Updated on 29 April 2013
EMA nod for Genzyme's matrix-induced autologous chondrocyte implantation (MACI) for repair of symptomatic, full-thickness knee cartilage defects
Singapore: European Medicines Agency's (EMA) Committee for Medicinal Products for Human Use (CHMP) has recommended marketing authorization for Genzyme's matrix-induced autologous chondrocyte implantation (MACI), an advanced-therapy medicinal product (ATMP), for the repair of symptomatic, full-thickness cartilage defects of the knee of three-to-20 cm2 in skeletally mature adult patients.
A number of surgical procedures aiming to repair cartilage have been developed to treat patients with articular cartilage defect of the knee. One of them is autologous chondrocyte implantation (ACI), a therapy based on tissue engineering which was first described in 1994. It uses chondrocytes, or cartilage cells, which are derived from the patient's own cartilage, grown outside the patient's body and then transplanted into the patient's lesions after several weeks. The benefit of ACI over other restoration techniques is that larger lesions can be treated.
MACI is a third-generation ACI product. Contrary to the previous generations, MACI uses a scaffold formed of porcine collagen on which autologous chondrocytes are seeded. At implantation, the scaffold is trimmed to the size and shape of the cartilage defect. The cells/collagen structure is held in place in the lesion with fibrin glue.
Being an ATMP, MACI was evaluated by the Agency's Committee for Advanced Therapies (CAT), which gave a positive opinion for the approval of MACI at its April 2013 meeting. The CHMP has now confirmed the CAT's opinion. Since the introduction of the European Union (EU) regulation on advanced therapies in 2007, the centralized procedure has become compulsory for ATMPs, such as gene-therapy, somatic cell-therapy or tissue-engineered medicines.
MACI was already authorized in certain EU countries before the regulation came into force, but in order to comply with the European legislation on ATMPs it had to be evaluated through the centralized procedure. MACI has now become the first combined tissue-engineering product recommended for approval across the EU. The CHMP opinion on MACI will now be sent to the European Commission for adoption of a marketing-authorization decision.