EU/3/22/2614 - orphan designation for treatment of myopathic mitochondrial DNA depletion syndrome

Elamipretide

Overview

This medicine was designated as an orphan medicine for the treatment of myopathic mitochondrial DNA depletion syndrome in the European Union on 16 May 2022.

This means that the developer will receive scientific and regulatory support from EMA to advance their medicine to the stage where they can apply for a marketing authorisation.

Orphan designation does not mean the medicine is available or authorised for use. All medicines, including designated orphan medicines, must be authorised before they can be marketed and made available to patients in the EU.

During the medicine's development, doctors may be able to enrol patients in clinical trials investigating the medicine. For information on ongoing clinical trials in the EU, see:

• EU Clinical Trials Register

• ClinicalTrials.gov

How the medicine is expected to work

Mitochondria are structures that produce energy in cells in the form of adenosine triphosphate (ATP). In patients with myopathic mitochondrial DNA depletion syndrome, the mitochondria do not work properly, leading to symptoms such as muscle weakness. Elamipretide is a mitochondria-protective agent that binds to a substance found in mitochondria called cardiolipin, which helps produce ATP and maintain the mitochondria structure. Cardiolipin can be damaged by harmful reactive oxygen species (ROS). By binding to cardiolipin in dysfunctional mitochondria, the medicine is expected to prevent the ROS damage, thereby increasing ATP levels and improving the structure of the mitochondria. These effects are expected to increase cell energy and prevent cell death, reducing symptoms of the condition. Elamipretide has minimal or no effect on normal mitochondria, cells or organs.

Based on description provided by sponsor

Stage of development at time of orphan designation

At the time of submission of the application for orphan designation:

• The effects of the medicine had been evaluated in experimental models.
• Clinical trials with the medicine in patients with myopathic mitochondrial DNA depletion syndrome were ongoing.

More information on how potential new medicines are tested during their development is available on Authorisation of medicines.

About orphan designation

Medicines intended for rare diseases can be granted an orphan designation during their development.

The orphan designation allows the developer to benefit from:

• scientific and regulatory support to advance their medicine to the stage where they can request marketing authorisation;

• market exclusivity once the medicine is on the market.

To qualify for orphan designation, a medicine must meet a number of criteria:

• it must be intended for the treatment, prevention or diagnosis of a disease that is life-threatening or chronically debilitating;

• the prevalence of the condition in the EU must not be more than 5 in 10,000 or it must be unlikely that marketing of the medicine would generate sufficient returns to justify the investment needed for its development;

• there are no satisfactory alternative methods for the diagnosis, prevention or treatment of the condition or, if such a method exists, the medicine is of significant benefit to those affected by the condition.

EMA's Committee for Orphan Medicinal Products (COMP) is responsible for issuing opinions on applications for orphan designations.

The Agency sends the COMP opinion to the European Commission, which is responsible for granting the orphan designation. The full list of orphan designations is available in the Community register of orphan medicinal products for human use.

For more information, see:

• Orphan designation: Overview

• Rare diseases, orphan medicines - Getting the facts straight

Minutes of the COMP meeting on 11-13 April 2022

AdoptedReference Number: EMA/COMP/214405/2022

Key facts

• Active substance:
  Elamipretide
• Intended use:
  Treatment of myopathic mitochondrial DNA depletion syndrome
• Orphan designation status:
  Positive
• EU designation number:
  EU/3/22/2614
• Date of designation:
  16/05/2022
• Sponsor:

  Scendea (NL) B.V.;