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A Elena le quieren retirar el fármaco que frenaba su enfermedad rara: "No tengo otra alternativa" Elena Árcega, paciente afectada por la recomendación de la EMA de retirar 'Ocaliva' ALBI
La EMA recomienda retirar la comercialización de 'Ocaliva', un fármaco para la colangitis biliar primaria Elena lleva 5 años tomándolo, y desde entonces su enfermedad no ha avanzado: "Me quedaría sin alterativa terapéutica" Sociedades científicas y pacientes han pedido a las autoridades sanitarias españolas frenar la recomendación de la EMA Hace 15 años que a Elena Árcega le diagnosticaron colangitis biliar primaria (CBP). Una enfermedad rara y autoinmune que gradualmente destruye los conductos biliares del hígado, pudiendo causar insuficiencia hepática y aumentar el riesgo de cáncer de hígado. Se calcula que en España la padecen unas 11.000 personas, la mayoría de ellas, mujeres.
Diez años fueron los que Elena se pasó sin encontrar un tratamiento que le ayudara. Hasta que llegó 'Ocaliva ' (ácido obeticólico). Un medicamento huérfano que se utiliza de segunda o tercera línea, es decir, se intenta con él cuando los principales tratamientos no son eficaces. Hecho que le sucede aproximadamente a un 30% de los pacientes con CBP. Entre ellos, Elena.
Cuando 'Ocaliva' llegó a su vida, la enfermedad comenzó a frenar por fin. "Esta medicación lleva cinco años parando el desarrollo de mi patología. Los parámetros se normalizaron y desde entonces la fibrosis que tengo en estado avanzado, no ha empeorado", expresa Elena, también presidenta de la Asociación para la Lucha contra las Enfermedades Biliares Inflamatorias (ALBI).
Elena Árcega Cedida por Elena Árcega
Petición de la EMA de retirar 'Ocaliva' Cuando todo iba bien para Elena, salió a la luz la noticia de que el Comité de Medicamentos de Uso Humano (CHMP, por sus siglas en inglés), de la Agencia Europea de Medicamentos (EMA) había pedido que se elimine la autorización de comercialización de 'Ocaliva' , "debido a que sus beneficios no compensan sus riesgos". Una sorpresa - non grata - que afecta a unos 1.700 pacientes que están bajo tratamiento con este fármaco.
"¿Qué va a pasar conmigo? Ahora que lo habíamos conseguido...", se pregunta Elena durante una entrevista a la web de Informativos Telecinco. "Estoy asustada, no tenemos otra alternativa terapéutica . Siento que me quitan la cura", -aunque como tal no es un tratamiento que cure-, es lo único que le funciona a Elena.
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¿Por qué piden su retirada ahora? 'Ocaliva' es un medicamento que recibió el visto bueno de comercialización en 2016 por la EMA bajo una condición. A pesar de que se había demostrado que mejoraba el estado hepático de los pacientes, se solicitaba que a posteriori se realizasen estudios adicionales que reconfirmaran su beneficio
Los resultados de este estudio (747-302), que han llegado 8 años después de su comercialización , no han superado las expectativas, ya que no se han observado diferencias significativas en la eficacia entre los pacientes tratados con este medicamento y los que recibieron placebo . De ahí, que la EMA haya pedido su retirada por no superar la condición que se indicó en un inicio.
Piden que se rectifique Ante esta petición, sociedades científicas y asociaciones de pacientes han pedido a las autoridades sanitarias españolas colaboración para frenar la recomendación de la EMA . Para ello, Elena, la presidenta de ALBI, se ha unido junto a la Asociación Española para el Estudio del Hígado (AEEH) y la Federación Nacional de Enfermos y Trasplantados Hepáticos (FNETH) para mandar un escrito formal a la ministra de Sanidad, a la directora de la Agencia Española del Medicamento y a los portavoces de las comisiones de sanidad de los grupos parlamentarios para solicitar su colaboración.
Elena Árcega, presidenta de ALBI Cedida por Elena Árcega
Como detallan en su carta, "los estudios y ensayos clínicos realizados en la vida real han puesto de manifiesto que el tratamiento con 'Ocaliva' es eficaz y seguro en pacientes compensados".
Además, afirman que el ensayo tiene dos limitaciones importantes . Por un lado, incluyó pacientes con enfermedad hepática avanzada en quienes el tratamiento actualmente está contraindicado, y, por otro, un elevado porcentaje de pacientes (fundamentalmente aquellos en el grupo placebo) decidieron salir del estudio e iniciar tratamiento con ácido obeticólico (Ocaliva). "Como consecuencia los resultados del estudio no pueden interpretarse adecuadamente ", enfatizan.
Manuel Romero, presidente de la AEEH JUNTA DE ANDALUCÍA
"Creemos que si se suspende la comercialización de 'Ocaliva' se privaría a muchos pacientes - que no tienen otra alternativa porque el fármaco de uso en primera línea no les funciona- de una buena opción terapéutica", ha afirmado el presidente de la AEEH, Manuel Romero.
Tanto él como Árcega lamentan que para esta recomendación no se haya tenido en cuenta la opinión de personas que lo usan como tratamiento actualmente.
Preocupación de los pacientes y profesionales A las asociaciones ha llegado la preocupación tanto de profesionales como de pacientes. "Algunos tienen miedo de seguir tomándola, otros de que se la quiten", cuenta Elena. "Se ha creado una sensación de alerta innecesaria ", apostilla Romero, también jefe de sección de Aparato Digestivo del Hospital Universitario Virgen del Rocío.
"Sabemos que hay otro medicamento de segundo orden en estudio , pero todavía no se ha aprobado, ni sé si me va a funcionar". Además, de que "este también saldrá bajo la condición de un estudio adicional, por lo que podría volver a pasar lo mismo que con 'Ocaliva'". Me siento en el limbo y me asusta volver a donde estaba y que la enfermedad aumente ", manifiesta Elena.
Me siento en el limbo y me asusta volver a donde estaba y que la enfermedad aumente
Manuel Romero, también hepatólogo, trata con pacientes con la enfermedad en el hospital y utiliza 'Ocaliva': "Hasta ahora nos ha funcionado bien , si no fuera así, los profesionales seríamos los primeros en no usarlo". A lo que apostilla la presidenta de ALBI: "A los médicos también les quitarían una alternativa terapéutica".
Ahora, los pacientes están a la espera de la decisión de la Comisión Europea (CE). Será la AEMPS quién informará de la decisión final de la CE y, en su caso, de la fecha efectiva de la retirada de la comercialización de 'Ocaliva'.
"Es una sensación de inquietud e injusticia. Pedimos que le den una nueva oportunidad ", finaliza Elena.
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