EU/3/13/1166 - orphan designation for treatment of citrullinaemia type 2

heterologous human adult liver-derived progenitor cells
Orphan Human

Overview

On 17 July 2013, orphan designation (EU/3/13/1166) was granted by the European Commission to Promethera Biosciences, Belgium, for heterologous human adult liver-derived progenitor cells for the treatment of citrullinaemia type 2.

Citrullinaemia type 2 is one of the inherited disorders known as 'urea-cycle disorders', which cause ammonia to accumulate in the blood. Patients with this disorder lack 'glutamate-aspartate transporter', one of the liver enzymes that are needed to get rid of excess nitrogen. In the absence of this liver enzyme, excess nitrogen accumulates in the body in the form of ammonia, which can be toxic at high levels, especially to the brain. Symptoms of the disease may appear during adulthood and include lethargy (lack of energy), vomiting, loss of appetite, seizures (fits) and coma.

Citrullinaemia type 2 is a long-term debilitating and life-threatening disease that leads to mental retardation and is associated with poor overall survival.

At the time of designation, citrullinaemia type 2 affected between 0.01 and 0.09 in 10,000 people in the European Union (EU). This was equivalent to a total of between 500 and 4,500 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).

At the time of designation, no satisfactory methods were authorised in the EU for the treatment of citrullinaemia type 2. Patients were advised to control their dietary intake of proteins, which are rich in nitrogen, to reduce the amount of ammonia formed in the body.

This medicine is an advanced-therapy medicine that belongs to the group called 'somatic-cell-therapy products'. These are medicines that contain cells or tissues that have been manipulated to change their biological characteristics so that they can be used to cure, diagnose or prevent a disease. The medicine is made up of progenitor (immature) cells derived from the liver of an adult donor ('heterologous'). When implanted into the liver of a patient, it is believed that these heterologous liver-derived progenitor cells will develop into mature, healthy liver cells that can produce the glutamate aspartate transporter enzyme. The new cells are thereby expected to reduce the accumulation of ammonia and to relieve the symptoms of the disease.

The effects of heterologous human adult liver-derived progenitor cells 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 urea-cycle disorders were ongoing.

At the time of submission, the medicine was not authorised anywhere in the EU for citrullinaemia type 2. Orphan designation of the medicine had been granted in the United States for urea-cycle disorders.

In accordance with Regulation (EC) No 141/2000 of 16 December 1999, the COMP adopted a positive opinion on 13 June 2013 recommending the granting of this designation.

  • 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

Active substance
heterologous human adult liver-derived progenitor cells
Intended use
Treatment of citrullinaemia type 2
Orphan designation status
Positive
EU designation number
EU/3/13/1166
Date of designation
Sponsor

Cellaion

Review of designation

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

Update history

Date Update
May 2024 The sponsorship was transferred Cellaion in May 2024.

EMA list of opinions on orphan medicinal product designation

EMA publishes information on orphan medicinal product designation adopted by the Committee for Orphan Medicinal Products (COMP) on the IRIS online platform:

Patients' organisations

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

  • European Organisation for Rare Diseases (EURORDIS), a non-governmental alliance of patient organisations and individuals active in the field of rare diseases.

  • Orphanet, a database containing information on rare diseases, which includes a directory of patients’ organisations registered in Europe.

EU register of orphan medicines

The list of medicines that have received an orphan designation in the EU is available on the European Commission's website:

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