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Orphan designation

On 26 November 2010, orphan designation (EU/3/10/808) was granted by the European Commission to ADIENNE S.r.l., Italy, for murine monoclonal antibody against CD26 for the treatment of graft-versus-host disease.

In January 2014, ADIENNE S.r.l. changed name to ADIENNE S.r.l.S.U.

For a list of the administrative updates to this public summary of opinion please refer to the PDF document below.

What is graft-versus-host disease?

Graft-versus-host disease (GvHD) is a complication that can affect patients who have received allogeneic haematopoietic (blood) stem-cell transplantation (HCT). This is a complex procedure used to treat diseases such as leukaemia or multiple myeloma (cancers of the white blood cells), whereby a patient receives stem cells from a matched donor to help restore the bone marrow, which produces new blood cells.

In GvHD, the transplanted cells recognise the patient as ‘foreign’ and attack the patients’ organs, such as the stomach, gut, skin and liver, leading to organ damage. GvHD may happen shortly after transplantation or later on, in which case a wider range of organs can be involved. GvHD is a serious and life-threatening disease with a high mortality rate.

What is the estimated number of patients affected by the condition?

At the time of designation, GvHD affected less than 0.4 in 10,000 people in the European Union (EU). This was equivalent to a total of fewer than 20,000 people*, and is below the threshold for orphan designation, which is 5 people in 10,000. This is based on the information provided by the sponsor and the knowledge of the Committee for Orphan Medicinal Products (COMP).

*Disclaimer: For the purpose of the designation, the number of patients affected by the condition is estimated and assessed on the basis of data from the European Union (EU 27), Norway, Iceland and Liechtenstein. At the time of designation, this represented a population of 506,300,000 (Eurostat 2010).

What treatments are available?

At the time of submission of the application for orphan drug designation, several medicines were authorised in the European Union (EU) for GvHD, such as ciclosporin and corticosteroids. Treatment aimed to reduce the activity of immune cells involved in GvHD, thereby reducing their ability to attack the patient’s organs.

The sponsor has provided sufficient information to show that murine monoclonal antibody against CD26 might be of significant benefit for patients with GvHD because early studies indicate that it might improve the treatment particularly of patients who do not respond to corticosteroids. This assumption will need to be confirmed at the time of marketing authorisation, in order to maintain the orphan status.

How is this medicine expected to work?

This medicine is a monoclonal antibody (a type of protein) that has been designed to attach to a receptor called CD26, which is present on the surface of T-cells. These are cells of the immune system that are involved in GvHD.

CD26 is responsible for stimulating the T-cells to divide. By attaching to CD26, this medicine is expected to block its activity, reducing the rate at which the T-cells multiply. This reduces the number of activated T-cells and lowers the risk of these cells attacking the patient’s organs.

What is the stage of development of this medicine?

The effects of murine monoclonal antibody against CD26 have been evaluated in experimental models.

At the time of submission of the application for orphan designation, clinical trials with the medicine in patients with GvHD were planned.

At the time of submission, murine monoclonal antibody against CD26 was not authorised anywhere in the EU for GvHD or designated as an orphan medicinal product elsewhere for this condition.

In accordance with Regulation (EC) No 141/2000 of 16 December 1999, the COMP adopted a positive opinion on 9 September 2010 recommending the granting of this designation.

Opinions on orphan medicinal product designations are based on the following three criteria
  • the seriousness of the condition;
  • the existence of alternative methods of diagnosis, prevention or treatment;
  • either the rarity of the condition (affecting not more than 5 in 10,000 people in the EU) or insufficient returns on investment.

Designated orphan medicinal products are products that are still under investigation and are considered for orphan designation on the basis of potential activity. An orphan designation is not a marketing authorisation. As a consequence, demonstration of quality, safety and efficacy is necessary before a product can be granted a marketing authorisation.

Key facts

Product details for <p>Murine monoclonal antibody against CD26</p>
Active substanceMurine monoclonal antibody against CD26
Medicine Name
Disease/conditiontreatment of graft-versus-host disease
Date of decision26/11/2010
Orphan decision numberEU/3/10/808

Review of designation

The Committee for Orphan Medicinal Products reviews the orphan designation of a product if it is approved for marketing authorisation.

Related information

Sponsor’s contact details

Via Galileo Galilei, 19
20867 Caponago (MB)
Tel. +39 02 4070 0445
Fax +39 02 9574 5179

Patients’ organisations

For contact details of patients’ organisations whose activities are targeted at rare diseases see:

  • Orphanet, a database containing information on rare diseases which includes a directory of patients’ organisations registered in Europe.
  • European Organisation for Rare Diseases (EURORDIS), a non-governmental alliance of patient organisations and individuals active in the field of rare diseases.