Sanofi US News

July 2, 2021

Clinical data and new research from Sanofi’s rare blood disorders portfolio of marketed and investigational therapies for people with hemophilia, immune thrombocytopenia (ITP) and acquired thrombotic thrombocytopenic purpura (aTTP) will be presented at the International Society on Thrombosis and Haemostasis (ISTH) 2021 Virtual Congress, July 17-21, 2021.

“Breaking barriers for people living with rare blood disorders requires that we push ourselves to transform the therapeutic landscape,” said Karin Knobe, MD, PhD, Head of Development, Rare Diseases and Rare Blood Disorders at Sanofi. “We deliver on that promise with our robust portfolio and pipeline of novel technologies that are designed to help address the underlying conditions or unmet needs for people with debilitating rare blood disorders. At ISTH, we are sharing data across all our innovative approaches and collectively, the data reinforce how our pipeline and portfolio may unlock new possibilities in the treatment of rare blood disorders.”

Breaking barriers in hemophilia: helping to evolve the treatment paradigm

Hemophilia is a rare, genetic bleeding disorder in which a person’s blood does not clot properly. Despite advances in treatment options in recent years, limitations still exist.  Sanofi’s two marketed extended half-life factor replacement therapies shifted a two-decades-old treatment paradigm when launched in 2014. Today, with the molecules in its hemophilia pipeline, Sanofi is focused on delivering potential first-in-class and best-in-class therapies with the goal of bringing efficacy and convenience to a new level for patients. 

Fitusiran is an investigational, subcutaneously administered small interference RNA therapy in development for the treatment of people with hemophilia A or B, with or without inhibitors and has the potential to transform treatment as it would be the only prophylactic therapy with as few as six injections per year. Population pharmacokinetic and pharmacodynamic modeling data to characterize the antithrombin (AT) lowering dynamics in hemophilia patients treated with  fitusiran will be shared in a poster presentation. These data support the revised fitusiran dose and dosing regimen implemented in the ongoing adult and adolescent studies.

• Abstract # PB0526 Fitusiran population pharmacokinetic and pharmacodynamic (PopPK/PD) modeling to support revised dose, dosing regimens and dose mitigation scheme. ePoster

New research will also be presented on Eloctate^® [Antihemophilic Factor (Recombinant), Fc Fusion Protein], Sanofi’s extended half-life factor VIII therapy for people with hemophilia A. Sanofi collaborates on the development and commercialization of Eloctate with Sobi, a global biopharmaceutical company.

• Abstract # PB0518 Treatment patterns and clinical outcomes among patients with hemophilia A treated with factor VIII replacement therapies and nonfactor therapy: an assessment of US real-world data. ePoster
   
• Abstract #PB0578 Evaluating the effectiveness of recombinant factor VIII Fc fusion protein (rFVIIIFc) in adolescents and children with hemophilia A in the real world in Japan: interim analysis of the multicenter, observational Fc Adolescent and Children Treatment study (FACTs). ePoster
   
• Abstract # PB0522 Final results of ReITIrate - a prospective study of rescue immune tolerance induction (ITI) with recombinant factor VIII Fc (rFVIIIFc) in patients who have failed previous ITI attempts (Joint with Sobi). ePoster
   
• Abstract # OC48.2 Transplacental delivery of recombinant Fc-fused factor VIII (rFVIIIFc) in FVIII-deficient mice (ESC). Investigator Sponsored Study. Oral presentation

Charting a new course in ITP and aTTP

ITP is an acquired autoimmune blood disorder characterized by immune-mediated platelet destruction and impairment of platelet production, which leads to thrombocytopenia, a predisposition to bleeding, and altered quality of life for patients. There remains a need in relapsed/refractory ITP patients failing to maintain their platelet counts with the current therapies.

Rilzabrutinib is an investigational Bruton’s tyrosine kinase (BTK) inhibitor incorporating Sanofi’s TAILORED COVALENCY® technology that is in development for the treatment of ITP.  Interim Phase 1/2 study data will be presented at ISTH.

• Abstract # OC72.2 Phase I/II ongoing study of rilzabrutinib, an oral Bruton tyrosine kinase (BTK) inhibitor, in immune thrombocytopenia (ITP): extended follow-up and long-term analyses with optimal dose. Oral Presentation

Acquired TTP is a rare, life-threatening, autoimmune blood clotting disorder and is considered a medical emergency. New research will be shared on Cablivi^® (caplacizumab-yhdp), a von Willebrand Factor-directed antibody fragment treatment indicated for use in combination with plasma exchange and immunosuppressive therapy for adult patients with aTTP.

• Abstract # PB0838 Caplacizumab rapidly inhibits VWF-platelet interaction: pharmacodynamic data from healthy volunteers and patients with aTTP. ePoster
• Abstract # PB0851 PK/PD modeling and simulations highlight the importance of the intravenous loading dose and daily dosing regimen with caplacizumab for patients with aTTP. ePoster

About the Sanofi and Sobi collaboration: Sanofi and Sobi collaborate on the development and commercialization of Eloctate®/Elocta® and Alprolix®. Sobi has final development and commercialization rights in the Sobi territory (essentially Europe, North Africa, Russia, and most Middle Eastern markets). Sanofi has final development and commercialization rights in North America and all other regions in the world excluding the Sobi territory and has manufacturing responsibility for Eloctate/Elocta and Alprolix. In September 2019, Sobi exercised early opt-in for the development and commercialization of efanesoctocog alfa, an investigational factor VIII therapy with the potential to provide extended protection from bleeds with once-weekly dosing for people with hemophilia A.

