FDA approves RNA therapy for rare genetic disease


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The US Food and Drug Administration has approved the RNA-based therapy Onpattro, for the treatment of the rare genetic disease polyneuropathy caused by hereditary transthyretin-mediated amyloidosis (hATTR) in adult patients.

The approval marks the first treatment for patients with polyneuropathy caused by hATTR, a rare, debilitating, genetic disease characterized by the build-up of abnormal amyloid protein in peripheral nerves, the heart and other organs.

The approval marks the first FDA approval of a small interfering ribonucleic acid (siRNA) treatment, an innovative class of drugs which may act to revolutionise the treatment of genetic diseases.

“This approval is part of a broader wave of advances that allow us to treat disease by actually targeting the root cause, enabling us to arrest or reverse a condition, rather than only being able to slow its progression or treat its symptoms. In this case, the effects of the disease cause a degeneration of the nerves, which can manifest in pain, weakness and loss of mobility,” said FDA Commissioner Dr Scott Gottlieb,

He continued in saying that: “New technologies like RNA inhibitors, that alter the genetic drivers of a disease, have the potential to transform medicine, so we can better confront and even cure debilitating illnesses. We’re committed to advancing scientific principles that enable the efficient development and review of safe, effective and ground-breaking treatments that have the potential to change patients’ lives.”

The innovative siRNA drugs act to silence RNA messengers which carry instructions from DNA for the synthesis of proteins. As such scientists can act to block the way in which certain genes are expressed.

In regards to hATTR, the siRNA drug Onpattro interferes with the production of the protein transthyretin (TTR) thus preventing build-ups of amyloid deposits in peripheral nerves.

“There has been a long-standing need for a treatment for hereditary transthyretin-mediated amyloidosis polyneuropathy. This unique targeted therapy offers these patients an innovative treatment for their symptoms that directly affects the underlying basis of this disease,” said Dr Billy Dunn, Director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research.

The efficacy of the drug was shown in a clinical trial of 225 patients. The FDA granted this application Fast Track, Priority Review and Breakthrough Therapy designations. Onpattro also received Orphan Drug designation, which provides incentives to assist and encourage the development of drugs for rare diseases.

Louis Goss