12 years and older who have at least one mutation in the CFTR gene or patients aged 12 or older who are shown to be homozygous for the F508del mutation. When used in combination with tezacaftor and elexacaftor in the product Trikafta, it is indicated for the treatment of cystic fibrosis in patients 12 years of age and older who have at least one F508del mutation in the CFTR gene.
Associated Conditions
- Cystic Fibrosis (CF)
Research Report
Comprehensive Monograph: Ivacaftor (VX-770)
Executive Summary
Ivacaftor, marketed as Kalydeco® and also known as VX-770, represents a landmark achievement in the field of precision medicine and a paradigm shift in the therapeutic management of cystic fibrosis (CF). As the first-in-class Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) potentiator, Ivacaftor was the first approved therapy to target the underlying molecular defect of CF rather than merely managing its downstream symptoms.[1] Its mechanism of action involves binding directly to specific mutant CFTR protein channels on the epithelial cell surface, where it increases the probability of the channel being open, thereby enhancing chloride ion transport.[2] This restoration of channel function is indicated for patients with specific
CFTR gene mutations that result in defective channel gating.
Clinically, treatment with Ivacaftor leads to rapid and significant improvements in key disease markers, including substantial reductions in sweat chloride concentration, a direct measure of restored CFTR activity. These pharmacodynamic effects translate into meaningful clinical benefits, such as improved lung function as measured by the percent predicted forced expiratory volume in one second (FEV1), increased body weight, and a reduced rate of pulmonary exacerbations.[1]
Clinical Trials
Title | Posted | Study ID | Phase | Status | Sponsor |
---|---|---|---|---|---|
2024/01/05 | N/A | Recruiting | |||
2020/08/11 | N/A | Recruiting | Sonya Heltshe | ||
2020/01/21 | Phase 3 | Completed | |||
2019/10/22 | Phase 2 | Completed | |||
2019/10/15 | Phase 2 | Completed | |||
2019/08/26 | Phase 2 | Withdrawn | |||
2019/07/05 | Phase 2 | Completed | |||
2019/05/20 | Phase 4 | Terminated | |||
2019/03/28 | Not Applicable | Completed | |||
2019/01/07 | N/A | Completed |
FDA Drug Approvals
Approved Product | Manufacturer | NDC Code | Route | Strength | Effective Date |
---|---|---|---|---|---|
Vertex Pharmaceuticals Incorporated | 51167-700 | ORAL | 125 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-809 | ORAL | 125 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-770 | ORAL | 13.4 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-300 | ORAL | 50 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-400 | ORAL | 75 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-600 | ORAL | 25 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-500 | ORAL | 188 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-122 | ORAL | 94 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-200 | ORAL | 150 mg in 1 1 | 8/10/2023 | |
Vertex Pharmaceuticals Incorporated | 51167-900 | ORAL | 125 mg in 1 1 | 8/10/2023 |
EMA Drug Approvals
Approved Product | Authorization Holder | Status | Issued Date |
---|---|---|---|
Authorised | 8/21/2020 | ||
Authorised | 11/19/2015 | ||
Authorised | 10/31/2018 | ||
Authorised | 7/23/2012 |
HSA Drug Approvals
Approved Product | Manufacturer | Approval Number | Dosage Form | Strength | Approval Date |
---|---|---|---|---|---|
No HSA approvals found for this drug. |
NMPA Drug Approvals
Approved Product | Company | Approval Number | Drug Type | Dosage Form | Approval Date |
---|---|---|---|---|---|
No NMPA approvals found for this drug. |
PPB Drug Approvals
Approved Product | Registration No. | Company | Licence No. | Strength | Registration Date |
---|---|---|---|---|---|
No PPB approvals found for this drug. |
TGA Drug Approvals
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