The U.S. Food and Drug Administration (FDA)  has accepted Global Blood Therapeutics’ (GBT’s) supplemental New Drug Application (sNDA) seeking accelerated approval for Oxbryta® (voxelotor) for the treatment of sickle cell disease (SCD) in children ages 4 to 11 years and its New Drug Application (NDA) seeking approval for a new age-appropriate dispersible tablet dosage form of Oxbryta suitable for pediatric patients (i.e., 300 mg grape flavoring tablets). Oxbryta is currently approved by the FDA in a tablet dosage form to treat SCD in patients age 12 years and older. Oxbryta is a first-in-class therapy that directly targets hemoglobin polymerization, the root cause of red blood cell sickling in SCD. For more information, read GBT press release here

We are excited to announce the first article by the ClinGen Hemoglobinopathy Variant Curation Expert Panel (https://www.clinicalgenome.org/affiliation/50052/), published in Human Mutation (DOI:10.1002/humu.24280), that discusses the process, challenges and considerations of specifying the ACMG/AMP guidelines for variants related to hemoglobinopathies. The ACMG/AMP guidelines comprise a series of generic criteria for the standardized interpretation and reporting of sequence variants across laboratories. Owing to the varying degrees of subjectivity and uncertainty allowed by these guidelines, the Clinical Genome Resource (ClinGen) assembles Variant Curation Expert Panels (VCEPs) to develop specifications for the ACMG/AMP framework. The ClinGen Hemoglobinopathy VCEP was created collaboratively between the ITHANET Portal (https://www.ithanet.eu/) and the Global Globin Network of the Human Variome Project (http://www.humanvariomeproject.org/gg2020/) for specifying the ACMG/AMP variant curation framework to evaluate all available evidence relevant to hemoglobinopathies and the globin genes, with the aim to standardize the curation and interpretation of variants in different conditions. The Hemoglobinopathy VCEP specifications were approved by ClinGen in April 2021 (Step 2 approval), which initiated the process of further validation and adaptation with known globin gene variants in a pilot study (toward Step 3 approval). The observations by the Hemoglobinopathy VCEP outlined in this article can help highlight the challenges generally encountered during variant curation and interpretation and during the specification of ACMG/AMP guidelines for future VCEPs.

We are excited to announce a paper about the recently formed International Hemologlobinopathy Research Network (INHERENT), published in the American Journal of Hematology (DOI: 10.1002/ajh.26323). Through a large-scale, multi-ethnic GWAS, INHERENT (https://inherentnetwork.org) will study how genetic modifiers influence the diverse clinical manifestations and the varying degree of severity of hemoglobinopathies, including thalassemia syndromes and sickle cell disease. INHERENT brings together 9 existing international/regional consortia in the field, namely ITHANET, RADeep, ARISE, SPARCO, SADaCC, REDAC, HVP GGN, IHR and ClinGen Hemoglobinopathy VCEP, and is endorsed by the European Reference Network on rare hematological diseases, ERN-EuroBloodNet. Participation in INHERENT is open to any group that can submit a minimum of 30 samples with their core phenotypic description. The current membership includes over 170 experts from 90 organizations, spanning 36 countries worldwide. With its current membership, the network has the potential to enroll over 73 thousand patients. The goal is to enroll at least 30 thousand patients, which is over one order of magnitude larger than any previous GWAS in the field. The large increase in the sample size and the diversity in the studied populations will enable novel discoveries and expand knowledge on hemoglobinopathy genetics, thus paving the way for advancing the science of personalized diagnosis and treatment.

For more information, please visit the INHERENT official website and see the information sheet.

Bluebird bio announced it has completed the rolling submission of its Biologics License Application (BLA) to the U.S. Food and Drug Administration (FDA) for approval of betibeglogene autotemcel (beti-cel) gene therapy in adult, adolescent and pediatric patients with β-thalassaemia who require regular red blood cell transfusions, across all β genotypes. Beti-cel is already cleared for market in Europe, where it's sold under the brand name Zynteglo. The BLA submission for beti-cel is based on data from Phase 1/2 and Phase 3 Northstar studies, which represent more than 220 patient-years of experience with beti-cel. The FDA previously granted beti-cel Orphan Drug status and Breakthrough Therapy designation for the treatment of transfusion-dependent β-thalassemia. If approved, beti-cel will be the first hematopoietic (blood) stem cell (HSC) ex-vivo gene therapy for patients in the United States. Source: bluebirdbio press release

Imara announced encouraging results from the Phase2a clinical trial on IMR-687 in 93 patients with sickle cell disease (SCD) at the EHA2021 Virtual Congress, June 9-17, 2021. IMR-687 is an oral disease-modifying treatment for SCD and β-thalassaemia that acts to reactivate foetal haemoglobin (HbF) by blocking a cGMP-selective phosphodiesterase, called PDE9.
Clinical data reported that treatment with IMR-687 at 200 mg was safe and well-tolerated as a monotherapy or in combination with hydroxyurea and, did not have treatment-related serious adverse events (mainly headache, nausea, and abdominal pain). The treatment sucessfully reduced the average annualized rate of vaso-occlusive crises (VOCs) by 40% and increased the time to first VOC by almost 2-fold compared with placebo. In addition, more than one-third (36%) of patients with SCD achieved absolute HbF increases of more than 3% at month eight with minimal change in total haemoglobin. Based on these findings, Imara launched the Ardent Phase2b clinical trial to assess the safety and clinical efficacy of IMR-687 at a higher daily dose of up to 400 mg in SCD. This trial is currently being conducted across 50 sites in 13 countries, including Africa, and patient enrollment is marked as complete. The company is currently enrolling patients for its Forte Phase 2b clinical trial of IMR-687 for β-thalassaemia. Imara recently announced that the United States Adopted Names (USAN) Council adopted “tovinontrine” as the generic name for IMR-687. For more information: ASH news, Imara press release-June, Imara press release-August

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