Sebelipase alfa for lysosomal acid lipase deficiency: 5-year treatment experience from a phase 2 open-label extension study

Vĕra Malinová, Manisha Balwani, Reena Sharma, Jean Baptiste Arnoux, John Kane, Chester B. Whitley, Sachin Marulkar, Florian Abel

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background and Aims: Lysosomal acid lipase deficiency is characterized by hepatomegaly and dyslipidaemia, which can lead to cirrhosis and premature atherosclerosis. Sebelipase alfa is an approved recombinant human lysosomal acid lipase. In an open-label extension study of adults with lysosomal acid lipase deficiency (LAL-CL04), sebelipase alfa treatment for 1 year reduced serum transaminase levels and liver fat content and improved serum lipid levels. Methods: Final data from LAL-CL04 are reported herein for patients who received sebelipase alfa infusions (1.0 or 3.0 mg/kg every other week) for up to 5 years. Results: Of 8 patients enrolled, 7 received sebelipase alfa for 224-260 weeks; 1 was lost to follow-up. Median baseline levels of alanine aminotransferase and aspartate aminotransferase (81.5 and 50.0 U/L, respectively) were decreased through the end-of-study visit (54.0 and 34.0 U/L). Median low-density lipoprotein cholesterol decreased from 113 to 78 mg/dL, total cholesterol decreased from 171 to 132 mg/dL, and high-density lipoprotein cholesterol increased from 37 to 42 mg/dL. Most treatment-emergent adverse events were nonserious (99%), mild/moderate (98%) and unrelated to sebelipase alfa (87%); no patient discontinued as a result of treatment-emergent adverse events. One patient had 2 serious treatment-emergent adverse events (cholecystitis and cholelithiasis; assessed as unlikely related to sebelipase alfa). Two patients had 20 nonserious infusion-associated reactions in weeks 6-38; all were manageable. One patient tested positive for antidrug antibodies (single occurrence). Conclusions: Sebelipase alfa was well tolerated and improved serum transaminase and lipid levels for up to 5 years in adults with lysosomal acid lipase deficiency. Trial registration number: ClinicalTrials.gov record NCT01488097.

Original languageEnglish (US)
Pages (from-to)2203-2214
Number of pages12
JournalLiver International
Volume40
Issue number9
DOIs
StatePublished - Sep 1 2020

Bibliographical note

Funding Information:
LAL-CL01 and LAL-CL04 were sponsored by Alexion Pharmaceuticals, Inc The sponsor also funded medical writing support to the authors from Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ. Editorial and medical writing support was provided by Jessica D. Herr, PharmD, of Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ and was funded by Alexion Pharmaceuticals, Inc, the study sponsor. In collaboration with the study sites, the sponsor designed and conducted the study, collected the data, monitored conduct of the study and performed the statistical analyses. The interpretation of the data was performed by the sponsor in collaboration with all of the authors. Alexion Pharmaceuticals, Inc provided review of this manuscript for the authors' consideration.

Funding Information:
Editorial and medical writing support was provided by Jessica D. Herr, PharmD, of Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ and was funded by Alexion Pharmaceuticals, Inc, the study sponsor. In collaboration with the study sites, the sponsor designed and conducted the study, collected the data, monitored conduct of the study and performed the statistical analyses. The interpretation of the data was performed by the sponsor in collaboration with all of the authors. Alexion Pharmaceuticals, Inc provided review of this manuscript for the authors' consideration.

Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

Keywords

  • enzyme replacement therapy
  • lipids
  • liver
  • lysosomal storage diseases
  • transaminases

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