Shire plc (LSE:SHP, NASDAQ:SHPG) announces that the Marketing Authorization Application (MAA) for Lifitegrast, submitted on 07 August 2017, has been validated by the UK as the Reference Member State involved in the Decentralized Procedure (DCP).
If approved, Lifitegrast would be the first and only treatment in a new class of drugs (LFA-1 antagonist) to address the signs and symptoms of dry eye disease in adults in Europe. The disease is most commonly associated with eye dryness and overall eye discomfort, as well as stinging, burning, and fluctuating blurry vision. Dry eye disease may significantly affect quality of life and may impact activities such as reading and using computers. It is one of the most common conditions seen by ophthalmologists and eye care practitioners worldwide.
“This submission is another important milestone for lifitegrast and the millions of patients living with dry eye disease, which can impact a person’s vision-related quality of life, affecting daily activities such as reading and using computers,” said Howard Mayer, M.D., Head of Clinical Development, R&D. “Shire is committed to continued innovation in ophthalmics, where there are opportunities to address unmet need and improve the lives of patients.”
Shire’s MAA for Lifitegrast is supported by the largest development program to date for an investigational-stage dry eye disease candidate, consisting of five clinical trials with more than 2,500 patients.,,,, In these studies, the signs of dry eye disease were measured using corneal staining and the symptoms by using patient reported eye dryness score (EDS).4-8
About the Lifitegrast Marketing Authorization Application
The lifitegrast MAA was submitted via the Decentralized Procedure (DCP) to Denmark, Norway, Sweden, Finland, the UK, Germany, the Netherlands, France, Italy, Portugal, Spain and Greece. The UK is the Reference Member State.
About Dry Eye Disease
The prevalence of dry eye disease, with and without symptoms, ranges from 5 to 50% in adults globally. An eye care professional can diagnose dry eye disease based on signs and symptoms and determine management options, which could include the use of a prescription treatment. Dry eye disease is a multifactorial disease of the ocular surface that is often chronic and may be progressive.1 The disease is most commonly associated with eye dryness and overall eye discomfort, as well as stinging, burning, or fluctuating blurry vision.1 Dry eye disease may significantly affect quality of life and may impact activities such as reading and using computers.2
Ophthalmologists and eye care professionals can diagnose dry eye disease based on patient reported symptoms as well as signs which can be objectively evaluated through various tests.9
Management options may include the use of non-prescription and prescription treatments.
Aging and gender are recognized as traditional risk factors of chronic dry eye disease, while modern risk factors include prolonged digital/computer screen time, contact lens wear and cataract or refractive surgery., Dry eye is a common complaint to ophthalmologists and eye care professionals.3
Lifitegrast is a lymphocyte function-associated antigen-1 (LFA-1) antagonist, the first medication in a new class of drugs. Lifitegrast binds to the integrin LFA-1, a cell surface protein found on leukocytes and blocks the interaction of LFA-1 with its cognate ligand intercellular adhesion molecule-1 (ICAM-1), which plays a prominent role in ocular surface inflammation.6 ICAM-1 may be over-expressed in corneal and conjunctival tissues in dry eye disease. LFA-1/ICAM-1 interaction can contribute to formation of an immunological synapse resulting in T-cell activation and migration to target tissues. In vitro studies have shown that lifitegrast may inhibit the recruitment of previously activated T cells, the activation of newly recruited T cells, and the release of pro-inflammatory cytokines-interrupting the perpetual cycle of inflammation.,
About Lifitegrast in the U.S.A.
The U.S. Food and Drug Administration approved lifitegrast under the brand name Xiidra® (lifitegrast ophthalmic solution) 5% for the treatment of signs and symptoms of dry eye disease in July 2016. For more information on the U.S. prescribing information, click here.
About Lifitegrast clinical studies
Shire’s MAA for lifitegrast is supported by the largest development program to date for an investigational-stage dry eye disease candidate, consisting of five clinical trials with more than 2,500 patients.4-8 In four safety and efficacy studies, lifitegrast improved symptoms as measured by patient reported eye dryness score (EDS), and in three of the four studies improved the objective signs of dry eye disease (measured using corneal staining). A statistically significant reduction in EDS favoring lifitegrast was seen in all four studies at week six and week 12 (the week six analysis was a post-hoc analysis in three studies). In two clinical trials, symptom improvement was noted at two, six and 12 weeks.4-8 A long-term safety study randomized to either lifitegrast (n=220) or placebo (n=111) over 360 days found lifitegrast to be generally well-tolerated with no serious treatment-emergent ocular adverse events.
