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FDA Grants Fast Track Designation to ALXN2220 for ATTR Amyloidosis with Cardiomyopathy

• The FDA has granted Fast Track designation to ALXN2220, a novel depleter monoclonal antibody, for treating transthyretin amyloidosis with cardiomyopathy (ATTR-CM). • ALXN2220 aims to address the unmet need in ATTR-CM by removing amyloid deposits and potentially restoring organ function. • The designation allows for more frequent interactions with the FDA and potential accelerated review and approval pathways. • ALXN2220 is currently being evaluated in the Phase 3 DepleTTR-CM trial to assess its efficacy as an add-on treatment for ATTR-CM.

AstraZeneca's rare disease unit, Alexion, has received Fast Track designation from the U.S. Food and Drug Administration (FDA) for ALXN2220, an investigational depleter monoclonal antibody, in the treatment of transthyretin amyloidosis with cardiomyopathy (ATTR-CM). This designation highlights the potential of ALXN2220 to address a significant unmet need in patients with this serious and progressive condition.
The Fast Track designation is reserved for therapies demonstrating the potential to treat serious conditions and fill unmet medical needs. It offers the developer opportunities for more frequent interactions with the FDA, potentially leading to accelerated priority review and approval processes.
ALXN2220 is designed to remove existing amyloid deposits in ATTR-CM patients. The rationale is that by clearing these deposits, the drug could restore organ function and improve patient outcomes. ATTR-CM is a debilitating disease characterized by the accumulation of misfolded transthyretin protein in the heart, leading to heart failure and other cardiovascular complications. Current treatment options are limited, underscoring the need for innovative therapies.
The Fast Track designation was supported by results from a Phase 1b trial published in The New England Journal of Medicine in 2023. The trial involved 40 patients with wild-type or variant ATTR-CM and chronic heart failure. Intravenous administration of ALXN2220 demonstrated improvements in cardiac tracer uptake and extracellular volume, both surrogate markers of cardiac amyloid load, over a 12-month period. Notably, no apparent drug-related adverse events were observed during the study.

Ongoing Phase 3 Trial

ALXN2220 is currently under evaluation in the Phase 3 DepleTTR-CM trial. This trial is designed to assess the efficacy of ALXN2220 as an add-on therapy to the standard of care for patients with ATTR-CM. The primary endpoint of the DepleTTR-CM trial is a composite of all-cause mortality and the cumulative frequency of cardiovascular clinical events.

Expert Commentary

"Given the progressive and disabling nature of ATTR-CM, there is an urgent need for additional treatment options," said Gianluca Pirozzi, senior vice president and head of development, regulatory and safety at Alexion, AstraZeneca Rare Disease. "With a novel depleter mechanism designed to remove existing amyloid deposits and restore organ function, we believe that ALXN2220 offers the potential to transform the course of this devastating disease."
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Reference News

[1]
ALXN2220 for ATTR amyloidosis with cardiomyopathy granted fast track designation
healio.com · Sep 24, 2024

ALXN2220, a novel monoclonal antibody for ATTR amyloidosis with cardiomyopathy, received fast track designation from the...

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