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Patient communities

Connecting with Patients is the Reward

As a research scientist, immunologist Huub Kreuwel, PhD never really worked with patients. He spent most of his time in an academic lab, trying to understand the basic biology of certain diseases and identifying molecules that could serve as targets for new therapies. He never got to see what happened in the later stages of drug development—that part where patients got better because of the discoveries he’d made.

When he left academia to serve as medical science liaison at Johnson and Johnson, however, he discovered a whole new experience. Now, years later, as Vice President for Scientific and Medical Affairs in the United States for Octapharma, talking to patients and providers about the plasma-based products his company produces is the best part of his job.

“When I came out of academia, I found it was very satisfying to actually talk to a patient who had tried our drug and had good results,” he says. “As an immunologist, it made sense to work on a lot of these rare diseases like primary immune deficiency and dermatomyositis. And it’s gotten more and more interesting over the years.”

Working in the medical affairs department also offers the opportunity to get involved with a wide variety of projects. Huub and his team work with regulatory agencies when the company is seeking approval for new products. They help set up clinical trials to test new therapies and answer physicians’ questions about how those therapies work. Best of all, he meets the people who benefit from Octapharma’s treatments, such as immune globulin (IG) therapies, and helps them enroll as research subjects in the company’s clinical trials.

Recently, the company completed a trial testing intravenous immune globulin (IVIG) therapy in patients with dermatomyositis (DM). While the results have not yet been made public, Huub says the trial did meet its primary endpoints, so it looks very promising that Octagam 10% will eventually become one of the few FDA-approved treatments for this disabling disease that affects the skin and muscles.

Part of what made this trial so successful was the feedback Huub and his team received from patients. In the process of developing the clinical trial, they worked with patient organizations, including The Myositis Association and Myositis Support and Understanding, to understand how patients experienced the disease so they could improve the study protocol and to help recruit participants for the trial.

“We work on a lot of orphan drugs,” Huub says. “And there aren’t that many patients sometimes, so we need everybody to help us to finish these trials. It worked quite well in the DM trial. Those were very productive relationships.”

The success Octapharma had with this phase III clinical trial with DM will also pave the way for future clinical trials for this indication. When rare diseases have few previous clinical trials, researchers often fumble to find tests that will tell them whether a particular drug is working or not. Octapharma’s trial in DM not only proved that the treatment was effective, it also showed that their measures of effectiveness worked in this patient population.

Huub is now developing protocols to test Octapharma products with other diseases. Among these are pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS for short—a disease in which psychiatric symptoms such as obsessive-compulsive disorder appear suddenly after a strep infection) and secondary immune deficiency (SID—a problem that occurs when immune system deficiencies occur because of something other than genetics, such as HIV or chemotherapy).

As they did with the DM study, he and his team are talking to patients to get input that will improve these studies. One way they do this is by recruiting an advisory board of about a dozen patients who spend the day with company representatives sharing their experiences and suggestions. These open-ended discussions provide insights into all manner of ideas: how to better explain data, ideas for new trials, how patients need to be supported during a trial, and more.

“Those discussions are really good for the company, and usually they’re very productive,” Huub says. “Often patients have ideas for new products or practical solutions that might make our products better. And a lot of times it actually has led to either different products or different marketing material or revamping our website or providing patient education sessions.”

These days the thing that has captured Huub’s interest is COVID-19. Healthcare providers on the front lines of the pandemic are finding success in treating the virus with IG. In fact, recent events have made Octapharma a leader in exploring new therapies for COVID-19.

The company is currently supporting two investigator-initiated projects—one testing IVIG as a treatment for COVID-related respiratory failure, the other using IVIG and steroids to treat COVID-19 patients who are developing heart problems. Octapharma is also conducting their own phase III clinical trial to see if high-dose IVIG can be used to improve severe COVID-19 symptoms. Initial results from the investigator-initiated study with COVID-related respiratory failure are very promising.

