BioCryst Highlights Real-world Data Showing ORLADEYO® (berotralstat) Consistently Reduces HAE Attacks Across All Ages

New data shared at the 14th C1-inhibitor Deficiency & Angioedema Workshop supports berotralstat use at all stages of life

RESEARCH TRIANGLE PARK, N.C., May 30, 2025 (GLOBE NEWSWIRE) -- BioCryst Pharmaceuticals, Inc. (Nasdaq: BCRX) today announced new data which highlights the reduction in the percentage of days with hereditary angioedema (HAE) symptoms among young children initiating berotralstat in the APeX-P trial, and the broad safety and efficacy outcomes observed across all age groups of patients taking ORLADEYO to prevent HAE attacks.

“These data underscore the potential of our oral, once-daily prophylactic treatment to deliver consistent, meaningful benefits for people living with HAE across all stages of life. From young children to adolescents and adults, ORLADEYO continues to show strong efficacy and tolerability, helping patients experience more days free from attacks. These clinical and real-world results give me confidence that we can continue to have a very positive impact on advancing care for all those living with HAE, regardless of their age,” said Helen Thackray, chief research and development officer at BioCryst.

The following three studies are being presented at the 14th C1-Inhibitor Deficiency & Angioedema Workshop in Budapest, Hungary from May 29–June 1, 2025.

• Reduction in Percentage of Days with Angioedema Symptoms Among Young Children Initiating Berotralstat – Interim Results from ApeX-P

Oral Presentation​ - Session IV - ​Saturday, May 31 - ​10:30 – 12:45 (12:00-12:15)

The ongoing open-label APeX-P study is evaluating berotralstat in children aged 2 to 11 years with HAE. There were four weight-based cohorts. Cohort 1 from these interim results received 150 mg capsules daily, while cohorts 2–4 received daily oral granule doses of 108, 96, and 78 mg, respectively. The median age was 8 years (range: 3–11), with disease onset typically between ages 2–6 years. Prior to enrollment, patients reported a mean (SD) of 18.0 (20.5) missed school days annually due to HAE. While on berotralstat, at least half of patients were attack-free each month. The percentage of days with angioedema symptoms dropped from a mean (SD) of 11 percent (9.4 percent) during the standard-of-care period, measured pre-study, to 4.0 percent (4.7 percent) over 12 weeks, with this improvement sustained up to 48 weeks. The most common treatment emergent adverse events (TEAEs) were nasopharyngitis, upper respiratory tract infection and headache. These interim findings suggest berotralstat may help children with HAE experience fewer symptoms and a more normal daily life.

• Berotralstat for the Prevention of Hereditary Angioedema Attacks: Results from the Italian Expanded Access Program

Oral Presentation - Session VI- Sunday, June 1 - 08:00 – 09:30 (09:00-09:15)

In the Italian expanded access program (EAP), 22 patients received berotralstat free of charge until commercial availability, with an additional 12 weeks of treatment to ensure continuity. Safety was monitored throughout, and data on breakthrough attacks, disease control, and quality of life (QoL) were collected.

Among 12 patients with available data, median (mean) Angioedema Control Test (AECT) scores improved from 11.5 (12.8) at baseline to 13.0 (14.0) at month three and 16.0 (14.8) at month six, indicating better disease control. Median (mean) AE-QoL total scores decreased from 45.0 (42.3) at baseline to 40.0 (37.6) at month three and 36.2 (34.0) at month six, reflecting clinically meaningful improvements in QoL.

All 15 patients still enrolled at program closure transitioned to commercially available ORLADEYO. The treatment was associated with a consistently low HAE attack rate, improved disease control and a safety profile consistent with clinical trial findings.

• Tolerability and Effectiveness of Berotralstat for Prophylaxis in Adolescents with Hereditary Angioedema: subgroup analysis of the Berolife Study

Oral Presentation - Session VI - Sunday June 1 – 08:00-9:30 (08:30-08:45)

The Berolife study, a real-world observational study in France, assessed the tolerability and effectiveness of berotralstat in patients with HAE, including a subgroup of adolescents (aged 12–17) who received 150 mg once daily.

The mean (SD) baseline attack rate was 1.8 (1.1) attacks/month (median: 1.8), based on the six months prior to enrolment. After six months of treatment, the median monthly attack rate decreased to 0.55 (from 2.25 at baseline), with similar reductions sustained at 12 and 18 months. TEAEs in adolescents were consistent with those seen in the overall Berolife population and in the APeX-2 and APeX-S clinical trials.

These findings support berotralstat as an effective and well-tolerated long-term prophylactic option for adolescents with HAE.

About ORLADEYO® (berotralstat)ORLADEYO® (berotralstat) is the first and only oral therapy designed specifically to prevent attacks of hereditary angioedema (HAE) in adult and pediatric patients 12 years and older. One capsule of ORLADEYO per day works to prevent HAE attacks by decreasing the activity of plasma kallikrein.

U.S. Indication and Important Safety InformationINDICATIONORLADEYO® (berotralstat) is a plasma kallikrein inhibitor indicated for prophylaxis to prevent attacks of hereditary angioedema (HAE) in adults and pediatric patients 12 years and older.

Limitations of use

The safety and effectiveness of ORLADEYO for the treatment of acute HAE attacks have not been established. ORLADEYO should not be used for the treatment of acute HAE attacks. Additional doses or dosages of ORLADEYO higher than 150 mg once daily are not recommended due to the potential for QT prolongation.

IMPORTANT SAFETY INFORMATION

An increase in QT prolongation was observed at dosages higher than the recommended 150 mg once-daily dosage and was concentration dependent.

The most common adverse reactions (≥10% and higher than placebo) in patients receiving ORLADEYO were abdominal pain, vomiting, diarrhea, back pain, and gastroesophageal reflux disease.

A reduced dosage of 110 mg taken orally once daily with food is recommended in patients with moderate or severe hepatic impairment (Child-Pugh B or C).

Berotralstat is a substrate of P-glycoprotein (P-gp) and breast cancer resistance protein. P-gp inducers (eg, rifampin, St. John’s wort) may decrease berotralstat plasma concentration, leading to reduced efficacy of ORLADEYO. The use of P-gp inducers is not recommended with ORLADEYO.

ORLADEYO at a dose of 150 mg is a moderate inhibitor of CYP2D6 and CYP3A4. For concomitant medications with a narrow therapeutic index that are predominantly metabolized by CYP2D6 or CYP3A4, appropriate monitoring and dose titration is recommended. ORLADEYO at a dose of 300 mg is a P-gp inhibitor. Appropriate monitoring and dose titration is recommended for P-gp substrates (eg, digoxin) when coadministering with ORLADEYO.

The safety and effectiveness of ORLADEYO in pediatric patients