Overview

Setmelanotide has been authorised in the EU as Imcivree since 16 July 2021.

On 14 July 2016, orphan designation (EU/3/16/1703) was granted by the European Commission to TMC Pharma Services Ltd, United Kingdom, for setmelanotide for the treatment of pro-opiomelanocortin deficiency.

Pro-opiomelanocortin deficiency is an inherited disease in which patients feel continuously hungry and constantly search for food. This behaviour starts in babies, and patients quickly become obese. The disease is caused by low levels of pro-opiomelanocortin, a substance that is converted into several hormones, including melanocyte-stimulating hormone (MSH) and adrenocorticotropic hormone (ACTH). In patients with this condition, low levels of MSH lead to loss of feeling of fullness after eating whereas low levels of ACTH lead to reduced levels of the stress hormone cortisol and symptoms such as muscle weakness and low blood pressure.

Pro-opiomelanocortin deficiency is a debilitating and life-threatening disease because of its serious symptoms, particularly obesity.

At the time of designation, pro-opiomelanocortin deficiency affected less than 0.1 in 10,000 people in the European Union (EU). This was equivalent to a total of fewer than 5,000 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 513,700,000 (Eurostat 2016).

At the time of designation, no satisfactory methods were authorised in the EU for the treatment of pro-opiomelanocortin deficiency. Patients were treated with the weight loss medicines orlistat and methylcellulose.

Setmelanotide acts as a replacement for MSH. It attaches to melanocortin receptors to promote a feeling of fullness after eating. This is expected to reduce excessive food intake and obesity.

The effects of setmelanotide have been evaluated in experimental models.

At the time of submission of the application for orphan designation, clinical trials with setmelanotide in patients with pro-opiomelanocortin deficiency were ongoing.

At the time of submission, setmelanotide was not authorised anywhere in the EU for pro-opiomelanocortin deficiency. Orphan designation of setmelanotide had been granted in the United States for this condition.

In accordance with Regulation (EC) No 141/2000 of 16 December 1999, the COMP adopted a positive opinion on 16 June 2016 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.

EU/3/16/1703: Public summary of opinion on orphan designation: Setmelanotide for the treatment of pro-opiomelanocortin deficiency

Key facts

Active substance
Setmelanotide
Intended use
Treatment of pro-opiomelanocortin deficiency
Orphan designation status
Positive
EU designation number
EU/3/16/1703
Date of designation
Sponsor

Rhythm Pharmaceuticals Netherlands B.V.

Review of designation

The Committee for Orphan Medicinal Products reviewed the orphan designation of Imcivree at the time of marketing authorisation, and confirmed that the orphan designation should be maintained. 

More information is available in the orphan medicine assessment report.

Update history

DateUpdate
July 2022The sponsor's address was updated.
October 2021The sponsorship was transferred to Rhythm Pharmaceuticals Netherlands B.V. in October 2021.
November 2020The sponsorship was transferred to Rhythm Pharmaceuticals Limited, Ireland, in November 2020.
March 2019The sponsorship was transferred to TMC Pharma (EU) Limited, Ireland, in March 2019.

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:

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:

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