EU/3/16/1616 - orphan designation for treatment of periodic paralysis

Diclofenamide
OrphanHuman

Overview

On 17 February 2016, orphan designation (EU/3/16/1616) was granted by the European Commission to Professor Michael Hanna, United Kingdom, for diclofenamide for the treatment of periodic paralysis.

The sponsorship was transferred to  Giampietro Schiavo, Italy in April 2021.

Periodic paralysis is a group of inherited muscle disorders that causes periodic attacks of weakness or paralysis (inability to move), which resolve spontaneously after some time. The attacks can be triggered by stress, excitement, physical activity, heat or cold. Muscle weakness can affect a small group of muscles, or can be more generalised and affect the whole body.

Periodic paralysis is caused by abnormalities in the ion channels, tiny pores in the muscle cells that control the passage of charged particles (ions) such as sodium or chloride and play a key role in the contraction and relaxation of muscles.

Periodic paralysis is a long-term debilitating disorder due to progressive muscle weakness, muscle pain and the need for mobility aids. It can be life threatening because of the risk of heart arrhythmias (unstable heartbeat) which could lead to a heart attack.

At the time of designation, periodic paralysis affected approximately 0.2 in 10,000 people in the European Union (EU). This was equivalent to a total of around 10,000 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 submission, no satisfactory methods were authorised in the EU for the treatment of periodic paralysis.

The way this medicine works in periodic paralysis is not fully understood, however it is thought to increase the elimination of bicarbonate, sodium and potassium through the urine. This increases the acidity of the body (a condition known as 'metabolic acidosis'), which studies show can help normalise the function of the ion channels in muscle cells, thus regulating muscle contraction.

The effects of diclofenamide have been evaluated in experimental models.

At the time of submission of the application for orphan designation, no clinical trials with diclofenamide in patients with periodic paralysis were ongoing.

At the time of submission, diclofenamide was authorised in the United States for the treatment of primary periodic paralysis.

At the time of submission, the medicine was not authorised anywhere in the EU for periodic paralysis. Orphan designation of the medicine had been granted in the United States for primary periodic paralysis.

In accordance with Regulation (EC) No 141/2000 of 16 December 1999, the COMP adopted a positive opinion on 21 January 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.

Key facts

Active substance
Diclofenamide
Intended use
Treatment of periodic paralysis
Orphan designation status
Positive
EU designation number
EU/3/16/1616
Date of designation
Sponsor

Giampietro Schiavo
Via Luigi Cadorna 16 
35031 Abano Terme (PD) 
Italy
Email: cnmd.contact@ucl.ac.uk

Review of designation

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

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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