Bylvay (odevixibat) is the first and only oral treatment available in Canada for the treatment of pruritus due to this rare genetic condition
ZUG, Switzerland and PARIS, Nov. 13, 2023 /PRNewswire/ — Today, Ipsen (Euronext: IPN) (ADR: IPSEY), a global biopharmaceutical company focused on transformative medicines in oncology, rare disease and neuroscience, and Medison Pharma (“Medison”), a global pharma company focused on providing access to highly innovative therapies to patients in international markets, are pleased to announce the Health Canada approval for Bylvay™ (odevixibat) for the treatment of pruritus in patients aged 6 months or older with Progressive Familial Intrahepatic Cholestasis (PFIC), a progressive and life-threatening liver disease. Bylvay is the first medication approved in Canada for the treatment of pruritus in patients aged six months or older with PFIC.
Medison and Ipsen are part of a multiregional partnership in both Canada and Israel to bring Bylvay, a highly innovative therapy for the treatment of pruritus due to PFIC, offering new hope for patients suffering from this rare disease, and their families.
“At Medison, accelerating patients’ access to innovative treatments is leading all that we do, so we are pleased and proud to bring Bylvay to patients in Canada,” said Gil Gurfinkel, CEO at Medison Pharma. “We work hard, leveraging our multi-regional platform, to be the partner-of-choice for emerging biotech companies seeking to make their products available in international markets.”
“Health Canada’s authorization of Bylvay brings an important medicine to Canadians living with PFIC and their families,” said Stewart Campbell, Executive Vice President and President of North America, Ipsen. “Bringing new medicines to new markets where unmet need exists illustrates Ipsen’s mission to improve patient lives. We are pleased to work with Medison to get Bylvay to prescribers as soon as possible.”
“I hope that the availability of Bylvay will immediately change the treatment paradigm for PFIC patients in Canada, providing physicians with a non-surgical option to help care for children with PFIC suffering from pruritus,” said Dr. Binita Kamath, Division Head (interim), Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children in Toronto. “Being involved with the clinical investigation of odevixibat, I have firsthand experience with the value this therapy can offer families – including potentially better outcomes.”
“Until today, surgery was the only treatment option available for PFIC patients,” said Mr. Walter Perez, President, Progressive Familial Intrahepatic Cholestasis Advocacy and Resource Network and father of a child living with PFIC. “As families like mine know, managing symptoms of PFIC is very challenging. We are extremely pleased that a less invasive treatment option is now available.”
About Bylvay™ (odevixibat)
Bylvay is a once-daily, non-systemic ileal bile acid transport inhibitor that acts locally in the small intestine and has minimal systemic exposure. It is approved in the U.S. for the treatment of pruritus in patients three months of age or older with PFIC, where it has orphan exclusivity. Bylvay was first launched as a treatment option for patients with PFIC in the U.S. in 2021, where it is supported by a program designed to assist with access to treatment and patient support. Bylvay also received regulatory approval in the E.U. for the treatment of PFIC in patients aged six months or older. It has launched in over nine countries and has secured public reimbursement across several major markets including Germany, Italy, the U.K., France and Belgium. In June 2023, Bylvay was also approved in the U.S. for the treatment of cholestatic pruritus in patients from 12 months of age with Alagille syndrome.
View full product monograph in Canada here.
Important Safety Information
Bylvay™ (odevixibat) is indicated for the treatment of pruritus in patients aged 6 months or older with progressive familial intrahepatic cholestasis (PFIC).
Limitation of use: Bylvay may not be effective in a subgroup of PFIC type 2 patients with specific ABCB11 variants resulting in non-functional or complete absence of the bile salt export pump protein.
Odevixibat is contraindicated in patients who are hypersensitive to this drug or to any ingredient in the formulation, including any non-medicinal ingredient, or component of the container.
Most Serious Warnings and Precautions
Liver test abnormalities: In clinical trials, increased levels of liver enzymes and bilirubin were observed in some patients receiving Bylvay. Assessment of hepatic laboratory tests (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase and total bilirubin) is recommended for all patients prior to initiating Bylvay, with monitoring per standard clinical practice.
Limited data are available in PFIC patients with cirrhosis or portal hypertension. Consider discontinuing Bylvay if a patient progresses to portal hypertension, cirrhosis or demonstrated hepatic decompensation.
Diarrhea has been reported as a common adverse reaction when taking Bylvay. Diarrhea may lead to dehydration. Patients should be monitored regularly to ensure adequate hydration during episodes of diarrhea. Interruption of treatment should be considered during acute episodes of diarrhea and/or vomiting that risk dehydration.
