Amgen (AMGN) announced that the US Food and Drug Administration (FDA) has approved UPLIZNA as the first and only medication for people with Immunoglobulin G4-related illness (IgG4-RD). IgG4-RD is a persistent and devastating immune-mediated inflammatory disease that can affect several organs. The FDA designated UPLIZNA as a Breakthrough Therapy for the treatment of IgG4-RD, acknowledging the significant unmet medical need in this devastating condition and the medicine’s potential to benefit patients.
The FDA approval of UPLIZNA marks a significant turning point for IgG4-RD patients and physicians who now have a proven treatment that targets a key driver of the disease, reducing the risk of flares and reliance on harmful long-term steroid use,
We are proud to deliver a therapy that has the potential to significantly improve care for patients with IgG4-RD and remain encouraged by UPLIZNA’s broader potential in other immune-mediated diseases, including neuromyelitis optica spectrum disorder and generalized myasthenia gravis. This approval underscores Amgen’s ongoing commitment and leadership in developing innovative treatments targeting CD19+ B-cells across multiple therapeutic areas.
Jay Bradner
IgG4-RD can arise in various organs, causing fibrosis and irreversible organ damage. Understanding how organ damage occurs is key to making an accurate diagnosis of IgG4-RD. Because of the diverse and unpredictable inflammatory flares that might occur, the condition is similar to other diseases. IgG4-RD can eventually impair almost any organ system.
Targeting CD19+ B cells with UPLIZNA has proven to be a highly effective approach to help address the pathophysiology of IgG4-RD,
The clinical community now has an FDA-approved therapeutic innovation for patients that targets underlying disease mechanisms and helps to control disease activity by reducing flares in IgG4-RD. Now, our work begins in raising awareness of this disease so that patients can access the right treatment as early as possible, avoiding a long and often harmful diagnostic journey.
John Stone
UPLIZNA’s approval for IgG4-RD is backed by data from the MITIGATE trial, which was the first randomized, double-blind, placebo-controlled trial in IgG4-RD. 1 This trial confirmed UPLIZNA’s ability to reduce disease activity in patients by lowering flares, while preserving efficacy and the established safety profile.
This is UPLIZNA’s second approved indication, after its approval by the FDA in June 2020 for the treatment of adult patients with AQP4-IgG+ Neuromyelitis Optica Spectrum Disorder (NMOSD). The FDA also designated UPLIZNA as an orphan drug for the treatment of generalized myasthenia gravis (gMG). gMG is currently undergoing regulatory filing processes, with the submission expected to be completed in H1 2025.
MITIGATE Trial
MITIGATE is a randomized, double-blind, placebo-controlled, parallel-group, multicenter trial that will compare the efficacy and safety of UPLIZNA to placebo in lowering the risk of flares in adults with IgG4-RD.
The primary endpoint was the time it took to initially treat and adjudicate an IgG4-RD flare. The three main secondary outcomes were the annualized flare rate, flare-free, treatment-free complete remission, and flare-free, corticosteroid-free complete remission. The MITIGATE study also includes an optional three-year open-label treatment phase and a two-year safety follow-up period following the withdrawal of UPLIZNA. The mission is expected to be completed in the first half of 2025.
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Immunoglobulin G4-related disease (IgG4-RD)
Immunoglobulin G4-related disease (IgG4-RD) is a chronic, systemic, immune-mediated, fibroinflammatory disease that can affect a variety of organs across the body. It is a progressive disease that can affect a wide range of organ systems and frequently affects numerous organs over time. It is distinguished by periods of remission and sudden disease flares. IgG4-RD can induce lasting organ damage, whether or not symptoms are present. Understanding how organ damage appears is vital for the timely diagnosis of IgG4-RD. IgG4-RD pathogenesis is mostly mediated by B lymphocytes. In IgG4-RD, CD19-expressing (CD19+) B cells are hypothesized to induce inflammatory and fibrotic processes while also interacting with other immune cells that contribute to disease activity.
Source: Amgen
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