RARE Daily

FDA Approves Takeda’s Hyqvia as Maintenance Therapy in Adults with CIDP

January 16, 2024

Rare Daily Staff

The U.S. Food and Drug Administration approved Takeda’s Hyqvia for the treatment of chronic inflammatory demyelinating polyneuropathy as maintenance therapy to prevent the relapse of neuromuscular disability and impairment in adults.

Hyqvia first received FDA approval in 2014 for the treatment of primary immunodeficiency in adults, which has since been expanded to include children 2 to 16 years old.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare, acquired, immune-mediated neuromuscular disorder affecting the peripheral nervous system. It is typically characterized by progressive, symmetric symptoms such as weakness, tingling, or loss of feeling in distal and proximal limbs, loss of reflexes and difficulty walking. Because its symptoms may overlap with other rare, neuromuscular conditions, CIDP is often misdiagnosed.

Hyqvia is the only FDA-approved combination of immunoglobulin (IG) and hyaluronidase, which makes it a facilitated subcutaneous immunoglobulin (SCIG) infusion. Because it is delivered subcutaneously, HYQVIA can be administered by a healthcare professional in a medical office, infusion center or at a patient’s home. In addition, it can be self-administered after appropriate patient or caregiver training.

“With the FDA approval of Hyqvia for CIDP, which builds on our expertise in rare neuro-immunological and neuromuscular disorders, we can now offer a personalized maintenance treatment option for adults with this debilitating disease,” said Giles Platford, president of Takeda’s Plasma-Derived Therapies Business Unit. “Research and clinical experience have shown that IG therapy is effective as maintenance treatment in adults with CIDP, and we hope that this approval for Hyqvia is the first of several around the world.”

This approval is based on results from a randomized, double-blinded, placebo-controlled study (ADVANCE-CIDP 1) and a single-arm, open-label, extension study (ADVANCE-CIDP 3) that evaluated the efficacy and safety of Hyqvia as a maintenance therapy in adults with CIDP. The efficacy evaluation included 122 adults from ADVANCE-CIDP 1 with a confirmed diagnosis of CIDP and who had remained on a stable dosing regimen of intravenous immunoglobulin (IVIG) therapy for at least three months prior to screening. The analysis of the primary endpoint demonstrated a statistically significant difference between the relapse rates in the Hyqvia group (14.0 percent) compared to the placebo group (32.3 percent). The treatment difference of -18.3 percent indicated that Hyqvia demonstrated superiority over placebo in preventing relapse of CIDP.

The safety of Hyqvia in adults with CIDP was evaluated across ADVANCE-CIDP 1 and ADVANCE-CIDP 3. The most common adverse reactions observed in greater than 5 percent of study subjects in clinical studies of Hyqvia for CIDP were local reactions, headache, pyrexia, nausea, fatigue, erythema, pruritus, increased lipase, abdominal pain, back pain, and pain in extremity.

The mechanism of action of IG in the treatment of CIDP in adults has not been fully elucidated but may include immunomodulatory effects. The role of IG therapy as maintenance treatment in CIDP has been well-established and is the guidelines-based standard of care for this complex and heterogeneous condition. However, there are aspects of IVIG treatment that can be challenging for patients such as long treatment duration associated with high IG volumes, potential for venous access challenges, and infusion setting limitations.

“While it is considered the standard-of-care for maintenance treatment of adults with CIDP, IVIG infusions may be challenging for some patients and their caregivers,” said Lisa Butler, executive director, GBS-CIDP Foundation International. “We’re excited that this therapy could offer some adults with CIDP an alternative subcutaneous option that may address some of these challenges and help personalize treatment.”

Hyqvia is now available as a maintenance therapy for adult patients with CIDP in the United States. In December 2023, Takeda said that the European Medicines Agency’s Committee for Medicinal Products for Human Use has recommended the approval of Hyqvia as maintenance therapy in patients with CIDP after stabilization with IVIG.

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