Axatilimab, sold under the brand name Niktimvo, is a

monoclonal antibody A monoclonal antibody (mAb, more rarely called moAb) is an antibody produced from a cell lineage made by cloning a unique white blood cell. All subsequent antibodies derived this way trace back to a unique parent cell. Monoclonal antibodie ...

used for the treatment of chronic

graft-versus-host disease Graft-versus-host disease (GvHD) is a syndrome, characterized by inflammation in different organs. GvHD is commonly associated with bone marrow transplants and stem cell transplants. White blood cells of the donor's immune system which rema ...

. It is a blocker of the colony stimulating factor-1 receptor. It is given by

injection into a vein Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutr ...

. The most common side effects include infections; increased blood level of liver enzymes; decreased blood level of phosphate; low red blood cell count (anemia); muscle, bone, or joint pain; increased blood level of pancreatic enzymes; low energy; increased blood level of calcium; increased blood level of a muscle enzyme; increased blood level of a bone enzyme; nausea; headache; diarrhea; cough; fever; shortness of breath; and infusion related reactions. Infusion-related reactions are common and can be serious. Axatilimab was approved for medical use in the United States in August 2024. The US

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

(FDA) considers it to be a

first-in-class medication A first-in-class medication is a prototype drug that uses a "new and unique mechanism of action" to treat a particular medical condition. While the Food and Drug Administration's Center for Drug Evaluation and Research tracks first-in-class medic ...

Medical use

Axatilimab is

indicated In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosis ...

for the treatment of chronic graft-versus-host disease after failure of at least two prior lines of systemic therapy in people weighing at least .

Adverse effects

The most common adverse reactions include increased

aspartate aminotransferase Aspartate transaminase (AST) or aspartate aminotransferase, also known as AspAT/ASAT/AAT or (serum) glutamic oxaloacetic transaminase (GOT, SGOT), is a pyridoxal phosphate (PLP)-dependent transaminase enzyme () that was first described by Arthur ...

(AST), infection (pathogen unspecified), increased

alanine aminotransferase Alanine aminotransferase (ALT or ALAT), formerly alanine transaminase (ALT), and even earlier referred to as serum glutamate-pyruvate transaminase (GPT) or serum glutamic-pyruvic transaminase (SGPT), is a transaminase enzyme () that was first ch ...

(ALT), decreased phosphate, decreased hemoglobin, viral infection, increased gamma glutamyl transferase (GGT), musculoskeletal pain, increased lipase, fatigue, increased amylase, increased calcium, increased

creatine phosphokinase Creatine kinase (CK), also known as creatine phosphokinase (CPK) or phosphocreatine kinase, is an enzyme () expressed by various tissues and cell types. CK catalyses the conversion of creatine and uses adenosine triphosphate (ATP) to create phos ...

(CPK), increased alkaline phosphatase (ALP), nausea, headache, diarrhea, cough, bacterial infection, pyrexia, and dyspnea.

History

Efficacy was evaluated in AGAVE-201 (NCT04710576), a randomized, open-label, multicenter trial investigating three dosages of axatilimab in people with recurrent or refractory chronic graft-versus-host disease who had received at least two lines of systemic therapy and required additional treatment. Axatilimab was evaluated in an open-label single arm clinical trial of 79 participants with chronic graft-versus-host disease who had received at least two prior systemic treatments and required additional treatment. All participants received axatilimab 0.3 mg/kg every two weeks, until chronic graft-versus-host disease progression or unacceptable toxicity. The US

(FDA) approved axatilimab based on evidence of safety and efficacy from a clinical trial which included a total of 79 participants with chronic graft-versus-host disease after failure of two prior lines of systemic therapy. The trial was conducted at 55 sites in 13 countries, including Australia, Belgium, Canada, Germany, Greece, France, Israel, Italy, Spain, South Korea, Taiwan, the United Kingdom, and the United States. There were 24 sites in the United States. Out of 79 participants, at the approved dose of 0.3 mg/kg every two weeks, 37 participants were enrolled in the United States, and 43 participants at the trial sites outside of the United States. The FDA granted the application for axatilimab

orphan drug An orphan drug is a medication, pharmaceutical agent that is developed to treat certain rare medical conditions. An orphan drug would not be profitable to produce without government assistance, due to the small population of patients affected by th ...

and

fast track Fast Track, Fast track, or Fasttrack may refer to: Processes and systems * Fast track (FDA), a U.S. Food and Drug Administration expedited review program * Fast track (trade), the authority of the U.S. President to broker trade agreements with lim ...

designations for the treatment of chronic graft-versus-host disease.

Society and culture

Legal status

Axatilimab was approved for medical use in the United States in August 2024.

Names

Axatilimab is the international nonproprietary name. Axatilimab is sold under the brand name Niktimvo.

References

External links

* {{Authority control Orphan drugs Monoclonal antibodies