On May 29, 2015 Pfizer reported that the U.S. Food and Drug Administration (FDA) has approved RAPAMUNE (sirolimus) for the treatment of lymphangioleiomyomatosis (LAM), a rare, progressive disease that affects the lungs, kidneys and the lymphatic system (Press release, Pfizer, MAY 29, 2015, View Source [SID:1234504888]). This is the first approved treatment that helps stabilize lung function in patients with LAM. Schedule your 30 min Free 1stOncology Demo! "Pfizer is proud to gain approval for RAPAMUNE as the first treatment for patients with LAM, through our work with the FDA, the clinical investigation team and the LAM Foundation," said Rory O’Connor, MD, senior vice president and head of Global Medical Affairs, Global Innovative Pharmaceuticals Business, Pfizer Inc. "This type of cooperative effort creates opportunities for innovation in developing therapies for patients with rare diseases."
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LAM is a rare progressive lung disease that usually affects women during their childbearing years and can result in abnormal growth of smooth muscle cells in the lung. Over time, the muscle growth can cause airway obstructions and limit the delivery of oxygen to the body. Approximately 800 patients in the U.S. are currently diagnosed with LAM, which is a rare disease and is often fatal. RAPAMUNE is also approved in the U.S. as an immunosuppressive agent for the prophylaxis of organ rejection in kidney transplant patients aged 13 years and older.
The FDA approval is based on the results from the Multicenter International Lymphangioleiomyomatosis Efficacy of Sirolimus or MILES Trial. The MILES Trial included 89 LAM patients with moderate lung impairment and showed that those treated with RAPAMUNE for one year experienced stabilization of lung function measured by forced expiratory volume in one second (FEV1). The adverse drug reactions observed in this trial were consistent with the known safety profile for renal transplant patients receiving RAPAMUNE, with the addition of weight decreased, which was reported at a greater incidence with RAPAMUNE versus placebo. Serious adverse events were reported more frequently during the treatment period in patients receiving RAPAMUNE compared to the placebo group.
"I am thrilled for families living with LAM," said Dr. Francis X. McCormack, director of Pulmonary, Critical Care and Sleep Medicine at the University of Cincinnati College of Medicine and lead investigator of the MILES Trial. "The courage of the women who enrolled in the MILES trial made this possible. I am proud of the 200 investigators, coordinators and nurses who participated in the MILES trial that enabled FDA approval, and I sincerely thank all who supported the study."
Pfizer worked with the FDA, Dr. McCormack and the LAM Foundation to evaluate RAPAMUNE as a treatment option for LAM in the United States. The MILES trial was conducted by Dr. McCormack and conducted within the National Institutes of Health Rare Lung Diseases Consortium. Pfizer provided study drug and a portion of the funding but had no involvement in the design or conduct of the study. The LAM Foundation assisted with the recruitment of patients and logistics for the study.
"This approval is a landmark breakthrough for LAM patients to have access to this important treatment option," said Susan E. Sherman, executive director of the LAM Foundation. "It is the result of decades of work by researchers and women of the LAM community who volunteered for this pivotal clinical trial."
About RAPAMUNE
RAPAMUNE is an immunosuppressive agent indicated in the United States for the prophylaxis of organ rejection in patients aged 13 years and older receiving kidney transplants. It is prescribed to kidney transplant patients to help prevent their natural immune system from rejecting the transplanted kidney. RAPAMUNE is also indicated for the treatment of patients with LAM. Therapeutic drug monitoring is recommended for all patients receiving RAPAMUNE. RAPAMUNE has a boxed warning for infections and certain cancers. Please see the full prescribing information, including boxed warning and full indications at www.pfizer.com/products/product-detail/rapamune.
Important Safety Information
There is an increased risk of developing infections or certain cancers, especially lymphoma and skin cancers.RAPAMUNE (sirolimus) has not been shown to be safe and effective in people who have had liver or lung transplants. Serious complications and death may happen in people who take RAPAMUNE after a liver or lung transplant. You should not take RAPAMUNE if you have had a liver or lung transplant without talking with your doctor.
Do not take RAPAMUNE if you know you are allergic to sirolimus or any of the other ingredients in RAPAMUNE. Symptoms of an allergic reaction include swelling of your face, eyes, or mouth; trouble breathing or wheezing; throat tightness; chest pain or tightness; feeling dizzy or faint; and rash or peeling of your skin.
Before taking RAPAMUNE, tell your doctor if you have liver problems, skin cancer or it runs in your family, high cholesterol or triglycerides, are breastfeeding or plan to breastfeed, and are pregnant or plan to become pregnant. Women of childbearing potential should use effective birth control before therapy, during therapy, and for 12 weeks after RAPAMUNE therapy has been stopped. RAPAMUNE may interact with other medicines. Make sure that your doctor is aware of all prescription and over-the-counter drugs that you are taking, including vitamins, herbs, and nutritional supplements.
RAPAMUNE may cause swelling in your hands, feet, and in various tissues of your body. Call your doctor if you have trouble breathing.
RAPAMUNE may cause your wounds to heal slowly or not heal well resulting in redness, drainage, or opening of the wound.
RAPAMUNE may increase the levels of cholesterol and triglycerides (lipids or fat) in your blood. Your doctor should do blood tests to check your lipids during treatment with RAPAMUNE. Your doctor may recommend treatment if your lipid levels become too high. Your lipid levels may remain high even if you follow your prescribed treatment plan.
In patients taking RAPAMUNE with cyclosporine, decreased kidney function has been observed. Your doctor will regularly check your kidney function.
RAPAMUNE may increase protein in your urine. Your doctor may monitor you for abnormal protein in your urine from time to time.
RAPAMUNE may increase your risk for viral infections. Certain viruses can live in your body and cause active infections when your immune system is weak. One of these viruses, BK virus, can affect how your kidney works and cause your transplanted kidney to fail. A certain virus can cause a rare serious brain infection called Progressive Multifocal Leukoencephalopathy causing death or severe disability.
RAPAMUNE may cause potentially life-threatening lung or breathing problems. Symptoms may include coughing, shortness of breath, or difficulty breathing.
When RAPAMUNE is taken with cyclosporine or tacrolimus, you may develop a blood clotting problem resulting in unexplained bleeding or bruising.
The most common side effects of RAPAMUNE in people with renal transplant include high blood pressure, pain (including stomach and joint pain), diarrhea, headache, fever, urinary tract infection, low red blood cell count (anemia), nausea, and low platelet count (cells that help blood to clot), and high blood sugar (diabetes).
The most common side effects of RAPAMUNE in people with LAM include mouth sores, diarrhea, stomach pain, nausea, sore throat, acne, chest pain, upper respiratory tract infection, headache, dizziness, and sore muscles.
Tell your doctor if you have any side effect that bothers you or that does not go away.