ELOCTATE INDICATION
ELOCTATE® [Antihemophilic Factor (Recombinant), Fc Fusion Protein] is an injectable medicine that is used to help control and prevent bleeding in people with Hemophilia A (congenital Factor VIII deficiency). Your healthcare provider may give you ELOCTATE when you have surgery.

IMPORTANT SAFETY INFORMATION
Do not use ELOCTATE if you have had an allergic reaction to it in the past.

Tell your healthcare provider if you have or have had any medical problems, take any medicines, including prescription and non-prescription medicines, supplements, or herbal medicines, have any allergies, are breastfeeding, are pregnant or planning to become pregnant, or have been told you have inhibitors (antibodies) to Factor VIII.

Allergic reactions may occur with ELOCTATE. Call your healthcare provider or get emergency treatment right away if you have any of the following symptoms: difficulty breathing, chest tightness, swelling of the face, rash, or hives.

Your body can also make antibodies called "inhibitors" against ELOCTATE, which may stop ELOCTATE from working properly.

Additional common side effects of ELOCTATE are headache, rash, joint pain, muscle pain and general discomfort.

If you have risk factors for developing abnormal blood clots in your body, such as an indwelling venous catheter, treatment with Factor VIII may increase this risk.

These are not all the possible side effects of ELOCTATE. Talk to your healthcare provider right away about any side effect that bothers you or that does not go away, or if bleeding is not controlled after using ELOCTATE.

PLEASE SEE FULL PRESCRIBING INFORMATION

CABLIVI INDICATION
CABLIVI (caplacizumab-yhdp) is a prescription medicine used for the treatment of adults with acquired thrombotic thrombocytopenic purpura (aTTP), in combination with plasma exchange and immunosuppressive therapy.

IMPORTANT SAFETY INFORMATION
Do not take CABLIVI if you’ve had an allergic reaction to caplacizumab-yhdp or to any of the ingredients in CABLIVI.

Tell your doctor if you have a medical condition including if you have a bleeding disorder. Tell your doctor about any medicines you take.

Talk to your doctor before scheduling any surgery, medical or dental procedure.

CABLIVI can cause severe bleeding. In clinical studies, severe bleeding adverse reactions of nosebleed, bleeding from the gums, bleeding in the stomach or intestines, and bleeding from the uterus were each reported in 1% of subjects. Contact your doctor immediately if excessive bleeding or bruising occur.

You may have a higher risk of bleeding if you have a bleeding disorder (i.e. hemophilia) or if you take other medicines that increase your risk of bleeding such as anti-coagulants.

CABLIVI should be stopped for 7 days before surgery or any medical or dental procedure. Talk to your doctor before you stop taking CABLIVI.

The most common side effects include nosebleed, headache and bleeding gums.

Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of CABLIVI. Call your doctor for medical advice about side effects.

PLEASE SEE FULL PRESCRIBING INFORMATION

Editor’s Note:

About fitusiran: Fitusiran is an investigational, subcutaneously administered, small interference RNA therapeutic in development for the prophylaxis treatment of people with hemophilia A or B, with or without inhibitors. Fitusiran is designed to target antithrombin, a protein that inhibits blood clotting, with the goal of promoting sufficient thrombin generation to rebalance hemostasis and prevent bleeds. Fitusiran utilizes Alnylam Pharmaceutical Inc.’s ESC-GalNAc conjugate technology, which enables subcutaneous dosing with increased potency and durability. Fitusiran is currently under clinical investigation and has not been evaluated by any regulatory authority.

About Eloctate: Eloctate® [Antihemophilic Factor (Recombinant), Fc Fusion Protein] is a recombinant clotting factor therapy developed for hemophilia A using Fc fusion technology to prolong circulation in the body. It is engineered by fusing factor VIII to the Fc portion of immunoglobulin G subclass 1, or IgG1 (a protein commonly found in the body), enabling Eloctate to use a naturally occurring pathway to extend the time the therapy remains in the body.

Eloctate is marketed by Sanofi in the United States, Japan and Canada. It is also approved in Australia, New Zealand, Brazil and other countries, and Sanofi has marketing rights in these regions. It is also approved as Elocta® in the European Union, Switzerland, Iceland, Liechtenstein, Norway and other countries where it is marketed by Sobi.

About rilzabrutinib: Rilzabrutinib is an oral, peripheral Bruton’s tyrosine kinase inhibitor incorporating Sanofi’s TAILORED COVALENCY® technology being investigated for the treatment of immune-mediated diseases, including immune thrombocytopenia. BTK is involved in innate and adaptive immune responses and is a signaling molecule in immune mediated diseases. Rilzabrutinib has the potential to target the underlying disease pathogenesis of ITP and has not been shown to alter platelet aggregation.

The clinical significance of these mechanisms is currently under investigation.

Rilzabrutinib is currently under clinical investigation and has not been evaluated by any regulatory authority. A Phase 3 clinical trial to evaluate rilzabrutinib for the treatment of ITP is currently underway with the first patient dosed in April 2021. Rilzabrutinib has been granted orphan drug designation and fast track designation by the U.S. FDA for ITP.

Rilzabrutinib is also being investigated in a Phase 3 trial for pemphigus, an immune- mediated disease characterized by blisters in mucous membranes and skin as well as a Phase 2 study in the autoimmune condition IgG4-related disease. Three additional Phase 2 studies in immunological diseases are planned to start in 2021.

About Cablivi: Cablivi is a von Willebrand Factor (vWF) antibody fragment, which inhibits the interaction between ultra-large vWF multimers and platelets and, therefore, stops the formation of the micro-clots that can form during an acute episode of acquired Thrombotic Thrombocytopenia Purpura.  Cablivi was approved in the European Union in August 2018 and in the United States in February 2019.

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*TAILORED COVALENCY is a registered trademark of Principia Biopharma Inc., a Sanofi Company