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USFDA Approves first systemic antisense drug Kynamro (mipomersen sodium) Injection for treatment of Homozygous Familial Hyperholesterolemia
G*-C*-C*-U*-C*-dA-dG-dT-dC-dT-dG-dmC-dT-dT-dmC-G*-C*-A*-C*-C*[d= 2′-deoxy,*= 2′-O-(2-methoxyethyl)]
with 3’→5′ phosphorothioate linkages
cas no 629167-92-6
USFDA Approves first systemic antisense drug Kynamro (mipomersen sodium) Injection for treatment of Homozygous Familial Hyperholesterolemia
30 January 2013
Sanofi and its subsidiary Genzyme, and Isis Pharmaceuticals Inc today announced that the U.S. Food and Drug Administration (FDA) has approved its New Drug Application (NDA) for KYNAMRO(mipomersen sodium) injection. KYNAMRO, given as a 200 mg weekly subcutaneous injection, has been approved as an adjunct to lipid-lowering medications and diet to reduce low density lipoprotein-cholesterol (LDL-C), apolipoprotein B (Apo B), total cholesterol (TC), and non-high density lipoprotein-cholesterol (non HDL-C) in patients with homozygous familial hypercholesterolemia.
In the United States, HoFH, an orphan indication, occurs in approximately one in one million individuals. For those with HoFH, heart attacks and death often occur before age 30.
Mipomersen (previously ISIS 301012, trade name Kynamro) is a cholesterol-reducing drug candidate. It is an antisense therapeutic that targets the messenger RNA forapolipoprotein B.[1][2][3] It is administered as a weekly injection.Structure
The compound is a ‘second-generation’ antisense oligonucleotide; the nucleotides are linked with phosphorothioate linkages rather than the phosphodiester linkages of RNA andDNA, and the sugar parts are deoxyribose in the middle part of the molecule and 2′-O-methoxyethyl-modified ribose at the two ends. These modifications make the drug resistant to degradation by nucleases, allowing it to be administered weekly. The drug accumulates in the liver, which is convenient since apolipoprotein B predominantly acts there.
The complete sequence is
G*-C*-C*-U*-C*-dA-dG-dT-dC-dT-dG-dmC-dT-dT-dmC-G*-C*-A*-C*-C*[d= 2′-deoxy,*= 2′-O-(2-methoxyethyl)]
with 3’→5′ phosphorothioate linkages.[4]
- Merki E, Graham MJ, Mullick AE, et al. (August 2008). “Antisense oligonucleotide directed to human apolipoprotein B-100 reduces lipoprotein(a) levels and oxidized phospholipids on human apolipoprotein B-100 particles in lipoprotein(a) transgenic mice”.Circulation 118 (7): 743–53. doi:10.1161/CIRCULATIONAHA.108.786822. PMID 18663084.
- El Harchaoui K, Akdim F, Stroes ES, Trip MD, Kastelein JJ (2008). “Current and future pharmacologic options for the management of patients unable to achieve low-density lipoprotein-cholesterol goals with statins”. Am J Cardiovasc Drugs 8 (4): 233–42.doi:10.2165/00129784-200808040-00003. PMID 18690757.
- Athyros VG, Kakafika AI, Tziomalos K, Karagiannis A, Mikhailidis DP (July 2008). “Antisense technology for the prevention or the treatment of cardiovascular disease: the next blockbuster?”. Expert Opin Investig Drugs 17 (7): 969–72.doi:10.1517/13543784.17.7.969. PMID 18549334.
- Statement on a nonproprietary name adopted by the USAN council: Mipomersen sodium
DRUG APPROVALS BY DR ANTHONY MELVIN CRASTO
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