Fat-soluble vitamin deficiency: In clinical trials, decreased levels of fat-soluble vitamins A, D, E, and K (measured using international normalized ratio (INR)) and calcium were observed in some patients receiving Bylvay, as well as increased potassium levels. All observed decreases in calcium and increases in potassium were not considered to be clinically significant by the investigators.
Assessment of fat-soluble vitamin levels (Vitamins A, D, E), calcium, potassium and INR are recommended for all patients prior to initiating BYLVAY, with monitoring per standard clinical practice. Consider Bylvay discontinuation for fat-soluble-vitamin deficiency refractory to supplementation.
Other relevant warnings and precautions
- Conditions, medications, or surgical procedures that impair gastrointestinal motility, or enterohepatic circulation of bile acids
- Interaction with lipophilic medicinal products
- Pregnant women
- Women of child-bearing potential
- Nursing women
- Geriatrics – limited information in patients of 65 years
For more information
Please consult the Bylvay Product Monograph at https://www.medisonpharma.com/product-monographs/ for important information relating to adverse reactions, drug interactions and dosing information that has not been discussed in this piece. The Product Monograph is also available by calling 1-800-696-1341.
Bylvay does not require refrigeration and can be swallowed whole as a capsule, or opened and the pellets sprinkled onto soft food, or in liquid. This administration flexibility is a factor of importance for adherence in a pediatric patient population.
Health Canada’s approval of Bylvay was supported by data from PEDFIC 1the largest, global, Phase 3 trial ever conducted in PFIC. In PEDFIC 1, a randomized, double-blind, placebo-controlled study, Bylvay met both its pruritus (p=0.004) and serum bile acid (p=0.003) primary endpoints and was well tolerated with low incidence of diarrhea/frequent bowel movements (9.5 per cent of treated patients vs. 5.0 per cent of placebo patients). Bylvay was well tolerated with diarrhea/frequent stools being the most common treatment-related gastrointestinal adverse events. There were no serious treatment-related adverse events.
About Progressive Familial Intrahepatic Cholestasis (PFIC)
PFIC is a group of inherited liver diseases resulting from mutations in genes that impact bile secretion that are progressive and life-threatening. Typical onset of PFIC is in infancy or early childhood with a hallmark feature of this condition being severe and debilitating pruritus (itching), which has been shown to considerably reduce quality of life and can result in the need for liver transplantation.[i], [ii]
The estimated global incidence of PFIC is one in 50,000 to 100,000 people worldwide,[iii] resulting in a designation of this condition as extremely or ultra rare.[iv]
About Medison Pharma
Medison is a global pharma company focused on providing access to highly innovative therapies to patients in international markets. Medison is the first to create an international commercialization platform for highly innovative therapies, helping to save and improve lives by making the best available novel treatments accessible to patients in international markets. Medison has a track record of multi-territorial partnerships with leading pharmaceutical and biotech companies seeking to expand their global reach. To learn more visit www.medisonpharma.com
Ipsen is a global, mid-sized biopharmaceutical company focused on transformative medicines in Oncology, Rare Disease and Neuroscience. With total sales of €3.0bn in FY 2022, Ipsen sells medicines in over 100 countries. Alongside its external-innovation strategy, the Company’s research and development efforts are focused on its innovative and differentiated technological platforms located in the heart of leading biotechnological and life-science hubs: Paris-Saclay, France; Oxford, U.K.; Cambridge, U.S.; Shanghai, China. Ipsen has around 5,400 colleagues worldwide and is listed in Paris (Euronext: IPN) and in the U.S. through a Sponsored Level I American Depositary Receipt program (ADR: IPSEY). For more information, visit ipsen.com
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[i] Progressive Familial Intrahepatic Cholestasis Advocacy and Resource Network. Learn About PFIC Disease. https://www.pfic.org/learn-about-pfic-disease/. Accessed October 5, 2023.
[ii] Thompson, R., Arnell, H., et. al. Odevixibat treatment in progressive familial intrahepatic cholestasis: a randomized, placebo-controlled, phase 3 study. Lancet Gastroenterol Hepatol 2022; 7: 830–42.
[iii] Progressive Familial Intrahepatic Cholestasis Advocacy and Resource Network. Learn About PFIC Disease. https://www.pfic.org/learn-about-pfic-disease/. Accessed October 5, 2023.
[iv] Smith, C.I., Bergman, P., Hagey, D. Estimating the number of diseases – the concept of rare, ultra-rare, and hyper-rare. iScience. 2022; Aug 19; 25(8): 104698.
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