AstraZeneca’s Ultomiris (ravulizumab) has been approved in Europe as an add-on to standard therapy for the treatment of adult patients with generalized myasthenia gravis (gMG) who are anti-acetylcholine receptor (AChR) antibody-positive.
This decision marks the first and only approval for a long-acting C5 complement inhibitor for the treatment of gMG in Europe. gMG is a rare, debilitating, chronic, autoimmune neuromuscular disease that leads to a loss of muscle function and severe weakness. The diagnosed prevalence of gMG in the EU is estimated at approximately 89,000.
The approval by the European Commission follows the positive opinion of the Committee for Medicinal Products for Human Use and is based on results from the CHAMPION-MG Phase III trial, which were published online in NEJM Evidence. In the trial, Ultomiris was superior to placebo in the primary endpoint of change from baseline in the Myasthenia Gravis-Activities of Daily Living Profile (MG-ADL) total score at Week 26, a patient-reported scale that assesses patients’ abilities to perform daily activities. Additionally, in prolonged follow-up results from the open-label extension, clinical benefit of Ultomiris was observed through 60 weeks.
Renato Mantegazza, Professor at the Department of Neuroimmunology and Neuromuscular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy, and CHAMPION-MG trial investigator, said: “As physicians, we see first-hand how gMG can have a debilitating impact on quality of life. Today’s approval is a major advancement for treating gMG in Europe, offering patients and physicians a new, long-acting treatment option which has shown reliable efficacy and sustained improvements in activities of daily living.”
Marc Dunoyer, Chief Executive Officer, Alexion, said: “This approval in Europe of the first and only long-acting C5 inhibitor is an important step towards realizing our vision of improving the lives of people living with gMG and increasing access to Ultomiris worldwide. Alexion’s pioneering leadership in complement science has affirmed C5 inhibition as a proven approach for managing this debilitating disease. We’re proud to offer a new treatment option that provides more convenience in dosing and has shown clinical benefit in a broader range of patients, including those who remain symptomatic despite their initial standard of care treatment.”
In CHAMPION-MG, the safety profile of Ultomiris was comparable to placebo and consistent with that observed in Phase III trials of Ultomiris in paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome (aHUS). The most common adverse reactions in patients receiving Ultomiris were diarrhea, upper respiratory tract infection, nasopharyngitis and headache.
Ultomiris was approved in the US in April 2022 and Japan in August 2022 for certain adults with gMG. Regulatory reviews are ongoing in additional countries.
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