[Updated 8/25/11 12 p.m. See below.] Today the FDA approved icatibant (Firazyr), a drug made by Shire (NASDAQ: SHPGY) to treat a rare disease called hereditary angioedema. The drug, which Shire picked up in its 2008 acquisition of Germany-based Jerini, was developed for the U.S. market by Shire’s Human Genetic Therapies unit in Lexington, MA.
Hereditary angioedema is an inflammatory disease that affects about 8,000 people in the U.S.. Icatibant is approved to treat the disease’s major symptom: acute attacks of painful swelling, which can occur in various areas of the body, such as the face, hands, and feet.
Shire developed the drug as an injection just under the skin that patients can do themselves—a clear differentiation from other products on the market, which have to be dosed in hospitals or doctors offices. In June, an advisory committee to the FDA recommended that the agency approve the drug, and 11 out of the 13 members of the group voted in favor of self-administration. Today’s approval includes labeling that allows patients to inject themselves with the drug and includes counseling on how to do so.
That ability for patients to dose themselves should be a major marketing advantage, says Hugh Cole, global franchise leader at Shire Human Genetic Therapies. The drug inhibits a hormone called bradykinin, which is responsible for inflammatory symptoms such as pain and redness. There are competitors on the market that target other players in the inflammatory pathway, including drugs made by Cambridge, MA-based Dyax (NASDAQ: DYAX) and Exton, PA-based ViroPharma (NASDAQ: VPHM). The ViroPharma drug can be self-dosed, but is designed to prevent acute attacks, not treat them. And the Dyax drug, which is approved for acute attacks, can’t be self-administered. “Ours is portable, you can store it at room temperature,” Cole says. “Patients can use it and keep going with their day. It gives them a lot of freedom to manage their disease.” [An earlier version of the paragraph mistakenly said the ViroPharma product couldn’t be self-administered. We regret the error. Further details have been added to describe the differences between the drugs and how they’re used.]
Shire may be able to tout a safety advantage, as well. Dyax’s drug, which was approved in December 2009, carries a prominent “black box” warning about potentially life-threatening allergic reactions. Shire’s drug was cleared without a black box warning.
Shire hasn’t estimated the market size for icatibant in dollars. But Dyax’s sales do provide a preview of the opportunity. In 2010, Dyax sold $8.8 million worth of its drug, and it is well on track to double that this year. In the most recent quarter, Dyax reported $5.2 million in sales and a patient base that grew 50 percent over the previous quarter.
The approval of icatibant is the latest feather in Shire’s rare-disease cap. The company, which is headquartered in Dublin, Ireland, made its first foray into orphan diseases back in 2005, when it bought Cambridge-based Transkaryotic Therapies (TKT) for $1.6 billion. That unit, now Human Genetic Therapies, is responsible for some of Shire’s biggest hits, including velaglucerase alfa (Vpriv) for Gaucher disease, and agalsidase alfa (Replagal) for Fabry disease. Shire CEO Angus Russell told Xconomy in May that targeting small patient populations could be lucrative for companies that go to market with clear advantages over the standard of care or the competition.
Cole is confident the company’s long history in rare diseases will serve it well in the competitive angioedema market. He says that Shire will provide a wide range of services for patients, including case managers they can call to talk about issues such as insurance reimbursement and managing their disease. “Part of our emphasis on rare diseases is providing those services,” he says. “We think we do that well.”
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