The European Commission (EC) has granted approval to Yuvanci (macitentan 10 mg and tadalafil 40 mg), a single-tablet combination therapy (STCT), for the treatment of pulmonary arterial hypertension (PAH) in adult patients. This approval marks Yuvanci as the first and only single-tablet combination therapy available in Europe for PAH, offering a new treatment option for patients already managed with a combination of macitentan and tadalafil administered as separate tablets. The approval is specifically for patients classified as World Health Organization (WHO) Functional Class (FC) II to III.
Clinical Efficacy and Study Results
The EC's decision was primarily based on the outcomes of the Phase 3 A DUE study, a multi-national, multi-center, double-blind, randomized, active-controlled trial involving 187 adult patients with PAH (WHO FC II to III). The study compared the efficacy and safety of Yuvanci STCT against macitentan and tadalafil monotherapies. The primary endpoint was the change in pulmonary vascular resistance (PVR) expressed as the ratio of Week 16 to baseline.
The A DUE study demonstrated that Yuvanci STCT led to a statistically significant reduction of 29% in PVR compared to macitentan alone (p < 0.0001) and a 28% reduction compared to tadalafil alone (p < 0.0001). Consistent efficacy was observed across various patient subgroups, including those stratified by age, sex, race, and baseline WHO FC. The most common adverse events reported in patients treated with Yuvanci STCT were anaemia/haemoglobin decrease (22.2%), oedema/fluid retention (17.3%), and headache (14.1%).
Addressing Unmet Needs in PAH Treatment
PAH is a progressive and life-threatening disease characterized by the constriction of small pulmonary arteries, leading to elevated blood pressure in the pulmonary circulation, eventually resulting in right heart failure and death. Initial double combination therapy with macitentan and tadalafil is often recommended; however, until now, patients had to take multiple pills to target the different PAH-specific pathways.
"People living with PAH face complex treatment regimens, with many having to take multiple pills per day. This can deeply impact their daily lives as they might struggle to maintain adherence to their treatment regimen," said Tamara Werner-Kiechle, M.D., EMEA Therapeutic Area Lead Neuroscience and Cardiopulmonary, Johnson & Johnson Innovative Medicine. "This approval addresses a significant unmet need for the PAH community."
Mechanism of Action
Yuvanci combines macitentan, an endothelin receptor antagonist (ERA), and tadalafil, a phosphodiesterase type 5 inhibitor (PDE5i). Macitentan works by dilating the constricted blood vessels between the right heart and the lungs, reducing cell overgrowth in the vessel walls. Tadalafil relaxes the blood vessels in the lungs, widening them to decrease pulmonary blood pressure and improve heart function.
Johnson & Johnson's Commitment to PAH
With the approval of Yuvanci, Johnson & Johnson now offers treatment options covering all three guideline-recommended foundational treatment pathways for PAH. This positions the company as a leader in providing a variety of healthcare solutions for individuals living with this condition.