The most common adverse reactions reported in 5 to 25 percent of patients were instillation site irritation, altered taste sensation (dysgeusia) and reduced visual acuity.4-8
Shire’s commitment to ophthalmology
Shire officially entered into ophthalmology with the acquisition of SARcode Bioscience in 2013. Shire’s multi-faceted approach to discovery, development, and delivery in rare diseases and specialty conditions includes our efforts to address unmet needs in eye care.
Shire’s ophthalmology franchise has been driven by a combination of strategic acquisitions and organic growth, and is focused on continuing to expand the portfolio to include treatment options for anterior and posterior segment eye conditions. In close to four years, acquisitions including SARcode followed by Foresight Biotherapeutics helped bolster Shire’s early-, mid- and late-stage ophthalmology pipeline. As a result of a collaborative license agreement with Parion Sciences Inc., Shire is developing SHP-659 (formerly P-321), another investigational candidate for the treatment of dry eye disease in adults. Shire’s ophthalmology pipeline also includes investigational candidates in infectious conjunctivitis and glaucoma.
Shire is the leading global biotechnology company focused on serving people with rare diseases. We strive to develop best-in-class products, many of which are available in more than 100 countries, across core therapeutic areas including Hematology, Immunology, Neuroscience, Ophthalmics, Lysosomal Storage Disorders, Gastrointestinal / Internal Medicine / Endocrine and Hereditary Angioedema; and a growing franchise in Oncology.
Our employees come to work every day with a shared mission: to develop and deliver breakthrough therapies for the hundreds of millions of people in the world affected by rare diseases and other high-need conditions, and who lack effective therapies to live their lives to the fullest.
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 Miljanovic, B. et al. (2007). “Impact of Dry Eye Syndrome on Vision-Related Quality of Life”. American Journal of Ophthalmology. 143(3): 409-415.
 O’Brien PD, Collum LM. (2004). “Dry eye: diagnosis and current treatment strategies”. Curr Allergy Asthma Rep. 4:314-319. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15175147 [Last accessed August 2017]
 Holland E J, Whitely WO, Sall Ke et al. (2016). “Lifitegrast clinical efficacy for treatment of signs and symptoms of dry eye disease across three randomized controlled trials”. Current Medical Research and Opinion. 32(10): 1759-1765.
 Sheppard JD, Torkildsen GL, Lonsdale JD et al. (2014). “Lifitegrast ophthalmic solution 5.0% for treatment of dry eye disease: results of the OPUS-1 phase 3 study”. Ophthalmology. 121(2): 475-83.
 Tauber J, Karpecki P, Latkany R et al. (2015). “Lifitegrast Ophthalmic Solution 5.0% versus Placebo for Treatment of Dry Eye Disease: Results of the Randomized Phase III OPUS-2 Study”. Ophthalmology. 122(12): 2423-2431.
 Holland E, Luchs J, Karpecki P et al. (2017). “Lifitegrast for the Treatment of Dry Eye Disease Results of a Phase III, Randomized, Double-Masked, Placebo-Controlled Trial (OPUS-3)”. Ophthalmology. 124(1): 53-60.
 Donnenfeld E, Karpecki PM, Majmudar PA et al. (2016). “Safety of Lifitegrast Ophthalmic Solution 5.0% in Patients with Dry Eye Disease: A 1-Year, Multicenter, Randomized, Placebo-Controlled Study”. Cornea. 35: 741-748.
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 Hovanesian JA, Shah SS, et al. (2001). “Symptoms of dry eye and recurrent erosion syndrome after refractive surgery”. J Cataract Refract Surg. 27:577-84.
 Pflugfelder, S. et al. (2017). “LFA-1/ICAM-1 Interaction as a Therapeutic Target in Dry Eye Disease”. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5240001/ [Last accessed July 2017].
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