German Cohort Observational Study to Investigate the Short- and Long-Term Safety and Clinical Effectiveness of Afamelanotide 16 mg (SCENESSE) in Patients With Erythropoietic Protoporphyria (EPP)

Abstract

Background: Afamelanotide 16 mg (SCENESSE) is the first approved treatment for erythropoietic protoporphyria (EPP). EPP is a rare autosomal recessive inherited disorder of the haem biosynthesis pathway, where patients experience severe and debilitating acute phototoxicity. It affects at least one in 140,000 of the European population. A postauthorisation safety study (PASS) and a disease registry were imposed as conditions of the European marketing authorisation.

Objectives: Evaluate the short- and long-term safety and clinical effectiveness of afamelanotide 16 mg in EPP patients enrolled in the PASS in Germany.

Methods: The PASS (EUPAS13004) is an ongoing observational study collecting safety and effectiveness variables from treated and untreated EPP patients in the European EPP Disease Registry. Patients (n = 200, none untreated) received afamelanotide according to the summary of product characteristics. Treatment-emergent adverse events were collected as safety variables. Clinical effectiveness was assessed with the EPP-QoL tool and through treatment continuity.

Results: The short- and long-term safety and benefit-risk profile of afamelanotide under real-world conditions is consistent with the positive safety profile seen in clinical trials. EPP patients reported a significant increase in QoL compared with baseline values (p < 0.0001) and 91.0% of patients who started treatment continue being treated. The safety profile of afamelanotide in patients over 70 years of age is consistent with the overall patient population.

Conclusions: Afamelanotide treatment was highly effective and associated with a higher QoL in EPP patients. The study shows a positive safety profile of afamelanotide, with the treatment providing an ongoing clinical benefit.

Keywords: SCENESSE; afamelanotide; erythropoietic protoporphyria; photoprotection; porphyria; real‐world evidence.

FIGURE 1

Frequency distribution of number of afamelanotide implants for patients by year.

FIGURE 2

Enrolment and patient status over time. Solid line represents cumulative number of patients enrolled; dotted line connotes number of patients continuing to receive treatment in Germany.

FIGURE 3

Mean EPP‐QoL total score for treated patients in Germany after treatment and matched baseline (at least one administration: Plain black bar, matched baseline: Striped bar). *Represents a statistically significant difference (p < 0.05).