On November 8, 2019, the Food and Drug Administration approved luspatercept-aamt (REBLOZYL, Celgene Corp.) for treatment of anemia in adult patients with beta thalassemia who require regular red blood cell transfusions.
Efficacy was evaluated in the BELIEVE trial (NCT02604433), a multicenter, randomized, double-blind, placebo-controlled trial enrolling 336 adult patients with beta thalassemia requiring regular red blood cell (RBC) transfusions. Patients were randomized 2:1 to luspatercept-aamt (224) or placebo (112). Luspatercept-aamt was administered subcutaneously once every 3 weeks as long as a reduction in transfusion requirement was observed or until unacceptable toxicity.
The primary efficacy outcome measure was the proportion of patients achieving RBC transfusion burden reduction from baseline of at least 33%, with a reduction of at least 2 units from week 13 to week 24. Of the patients who received luspatercept-aamt, 21.4% achieved the primary endpoint compared with 4.5% of those who received placebo (risk difference 17.0; 95% CI 10.4, 23.6; p<0.0001).
The most common adverse reactions (>10%) in patients with beta thalassemia were headache, bone pain, arthralgia, fatigue, cough, abdominal pain, diarrhea, and dizziness.
The recommended starting dose is 1 mg/kg once every 3 weeks by subcutaneous injection.
View full prescribing information for REBLOZYL.
FDA granted this application fast track and orphan drug designations. A description of FDA expedited programs is in the Guidance for Industry: Expedited Programs for Serious Conditions-Drugs and Biologics.
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