Near complete resolution of pain events in patients, including adolescents
by
Mike Bassett, Staff Writer, MedPage Today
December 10, 2023
SAN DIEGO — A one-time treatment with lovotibeglogene autotemcel (Lyfgenia, lovo-cel) achieved near complete resolution of severe pain crises in patients with sickle cell disease (SCD) in an analysis presented here.
Of 34 evaluable patients, 88.2% (95% CI 72.5-96.7) achieved complete resolution of all vaso-occlusive events (VOEs) and 94.1% (95% CI 80.3-99.3) experienced complete resolution of severe VOEs during a 6 to 18 month assessment period following lovo-cel infusion, reported Julie Kanter, MD, of the University of Alabama at Birmingham.
Patients who experienced any kind of acute pain event or vaso-occlusive event post-treatment experienced a reduction of at least 50% compared with baseline, as well as a reduction in hospital admissions (2.5 to 0.4) and days in hospital (15.75 to 2.20).
All 10 adolescents (≥12 years to <18 years) in the study experienced a complete resolution of VOEs during the assessment period, showing the therapy was also effective in younger patients.
“When you talk to the individuals who have experienced this therapy, they will tell you it is a life-changing, transformative therapy.” Kanter said during press briefing at the annual meeting of the American Society of Hematology. “We will need to follow these individuals long term in sickle cell disease centers so that they can be appropriately followed and managed to confirm previous findings of the efficacy, safety, and patient experience with lovo-cel, including adolescent patients.”
Patients underwent plerixafor mobilization and apheresis, followed by myeloablative busulfan conditioning and lovo-cel infusion. “What we are doing is inserting a gene that makes hemoglobin A (HBA) labeled with T87Q,” Kanter explained. “This has a near identical oxygen affinity to wild-type adult healthy hemoglobin.”
Regarding biologic response, “we couldn’t ask for too much better,” Kanter said, noting that median percent of HBAT87Q of non-transfused total hemoglobin was 40% or more, representing the amount of healthy hemoglobin being produced from the gene therapy.
All patients maintained a stable hemoglobin level from 6 months to the last follow-up, with some maintaining that level up to 60 months. “So we are really talking about a highly durable therapy,” Kanter said.
About 87% of patients achieved a globin response (a composite endpoint evaluating HbAT87Q percentage and total hemoglobin), with all of those patients maintaining that response through the last follow-up.
No patients with a history of stroke experienced a stroke post-treatment.
Effectiveness was also demonstrated by quality of life results, Kanter said, with clinically meaningful improvements in pain intensity, pain interference, and fatigue reported in 57%, 64%, and 64% of patients, respectively. These outcomes “really demonstrate what is important to our patients and those individuals living with sickle cell,” she said.
Most adverse events occurred within one year of lovo-cel infusion and were consistent with side effects exhibited with busulfan conditioning.
