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Mitapivat improves clinical outcomes in patients with non-transfusion dependent thalassemia
1. Hemoglobin response was significantly greater in the treatment group compared to placebo.
2. Majority of adverse events were mild in nature with no fatalities reported.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Non-transfusion-dependent (NTD) α- and β-thalassemia can cause chronic anemia, complications, and reduced quality of life. No oral disease-modifying therapies are currently approved for these conditions. This randomized controlled trial aimed to assess the efficacy and safety of mitapivat versus placebo in adults with NTD thalassemia and low hemoglobin levels. The primary outcome of this study was hemoglobin response (≥1 g/dL increase from baseline), while the key secondary outcome was safety based on treatment-emergent adverse events. Hemoglobin response was achieved in a significantly larger proportion of patients receiving mitapivat compared to placebo. Although this study was well done, it was limited by a short duration and modest sample size.
Click to read the study in The Lancet
Relevant Reading: Mitapivat versus Placebo for Pyruvate Kinase Deficiency
In-depth [randomized controlled trial]: Between Nov 8, 2021, and Mar 31, 2023, 235 patients were assessed for eligibility across 70 hospitals in 18 countries. Included were patients aged ≥ 18 years with NTD α- or β-thalassemia and baseline hemoglobin concentrations of ≤ 10 g/dL. Altogether, 194 patients (130 to mitapivat and 64 to placebo) were included in the final analysis. The primary outcome of hemoglobin response was significantly greater in the mitapivat group compared to placebo (42% vs. 2%, 95% confidence interval [CI] 32-50, p<0.0001). The majority of adverse events were mild, with headache (22%), insomnia (14%), and nausea (12%) being most common. No deaths were reported. Findings from this study suggest that mitapivat is effective and well-tolerated in adults with NTD thalassemia.
Image: PD
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