EU/3/13/1118

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Orphan designation

This medicine is now known as cerliponase alfa.

On 12 March 2013, orphan designation (EU/3/13/1118) was granted by the European Commission to BioMarin Europe Ltd., UK, for recombinant human tripeptidyl-peptidase 1 for the treatment of neuronal ceroid lipofuscinosis type 2.

The sponsorship was transferred to BioMarin International Limited, Ireland, in October 2015.

Recombinant human tripeptidyl-peptidase 1 has been authorised in the EU as Brineura since 30 May 2017.

What is neuronal ceroid lipofuscinosis type 2?

Neuronal ceroid lipofuscinosis type 2 (also known as Jansky-Bielschowsky disease) is one of a group of inherited diseases belonging to the larger family of metabolic disorders called ‘lysosomal storage diseases’. Patients with this condition are unable to produce enough of the enzyme tripeptidyl-peptidase 1, which plays a role in breaking down proteins inside the cells. This results in a build-up of deposits known as lipofuscins in the cells, including nerve cells, which damages tissues and leads to progressive degeneration of the brain and retina (the light-sensitive layer at the back of the eye). Symptoms usually begin between two and four years of age, and include delayed speech, inability to coordinate muscle movements, fits, loss of vision and mental deterioration.

Neuronal ceroid lipofuscinosis type 2 is a long-term debilitating and life-threatening disease that usually leads to death between the ages of eight and 12.

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

At the time of designation, neuronal ceroid lipofuscinosis type 2 affected approximately 0.3 in 10,000 people in the European Union (EU). This was equivalent to a total of around 15,000 people*, and is below the ceiling 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. This represents a population of 509,000,000 (Eurostat 2013).

What treatments are available?

At the time of orphan designation there were no satisfactory treatments authorised in the EU for neuronal ceroid lipofuscinosis type 2. The disease was managed by treating the symptoms of the disease.

How is this medicine expected to work?

Tripeptidyl-peptidase 1 is the enzyme that is lacking in patients with neuronal ceroid lipofuscinosis type 2. The medicine is expected to act as a replacement for the missing enzyme, carrying out its normal function of breaking down protein in the cells, which is ultimately expected to improve the overall outcome of patients.

The enzyme in this medicine is produced by a method known as ‘recombinant DNA technology’: it is made by cells that have received a gene (DNA), which makes them able to produce the enzyme.

What is the stage of development of this medicine?

The effects of recombinant human tripeptidyl-peptidase 1 have been evaluated in experimental models.

At the time of submission of the application for orphan designation, no clinical trials with the medicine in patients with neuronal ceroid lipofuscinosis type 2 had been started.

At the time of submission, the medicine was not authorised anywhere in the EU for neuronal ceroid lipofuscinosis type 2 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 6 February 2013 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>Recombinant human tripeptidyl-peptidase 1</p>
Active substanceRecombinant human tripeptidyl-peptidase 1
Medicine Name
Disease/conditionTreatment of neuronal ceroid lipofuscinosis type 2
Date of decision12/03/2013
OutcomePositive
Orphan decision numberEU/3/13/1118

Review of designation

On 26 April 2017, the Committee for Orphan Medicinal Products (COMP) completed its review of the designation EU/3/13/1118 for Brineura (cerliponase alfa1) as an orphan medicinal product for the treatment of neuronal ceroid lipofuscinosis2. The COMP assessed whether, at the time of marketing authorisation, the medicinal product still met the criteria for orphan designation. The Committee looked at the seriousness and prevalence of the condition, and the existence of other methods of treatment. The COMP recommended that the orphan designation of the medicine be maintained3


1 Previously known as recombinant human tripeptidyl-peptidase 1.

2During this review the original orphan indication (neuronal ceroid lipofuscinosis type 2) was expanded to include all types of neuronal ceroid lipofuscinosis.

3The maintenance of the orphan designation at time of marketing authorisation would, except in specific situations, give an orphan medicinal product 10 years of market exclusivity in the EU. This means that in the 10 years after its authorisation similar products with the same therapeutic indication cannot be placed on the market.

Life-threatening or long-term debilitating nature of the condition

The Committee for Medicinal Products for Human Use (CHMP) recommended the authorisation of Brineura for:

‘the treatment of neuronal ceroid lipofuscinosis type 2 (CLN2) disease, also known as tripeptidyl peptidase 1 (TPP1) deficiency.’

This falls within the scope of the product’s designated orphan indication, which was originally neuronal ceroid lipofuscinosis type 2 but has been expanded to include all types of the condition.

The COMP concluded that there had been no change in the seriousness of the condition since the orphan designation in 2013. Neuronal ceroid lipofuscinosis is a seriously debilitating and life-threatening disease that results in progressive brain damage and usually leads to death in the second decade of life.

Prevalence of the condition

The sponsor provided information on the prevalence of neuronal ceroid lipofuscinosis. On the basis of the information provided by the sponsor and the knowledge of the COMP, the COMP concluded that the prevalence of neuronal ceroid lipofuscinosis is below the ceiling for orphan designation, which is 5 people in 10,000. At the time of the review of the orphan designation, the prevalence was estimated to be 0.3 people in 10,000. This is equivalent to a total of around 15,000 people in the EU.

Existence of other methods of treatment

The COMP noted that, at the time of the review of the orphan designation, no satisfactory treatments were authorised in the EU for patients affected by this condition.

Conclusions

Based on the data submitted and the scientific discussion within the COMP, the COMP considered that Brineura still meets the criteria for designation as an orphan medicinal product and that it should remain in the Community Register of Orphan Medicinal Products.

Related information

Sponsor's contact details:

BioMarin International Limited
Shanbally
Ringaskiddy
County Cork
Ireland
Tel. +353 21 500 8600
E-mail: Shanbally@bmrn.com

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.