OPSUMIT (macitentan), endothelin receptor antagonist

CARDIOLOGY - New medicinal product
Opinions on drugs - Posted on Jan 21 2015

Reason for request

Inclusion

No clinical added value demonstrated in patients with class II or III functional status of pulmonary arterial hypertension by comparison with the available treatments

 

  • OPSUMIT has Marketing Authorisation, in monotherapy or in combination, for the long-term treatment of adult patients with WHO class II or III functional status of pulmonary arterial hypertension (PAH). Its efficacy has been demonstrated in patients with idiopathic and heritable PAH, associated with connective tissue disorders and associated with corrected simple congenital heart disease.
  • A study of morbidity and mortality versus placebo favours macitentan in a combined endpoint linking elements of differing weights. The results are based mainly on the reduction in episodes of exacerbations of PAH. No significant difference in terms of mortality was observed.

Clinical Benefit

Moderate

the actual benefit of OPSUMIT as monotherapy or in combination, for the long-term treatment of pulmonary arterial hypertension in adult patients of WHO Functional Class II to III, is moderate.


Clinical Added Value

no clinical added value

Given the available clinical data and in the absence of data versus active comparators (other endothelin receptor antagonists or phosphodiesterase type 5 inhibitors), the Committee considers that OPSUMIT (macitentan), 4th agent of the class of endothelin receptor antagonists, does not provide an improvement in actual benefit (IAB V, non-existent) in the therapeutic management strategy of pulmonary arterial hypertension in adult patients of WHO Functional Class II or III.


Therapeutic use

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