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Orphan designation

On 21 March 2018, orphan designation (EU/3/18/2000) was granted by the European Commission to Amicus Therapeutics UK Ltd, United Kingdom, for recombinant human acid alpha-glucosidase (also known as ATB200) for the treatment of glycogen storage disease type II (Pompe's disease).

What is glycogen storage disease type II (Pompe's disease)?

Glycogen storage disease type II, also known as Pompe’s disease, is an inherited disorder caused by the lack of an enzyme called acid alpha glucosidase (GAA). This enzyme is contained in lysosomes (part of the body’s cells that break down nutrients and other materials). GAA breaks down glycogen (a complex sugar stored in the body) into glucose (a simple sugar). When this enzyme is lacking, large amounts of glycogen build up in the muscles, including the heart and diaphragm (the main breathing muscle under the lungs). The progressive build-up of glycogen causes a wide range of signs and symptoms, including heart problems, breathing difficulties and muscle weakness.

Glycogen storage disease type II is a long-term debilitating and life-threatening disease because it causes breathing and heart problems and is associated with premature death.

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

At the time of designation, glycogen storage disease type II affected approximately 0.3 in 10,000 people in the European Union (EU). This was equivalent to a total of around 16,000 people*, and is below the ceiling for orphan designation, which is 5 people in 10,000. This isbased 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 28), Norway, Iceland and Liechtenstein. This represents a population of 517,400,000 (Eurostat 2018).

What treatments are available?

At the time of designation, Myozyme (alglucosidase alfa) was authorised for the treatment of glycogen storage disease type II in the EU. Myozyme is an ‘enzyme replacement therapy’ that works by replacing the missing GAA enzyme.

The sponsor has provided sufficient information to show that the medicine might be of significant benefit for patients with glycogen storage disease type II because early studies have found that the medicine improves muscle function better than the authorised treatment. 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?

The medicine is similar to the natural GAA enzyme. The medicine, which is given by injection into a vein, is intended to be used with another medicine called miglustat given by mouth. Miglustat prevents the medicine from breaking down in the blood and so more of the GAA enzyme is expected to get into the lysosomes.

The medicine is expected to replace the missing enzyme thus improving the symptoms of the disease.

What is the stage of development of this medicine?

The effects of the medicine have been evaluated in experimental models.

At the time of submission, clinical trials with the medicine in patients with glycogen storage disease type II were ongoing.

At the time of submission, the medicine was not authorised anywhere in the EU for glycogen storage disease type II. Orphan designation of the medicine had been granted in the United States for the condition.

In accordance with Regulation (EC) No 141/2000 of 16 December 1999, the COMP adopted a positive opinion on 15 February 2018 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 acid alpha-glucosidase</p>
Active substanceRecombinant human acid alpha-glucosidase
Medicine Name
Disease/conditionTreatment of glycogen storage disease type II (Pompe's disease)
Date of decision21/03/2018
Orphan decision numberEU/3/18/2000

Review of designation

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

Sponsor's contact details

Amicus Therapeutics UK Ltd
Phoenix House, Oxford Road
Tatling End
Gerrards Cross
Buckinghamshire SL9 7AP
United Kingdom
Tel. + 44 (0)1844 211 669

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.