Availability of Endari Not Affected by COVID-19 Pandemic, Emmaus Says

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by David Melamed, PhD |

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Endari and COVID-19

The supply of the sickle cell disease (SCD) medication Endari (L-glutamine) will not be affected by the ongoing COVID-19 outbreak, Emmaus Life Sciences said in an update to the SCD community

While closely monitoring the pandemic, the company said its supply of Endari is large enough to meet current and projected future needs.

Emmaus is also confident that home deliveries of Endari will remain on schedule, as partnerships with pharmacies and clinics will remain in place.

“Our patients are our first priority and we have invested heavily in our distribution network,” George Sekulich, senior vice president of global commercialization of Emmaus, said in a press release. “We are confident the mail order and home delivery systems we have instituted with our specialty pharmacy network and GPO [group purchasing organization] in-house dispensing clinics will continue to give our patients the highest level of service.”

Working with Emmaus and others, the Sickle Cell Disease Association of America (SCDAA) has been providing updates to ensure that patients have reliable and up-to-date information about the current pandemic.

Among other measures, the latest SCDAA update recommends staying at home as much as possible, and maintaining proper hygiene and social distancing. It calls attention to the weakened immune system of SCD patients, which makes it even more important to avoid infection.

Patients are also advised to continue taking their SCD treatments, and to make sure they have a sufficient supply of medications to treat fever and other COVID-19 symptoms.

Endari is an oral formulation of L-glutamine, an amino acid that plays an important role in metabolism. It is indicated for SCD patients ages 5 and older.

It works by increasing the amount of this amino acid circulating freely in the blood, which is taken up by sickled red blood cells. As L-glutamine is broken down (metabolized), antioxidant molecules are produced that help to neutralize oxidative stress, and improve blood flow and oxygen transport. Oxidative stress, which sickled blood cells are particularly vulnerable to, occurs when free radicals outweigh antioxidant defenses.

Emmaus is also evaluating whether an oral rehydration therapy that includes Endari may help people infected with this coronavirus to recover.

This therapy is given to prevent dehydration, typically consisting of water, glucose, and salts to normalize the amount of fluids, sugars, and electrolytes in the body.

“We are looking into the possibility of providing our prescription grade L-glutamine as part of the oral rehydration therapy (ORT) that some patients might need to mitigate the impact of the coronavirus,” said Yutaka Niihara, MD, the Chairman and CEO of Emmaus.

“A study regarding ORT has suggested that an oral hydration solution containing glutamine and glucose might be superior to conventional glucose ORT in viral enteritis [inflammation of the small intestine], but further study is warranted to confirm that hypothesis,” Niihara added.