Biogen Idec announced that Health Canada has approved Alprolix [Coagulation Factor IX (Recombinant), Fc Fusion Protein], for the control and prevention of bleeding episodes and routine prophylaxis in adults, and children aged 12 and older, with haemophilia B.

Alprolix is the first approved long-acting haemophilia B therapy and is indicated to prevent or reduce the frequency of bleeding episodes with prophylactic (protective) infusions starting at once weekly or once every 10-14 days.

This is the first regulatory approval worldwide for Alprolix, which is currently under review by regulatory authorities in several other countries, including the United States, Australia and Japan.

“Health Canada’s approval of Alprolix marks the first significant treatment advance in haemophilia B in 17 years, and reinforces our commitment to developing innovative therapies that help address the critical needs of the haemophilia community,” said George A. Scangos, chief executive officer of Biogen Idec. “We believe that the safety, efficacy and prophylactic dosing schedule demonstrated with Alprolix will provide people with hemophilia B a meaningful new way to manage their condition.”

The World Federation of Haemophilia recommends a prophylactic (prevention of bleeding) regimen as the goal of treatment for people with severe haemophilia. Guidelines established by the Medical and Scientific Advisory Council of the National Haemophilia Foundation recommend prophylactic infusions two or more times a week with traditional haemophilia treatments. Frequent prophylactic infusions can be a burden to people with haemophilia and may reduce adoption to this type of treatment regimen.

The Health Canada approval of Alprolix is based on results from the global, phase 3 B-LONG study, the largest registrational study in haemophilia B ever completed. It demonstrated that Alprolix safely and effectively prevented, or reduced, bleeding episodes with prophylactic infusions given once weekly or once every 10-14 days in adults and adolescents with severe haemophilia B. In addition, more than 90 per cent of all bleeding episodes were controlled by a single Alprolix infusion.

“Health Canada’s approval of Alprolix provides people with haemophilia B an important new option in maintaining a prophylactic regimen,” said Manuel Carcao, Paediatric Haematologist and co-director of the Comprehensive Care Haemophilia Program at the Hospital for Sick Children in Toronto. “Alprolix, the first approved long-acting factor concentrate, has been shown to help individuals with haemophilia B achieve effective bleed prevention with prophylactic dosing once a week or once every 10 to 14 days.”

Haemophilia B is a rare, chronic, inherited disorder in which the ability of a person’s blood to clot is impaired, which can lead to recurrent and extended bleeding episodes. It is due to a substantial reduction of, or no factor IX activity, which is needed for normal blood clotting. People with haemophilia B experience bleeding episodes that can cause pain, irreversible joint damage and haemorrhage. Haemophilia B affects approximately one in 25,000 male births, or about 700 people in Canada. The World Federation of Haemophilia global survey conducted in 2012 estimates that about 28,000 people are currently diagnosed with haemophilia B worldwide.

"The Canadian Hemophilia Society (CHS) is pleased that Health Canada has approved Alprolix, a second recombinant factor IX product to treat haemophilia B," said Craig Upshaw, CHS president. "Moreover, it is the first in a promising new class of factor products with extended half-life. We hope it will be available to Canadian patients in the very near future."

Biogen Idec is committed to helping people with haemophilia B and is working with Canadian Blood Services, the Service de Biovigilance du Ministère de la Santé et des Services sociaux and other provincial and national authorities to make Alprolix commercially available to all Canadians with haemophilia B.

B-LONG was a global, open-label, multi-centre phase 3 study that evaluated the efficacy, safety and pharmacokinetics (measurement of the presence of the therapy in a patient’s body over time), of Alprolix in 123 males aged 12 years and older with haemophilia B. These findings were published in the December 12, 2013 issue of The New England Journal of Medicine. The study involved 50 haemophilia treatment centres in 17 countries, on six continents.

The overall median annualized bleeding rates (ABR), or projected rate of bleeding episodes per year, reported in the study were 2.95 for the weekly prophylaxis arm and 1.38 for the individualized-interval prophylactic regimens arm, in which the dosing interval started at every 10 days, and 17.69 in the on-demand treatment arm. The overall median dosing interval with individualized-interval prophylaxis was 12.5 days. During the last six months of the study the median dosing interval was 13.8 days.

The most common adverse events (incidence of =5 percent in a pooled analysis of groups 1, 2, and 3) were nasopharyngitis (common cold), influenza (flu), arthralgia (joint pain), upper respiratory tract infection, hypertension (high blood pressure) and headache.

Alprolix [Coagulation Factor IX (Recombinant), Fc Fusion Protein] is the first long-acting fully recombinant clotting factor therapy. It is indicated for the control and prevention of bleeding episodes and routine prophylaxis in adults, and children 12 years and older, with haemophilia B. Alprolix is developed by fusing factor IX to the Fc portion of Immunoglobulin G Subclass 1, or IgG1 (protein commonly found in the body). It is believed that this enables Alprolix to use a naturally occurring pathway to prolong the time therapy remains in the body. While Fc fusion has been used for more than 15 years, Biogen Idec is the only company to apply it in haemophilia.

The most common adverse drug reactions observed in the clinical trial (incidence = 1%) were headaches and oral paresthesia (an abnormal sensation in the mouth).

Biogen Idec and Swedish Orphan Biovitrum (Sobi) are partners in the development and commercialization of Alprolix for haemophilia B. Biogen Idec leads development, has manufacturing rights, and has commercialization rights in North America and all other regions in the world excluding the Sobi territory. Sobi has the right to opt in to assume final development and commercialization in Europe, Russia, the Middle East and Northern Africa.

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