The U.S. Food and Drug Administration has approved expanded pediatric indications for YUFLYMA (adalimumab-aaty) and its unbranded version, marking a significant advancement in treatment options for young patients with chronic inflammatory conditions. Celltrion announced that the biosimilar to Humira is now approved for treating hidradenitis suppurativa in adolescent patients aged 12 years and older, and uveitis in pediatric patients aged 2 years and older.
Addressing Critical Pediatric Inflammatory Conditions
The newly approved indications target two serious inflammatory conditions that significantly impact pediatric populations. Pediatric uveitis, a potentially sight-threatening eye condition, accounts for 5-10% of all uveitis cases in the United States. The condition is frequently asymptomatic in children but can become chronic and lead to significant morbidities including cataracts, glaucoma, and amblyopia.
Hidradenitis suppurativa affects approximately 1-4% of the U.S. population and presents as a chronic, inflammatory, recurrent skin condition characterized by painful nodules, abscesses, comedones, fistulas, sinus tracts, and scarring in intertriginous areas. In adolescent patients, the condition shares similar clinical features with adult presentations and often disrupts school and daily life activities.
"Adolescent HS and pediatric UV are chronic inflammatory conditions that can have serious sequelae and place a significant burden on patients, their families, and caregivers. It impacts patients physically and also emotionally and socially," said Dr. Juby Jacob-Nara, Senior Vice President and Chief Medical Officer at Celltrion USA.
Expanding Treatment Access Through Biosimilar Innovation
YUFLYMA was previously approved by the FDA as a biosimilar to Humira for multiple indications including rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and plaque psoriasis. While hidradenitis suppurativa and uveitis were previously approved for adult patients, this latest approval extends these indications to include pediatric and adolescent populations.
The biosimilar is available as a high-concentration, low-volume, and citrate-free formulation that has been designated by the FDA as an interchangeable biosimilar. YUFLYMA is formulated as a recombinant fully human anti-tumor necrosis factor α (anti-TNFα) monoclonal antibody and is available in multiple dosing options including 20mg, 40mg, and 80mg solutions for injection in prefilled syringes and autoinjectors.
Commercial Strategy and Market Impact
YUFLYMA was first introduced to the U.S. market in July 2023, and Celltrion offers both branded and unbranded versions with dual pricing options designed to meet varying patient needs and improve affordability. The company's strategy addresses the significant cost burden associated with TNF blocker therapies while maintaining therapeutic equivalence to the reference product.
"The expansion of pediatric indications for YUFLYMA highlights our commitment to addressing unmet needs in both adult and pediatric immune-mediated diseases," said Thomas Nusbickel, Chief Commercial Officer at Celltrion USA. "The approval of pediatric indications for YUFLYMA and unbranded adalimumab-aaty strengthens our growing immunology portfolio and supports broader patient access to high-quality, affordable treatments."
Safety Profile and Clinical Considerations
The expanded approval comes with comprehensive safety information reflecting the established profile of TNF blockers. Patients treated with adalimumab-aaty face increased risk for developing serious infections that may lead to hospitalization or death, particularly when taking concomitant immunosuppressants such as methotrexate or corticosteroids.
Clinical trial data from 39 global adalimumab studies revealed specific safety metrics, including non-melanoma skin cancer rates of 0.8 per 100 patient-years among adalimumab-treated patients compared to 0.2 per 100 patient-years among control-treated patients. The most common adverse reactions observed in clinical trials included infections, injection site reactions, headache, and rash.
The approval also carries warnings regarding malignancy risks, particularly lymphoma and other malignancies in children and adolescent patients treated with TNF blockers. Postmarketing cases of hepatosplenic T-cell lymphoma, a rare and aggressive form of T-cell lymphoma, have been reported, with the majority occurring in patients with Crohn's disease or ulcerative colitis, particularly in adolescent and young adult males.
Strengthening Biosimilar Portfolio
This approval reinforces Celltrion's position as a pioneer in the biosimilar space, having launched the world's first monoclonal antibody biosimilar. The company's FDA-approved biosimilar portfolio spans multiple therapeutic areas including immunology, oncology, hematology, endocrinology, and ophthalmology, with products including INFLECTRA, TRUXIMA, HERZUMA, VEGZELMA, AVTOZMA, and others.
The expanded pediatric indications for YUFLYMA represent a strategic advancement in addressing unmet medical needs in pediatric immune-mediated diseases while providing healthcare systems with more cost-effective treatment alternatives. With the biosimilar maintaining the same efficacy profile as the reference product while offering improved affordability, the approval potentially expands access to critical TNF blocker therapy for vulnerable pediatric populations.
