EU/3/20/2315 - orphan designation for treatment of mucopolysaccharidosis VI (Maroteaux-Lamy syndrome)

pentosan polysulfate sodium
OrphanHuman

Overview

On 21 August 2020, orphan designation EU/3/20/2315 was granted by the European Commission to Paradigm Biopharmaceuticals (Ireland) Limited, Ireland, for pentosan polysulfate sodium for the treatment of mucopolysaccharidosis type VI.

Mucopolysaccharidosis type VI (also known as Maroteaux-Lamy syndrome) is an inherited disease caused by the lack of an enzyme called arylsulfatase B (ARSB). This enzyme is needed to break down substances in the body called glycosaminoglycans (GAGs). Because the enzyme is not present, GAGs build up in the cells and damage them. This causes a wide range of symptoms, the most noticeable being a short body, a large head, difficulty moving about, clouding of the eyes and hearing loss. The disease is usually diagnosed in children between one and five years of age.

Mucopolysaccharidosis VI is a long-lasting and life-threatening disease because of the damage to various parts of the body, particularly the spine, heart and lungs.

At the time of designation, mucopolysaccharidosis type VI affected approximately 0.01 in 10,000 people in the European Union (EU). This was equivalent to a total of around 500 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).


*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, Iceland, Liechtenstein, Norway and the United Kingdom. This represents a population of 519,200,000 (Eurostat 2020).

At the time of designation, galsulfase was authorised in the EU for the treatment of mucopolysaccharidosis VI. This is an enzyme replacement therapy (ERT) which provides patients with the enzyme they are lacking. Some patients may undergo transplantation to receive haematopoietic (blood) stem cells that are able to produce the missing enzyme.

The sponsor has provided sufficient information to show that pentosan polysulfate sodium might be of significant benefit for patients with mucopolysaccharidosis VI when combined with ERT. Laboratory studies indicate that pentosan polysulfate sodium may improve symptoms not managed by the currently authorised medicine, such as mobility, and preliminary clinical data showed lower levels of GAGs in the urine. This assumption will need to be confirmed at the time of marketing authorisation, in order to maintain the orphan status.

Pentosan polysulfate sodium is thought to block the effects of inflammatory proteins produced as a result of a build-up of GAGs within the structures of the joint, especially in cartilage. The medicine may also reduce the amount of GAGs in some tissues but it is not understood if this results from reduced production of GAGs or their increased break-down. When used in combination with enzyme replacement therapy, the medicine is expected to reduce inflammation and pain in patients with mucopolysaccharidosis VI.

The effects of pentosan polysulfate sodium have been evaluated in experimental models

At the time of submission of the application for orphan designation, no clinical trials with pentosan polysulfate sodium in patients with mucopolysaccharidosis VI had been started.

Pentosan polysulfate sodium is a well-established substance authorised in the EU for several conditions, including the relief of bladder pain and certain vascular disorders.

At the time of submission, pentosan polysulfate sodium was not authorised anywhere in the EU for mucopolysaccharidosis VI. Orphan designation of the medicine had been granted in the United States for this condition. 

In accordance with Regulation (EC) No 141/2000, the COMP adopted a positive opinion on 16 July 2020, 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
pentosan polysulfate sodium
Intended use
Treatment of mucopolysaccharidosis VI (Maroteaux-Lamy syndrome)
Orphan designation status
Positive
EU designation number
EU/3/20/2315
Date of designation
Sponsor

Paradigm Biopharmaceuticals (Ireland) Limited 
Fitzwilliam Hall
Fitzwilliam Place
Dublin 2
D02 T292
Ireland 
E-mail: regulatory.affairs@paradigmbiopharma.com

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

DateUpdate
December 2022The sponsor's address was updated.

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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