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Pierre Fabre and the EspeRare Foundation start the EDELIFE clinical trial of a prenatal treatment for a rare genetic disease, XLHED

15 Novembre 2021

GENEVA and CASTRES, France, Nov. 15, 2021 /PRNewswire/ -- The EspeRare Foundation and the Pierre Fabre group announced today the start of the EDELIFE clinical trial aimed at confirming the safety and efficacy of ER004, a prenatal treatment for XLHED (X-linked Hypohidrotic Ectodermal Dysplasia), a rare and debilitating congenital disease. If positive, the study could lead to the first approved treatment for XLHED by 2026.

XLHED is a rare disease which affects approximately 4/100,000 live male births every year. This genetic disorder is a dermatologic-related condition which leads to abnormal development of the skin, sweat glands, sebaceous glands, hair, oral cavity and respiratory mucosal glands resulting in serious clinical manifestations such as hyperthermia, craniofacial anomalies and recurrent respiratory infections.

"Starting patient enrolment in the EDELIFE clinical trial is a huge milestone for the Hypohidrotic Ectodermal Dysplasia community," said Caroline Kant, the Co-founder and CEO of the EspeRare Foundation, the primary sponsor of the study. "Administered during the second and third trimesters of pregnancy, ER004 has the potential to become a 'single-course treatment,' which significantly improves the symptoms of this debilitating disease throughout the lives of patients. If successful, ER004 could fundamentally change the lives of these patients and may also pave the way for other prenatal therapies to correct genetic diseases before birth."

The EDELIFE clinical trial will investigate the efficacy and safety of intra-amniotic ER004 as a prenatal treatment for male foetuses who have been confirmed to have XLHED. In the main study phase, efficacy and safety of approximately 15 treated children will be assessed up to 6 months of age and safety of the mothers will be assessed up to 1 month after delivery. In the long-term follow-up phase, efficacy and safety of the treated children will be assessed up to 5 years of age. Treated children's sweating ability will be compared to that of an untreated affected relative, when available, or to that of a genotype-matched control subject coming from disease natural history data. The main phase of the clinical study is expected to last until 2025.

The study starts first in Germany, at the University Hospital of Erlangen, with Pr Schneider as the study coordinating investigator. Additional study centers will be progressively opened in France, Italy, Spain, United Kingdom and the USA.

"The EDELIFE study truly exemplifies Pierre Fabre's commitment to supporting those with rare dermatologic diseases as we have already done in infantile hemangiomas," said Eric Ducournau, CEO of the Pierre Fabre Group. "Our priority is to enrol 20 pregnant women with a confirmed diagnosis of XLHED in the foetus. As this is a very rare condition, together with the patient community, we are doing everything we can to support these women participate in the study, including helping them travel to a nearby country if there is no open investigational site in their own country."

The treatment ER004 has received the "breakthrough therapy" designation in 2020 by the US Federal Drug Administration (FDA). Its clinical development also benefits from the European Medical Agency's (EMA) PRIME (PRIority MEdicines) program.

A dedicated web site ( is being made available for interested families, providing details on the clinical trial and the conditions for enrolment. Details are also available on


XLHED is a severe genetic disorder that affects the structure of the ectoderm, the most exterior part of the three primary germ layers formed during early embryonic life, from which the skin and its appendages are derived. XLHED is caused by mutations in EDA, a gene that encodes an important developmental signaling protein, EDA1. The absence of functional EDA1 in the ectoderm results in abnormal development of the skin, sweat glands, sebaceous glands, hair, oral cavity, and respiratory mucosal glands.

About ER004

ER004 is a pioneering in-utero therapy designed to replace the function of endogenous Ectodysplasin A1 (EDA1), a protein key to the normal development of ectodermal structures in the foetus. ER-004 is a recombinant, soluble, and humanized form of EDA1 that is given as a single course treatment and delivered through intra-amniotic injections during the late stage of pregnancy. This approach has already demonstrated a significant potential in humans where it normalized sweat gland function in three patients treated in this fashion by Prof. Holm Schneider at the University Hospital Erlangen in Germany. First results were published in the New England Journal of Medicine[1] and in the British Journal of Clinical Pharmacology[2] as well as featured in Nature Medicine's Research Highlights[3].

For more information on the EspeRare Foundation, please visit

For more information on the Pierre Fabre Group, please visit


1. Prenatal Correction of X-Linked Hypohidrotic Ectodermal Dysplasia. Schneider H, Faschingbauer F, Schuepbach-Mallepell S, Körber I, Wohlfart S, Dick A, Wahlbuhl M, Kowalczyk-Quintas C, Vigolo M, Kirby N, Tannert C, Rompel O, Rascher W, Beckmann MW, Schneider P. N Engl J Med 2018; 378: 1604-1610.2. Safety and immunogenicity of Fc-EDA, a recombinant ectodysplasin A1 replacement protein, in human subjects. Körber I, Klein OD, Morhart P, Faschingbauer F, Grange DK, Clarke A, Bodemer C, Maitz S, Huttner K, Kirby N, Durand C, Schneider H. Br J Clin Pharmacol. 2020;86(10):2063-2069.3.In utero correction of a genetic disorder. Stower H. Nature Medicine 2018; 24: 702.



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