Alglucosidase alfa

Alglucosidase alfa, sold under the brand name Myozyme among others, is an enzyme replacement therapy (ERT) orphan drug for treatment of Pompe disease (Glycogen storage disease type II), a rare lysosomal storage disorder (LSD).[4] Chemically speaking, the drug is an analog of the enzyme that is deficient in patients affected by Pompe disease, alpha-glucosidase. It is the first drug available to treat this disease.[2]

Not to be confused with Avalglucosidase alfa.
Alglucosidase alfa
Clinical data
Trade namesMyozyme, Lumizyme, others
AHFS/Drugs.comMonograph
License data
Routes of
administration		Intravenous[1][2]
ATC code
Legal status
Legal status
Identifiers
IUPAC name
  • Human glucosidase, prepro-α-[199-arginine,223-histidine][3]
CAS Number
DrugBank
ChemSpider
  • none
UNII
KEGG
Chemical and physical data
FormulaC4758H7262N1274O1369S35[3]
Molar mass105338 g·mol−1[3]
 NY (what is this?)  (verify)

It was approved for medical use in the United States in April 2006, as Myozyme[5] and in May 2010, as Lumizyme.[6]

Medical uses

Alglucosidase alfa is indicated for people with Pompe disease (GAA deficiency).[1]

In 2014 the U.S. Food and Drug Administration announced the approval of alglucosidase alfa for treatment of people with infantile-onset Pompe disease, including people who are less than eight years of age. In addition, the Risk Evaluation and Mitigation Strategy (REMS) is being eliminated.[7]

Side effects

Common observed adverse reactions to alglucosidase alfa treatment are pneumonia, respiratory complications, infections and fever. More serious reactions reported include heart and lung failure and allergic shock. Myozyme boxes carry warnings regarding the possibility of life-threatening allergic response.[2]

Cost

Some health plans have refused to subsidize Myozyme for adults because it lacks approval for treatment in adults, as well as its high cost (US$300,000 per year for life).[8]

In 2015, Lumizyme was ranked the costliest drug per patient, with an average charge of $630,159.[9]

References
  1. "Lumizyme- alglucosidase alfa injection, powder, for solution". DailyMed. 22 February 2020. Retrieved 14 August 2020.
  2. "FDA Approves First Treatment for Pompe Disease". FDA. 2006-04-28. Archived from the original on May 19, 2006. Retrieved 2008-07-07.
  3. American Medical Association (USAN). "Alglucosidase alfa". Statement on a Nonproprietary Name Adopted by the USAN Council. Archived from the original (Microsoft Word) on 12 February 2012. Retrieved 18 December 2007.
  4. Kishnani PS, Corzo D, Nicolino M, Byrne B, Mandel H, Hwu WL, et al. (January 2007). "Recombinant human acid [alpha]-glucosidase: major clinical benefits in infantile-onset Pompe disease". Neurology. 68 (2): 99–109. doi:10.1212/01.wnl.0000251268.41188.04. PMID 17151339.
  5. "Drug Approval Package: Myozyme (Alglucosidase Alfa) NDA #125141". U.S. Food and Drug Administration. Retrieved 14 August 2020.
  6. "Drug Approval Package: Lumizyme (alglucosidase alfa) NDA #125291". U.S. Food and Drug Administration. Retrieved 14 August 2020.
  7. "FDA expands approval of drug to treat Pompe disease to patients of all ages; removes risk mitigation strategy requirements". FDA. 2014-08-14. Archived from the original on 2014-08-03.
  8. Anand G (2007-09-18). "As Costs Rise, New Medicines Face Pushback". The Wall Street Journal. Dow Jones & Company. Retrieved 2008-07-07.
  9. "Magellan Rx Management Medical Pharmacy Trend Report" (PDF) (7th ed.). 2016. Archived from the original (PDF) on 29 March 2019.
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