“Of course COVID is horrible,” Huub says. “But it also became an opportunity for us to delve deeper into IVIG and how it can potentially work in that disease. It’s very satisfying for me personally and for my team to try and come up with other drugs that could help COVID. So overall, it’s been a very interesting ride.”

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Patient communities

Honoring Our Rare

As the shortest month of the year, February is always the rarest month. Because of this, the last day of February has been chosen as Rare Disease Day. This year, however, is rarer still, because it’s leap year, the time when an extra day is added to the calendar: February 29. Which makes it an even better time to honor our rare disease patients!

Rare Disease Day is a time when advocates take to the soapbox to raise awareness for the more than 6,000 rare diseases that have been identified worldwide. More than 300 million people are affected by these diseases at some point in their lives, which adds up to about the population of the United States!

CSI Pharmacy works with a number of rare disease organizations to bring awareness and education. Among these is Myositis Support and Understanding. Founder Jerry Williams was diagnosed with polymyositis in 2003. He is a tireless (despite the fatigue of his illness) advocate for those living with myositis diseases.

Like many who live with a rare disease, Jerry’s myositis journey has been long and challenging. It started with muscle pain, severe weakness, muscle wasting, and fatigue. Initially, when they couldn’t figure out what was going on, doctors told him these symptoms were all in his head. Even after being identified as myositis, his disease has resisted treatment and been riddled with complications. He’s spent long stretches of time in the hospital over the last 17 years with flares, infections, and other complications. Myositis has even forced him to end his career in the banking industry and go on long-term disability.

“Leaving the workforce was a blow,” Jerry says. “I thought, what am I going to do? I knew I needed a purpose.”

Jerry set to work learning about this autoimmune disease of the muscles. In addition to reading everything he could, he looked around for others who had myositis. He knew their first-hand experiences would be at least as helpful as the information from medical sources.

Through this process, Jerry recognized there was a need for more patient-focused services and programs for those who live with myositis diseases. In 2010, he started a Facebook support group called “Polymyowhat: Understanding Myositis.” As the group attracted members with the several other forms of myositis in addition to polymyositis, he changed the name and eventually formed the nonprofit Myositis Support and Understanding (MSU). The all-volunteer organization is run completely by those who are directly affected by myositis, including patients and care partners. Jerry serves as President and Executive Director.

On this the rarest day of the year, Jerry’s message to others who live with rare diseases is never give up.

“Don’t accept the status quo,” he says. “When you’re diagnosed with a disease like myositis that limits your life, you have to find new ways to live your passion.”

Jerry has found his passion in helping to empower others who live with myositis to advocate for their best life. MSU now has two websites, several Facebook support groups, and live online video support sessions. MSU operates the official Myositis Support Community on the Inspire health support platform. They also provide educational programs, a smartphone app for tracking symptoms and treatments, clinical trials opportunities, and a financial assistance program.

“Living with chronic illness has also offered me some wonderful opportunities,” Jerry says. “It’s amazing the relationships I have built. And I never would have imagined working with a nonprofit as part of what I do and who I am. Now I can’t imagine not doing it.”

CSI Pharmacy is pleased to support the efforts of MSU and other patient organizations that are helping rare disease patients stay engaged with the world. We provide therapies uniquely suited to rare diseases, offering these therapies to more than a dozen patient communities. This month we are thrilled to honor those who daily cope with the challenges of the following rare diseases:

  • Chronic inflammatory demyelinating polyneuropathy (CIDP)
  • Guillain–Barré syndrome (GBS)
  • Huntington’s disease
  • Immune thrombocytopenia (ITP)
  • Multifocal motor neuropathy (MMN)
  • Multiple sclerosis (MS)
  • Myasthenia gravis (MG)
  • Myositis
  • Pemphigus and pemphigoid
  • Primary immune deficiency diseases (PIDD)
  • Stiff-person syndrome (SPS)