Alexion Receives Positive CHMP Opinion for ULTOMIRIS® (ravulizumab) in Adults with Paroxysmal Nocturnal Hemoglobinuria (PNH)

– Final European Commission decision anticipated in June 2019 –

– ULTOMIRIS has the potential to become the new standard of care for
both complement inhibitor-naïve patients and patients switching from
SOLIRIS^® (eculizumab) –

BOSTON & ZURICH–(BUSINESS WIRE)–Alexion
Pharmaceuticals, Inc. (NASDAQ:ALXN) today announced that the
European Medicines Agency’s (EMA) Committee for Medicinal Products for
Human Use (CHMP) has adopted a positive opinion, recommending marketing
authorization for ULTOMIRIS^® (ravulizumab), the first and
only long-acting C5 complement inhibitor administered every eight weeks.
The recommended indication is for the treatment of adult patients with
paroxysmal nocturnal haemoglobinuria (PNH) with haemolysis with clinical
symptoms indicative of high disease activity,¹ and also for
adult patients who are clinically stable² after having been
treated with SOLIRIS^® (eculizumab) for at least the past six
months. PNH is a severe, complement-mediated ultra-rare disease that can
cause a wide range of debilitating symptoms and complications, including
thrombosis, which can occur throughout the body and result in organ
damage and premature death.^{3,4,5,6,7,8,9,10}

“This critical milestone brings us one step closer to our goal of
bringing ULTOMIRIS to patients with PNH in the EU,” said John Orloff,
M.D., Executive Vice President and Head of Research & Development at
Alexion. “Immediate and complete C5 inhibition sustained for eight weeks
can provide meaningful benefits for patients and their families.
ULTOMIRIS has the potential to become the new standard of care for
patients with PNH based on the totality of our Phase 3 data and the
reduction from 26 infusions per year with SOLIRIS to only six or seven
for ULTOMIRIS.”

The CHMP opinion is based on comprehensive results from two Phase 3
studies, which represent the largest Phase 3 program ever conducted in
PNH.^11,12 In these studies, which included more than 440
patients who had either never been treated with a complement inhibitor
before,¹¹ or who had been stable on SOLIRIS,¹² the
efficacy of ULTOMIRIS administered every eight weeks was non-inferior to
the efficacy of SOLIRIS administered every two weeks on all 11
endpoints. The safety profile of ULTOMIRIS was similar to that of
SOLIRIS. Additional data showed that ULTOMIRIS provided immediate and
complete C5 inhibition that was sustained for eight weeks,¹³
and that ULTOMIRIS eliminated breakthrough hemolysis associated with
incomplete C5 inhibition.¹⁴ The entire clinical development
program for ULTOMIRIS in PNH to date represents more than 750 patient
years of experience.

The European Commission will review the CHMP recommendation and
typically delivers its final decision within two months. The U.S. Food
and Drug Administration (FDA) approved ULTOMIRIS (ravulizumab-cwvz) for
adult patients with PNH on December
21, 2018. Regulatory authorities in Japan are reviewing Alexion’s
application for the approval of ULTOMIRIS as a treatment for patients
with PNH.

About Paroxysmal Nocturnal Hemoglobinuria (PNH)
Paroxysmal
nocturnal hemoglobinuria (PNH) is a chronic, progressive, debilitating
and life-threatening ultra-rare blood disorder characterized by
hemolysis (destruction of red blood cells) that is mediated by an
uncontrolled activation of the complement system, a component of the
body’s immune system.^3,4,15 PNH can strike men and women of
all races, backgrounds and ages without warning, with an average age of
onset in the early 30s.^3,16 PNH often goes unrecognized, with
delays in diagnosis ranging from one to more than five years.¹⁷
Patients with PNH may experience a wide range of signs and symptoms,
such as fatigue, difficulty swallowing, shortness of breath, abdominal
pain, erectile dysfunction, dark-colored urine and anemia.^{5,6,7,8,9,10,15}
The most devastating consequence of chronic hemolysis is thrombosis,
which can occur in blood vessels throughout the body, damage vital
organs and cause premature death.¹⁸ The first thrombotic
event can be fatal.^3,16,19 Despite historical supportive
care, including transfusion and anticoagulation management, 20 to 35
percent of patients with PNH die within five to 10 years of diagnosis.^20,21
Patients with certain types of hemolytic anemia, bone marrow
disorders and unexplained venous or arterial thrombosis are at increased
risk of PNH.^{15,22,23,24,25,26}

About ULTOMIRIS^®
ULTOMIRIS
(ravulizumab-cwvz), the first and only long-acting C5 inhibitor
administered every eight weeks, is approved in the U.S. as a treatment
for adults with paroxysmal nocturnal hemoglobinuria (PNH). ULTOMIRIS
works by inhibiting the C5 protein in the terminal complement cascade, a
part of the body’s immune system. The terminal complement cascade, when
activated in an uncontrolled manner, plays a role in severe ultra-rare
disorders like PNH, atypical hemolytic uremic syndrome (aHUS),
anti-acetylcholine receptor (AchR) antibody-positive myasthenia gravis
(MG) and anti-aquaporin-4 (AQP4) auto-antibody-positive neuromyelitis
optica spectrum disorder (NMOSD). Regulatory authorities in the European
Union (EU) and Japan are reviewing applications for the approval of
ULTOMIRIS as a treatment for adult patients and patients with PNH,
respectively. In Phase 3 clinical studies in complement inhibitor-naïve
patients with PNH¹¹ and patients with PNH who had been stable
on SOLIRIS^® (eculizumab),¹² intravenous treatment
with ULTOMIRIS every eight weeks demonstrated non-inferiority to
intravenous treatment with SOLIRIS every two weeks on all 11 endpoints.

The Phase 3 study of ULTOMIRIS, administered intravenously every eight
weeks in adult patients with aHUS, met
its primary objective. Alexion has submitted a supplemental
Biologics License Application (sBLA) to the U.S. Food and Drug
Administration (FDA) for approval of ULTOMIRIS as a treatment for
patients with aHUS and plans to submit similar applications in the EU
and Japan later in 2019. ULTOMIRIS is also currently being evaluated in
a Phase 3 clinical study in children and adolescents with aHUS,
administered intravenously every eight weeks. Alexion has initiated a
Phase 3 study of ULTOMIRIS, intravenously administered every eight
weeks, as a potential treatment for patients with generalized MG (gMG),
and is planning to initiate a Phase 3 in patients with NMOSD. In
addition, Alexion has initiated Phase 3 studies of ULTOMIRIS delivered
subcutaneously once per week as a potential treatment for patients with
PNH, aHUS and gMG.

ULTOMIRIS has received Orphan Drug Designation (ODD) for the treatment
of patients with PNH in the U.S., EU and Japan and for the subcutaneous
treatment of patients with aHUS in the U.S.

U.S. Indication of ULTOMIRIS^®
(ravulizumab-cwvz)
ULTOMIRIS is a prescription medicine called
a monoclonal antibody. ULTOMIRIS is used to treat adults with a disease
called paroxysmal nocturnal hemoglobinuria (PNH). It is not known if
ULTOMIRIS is safe and effective in children.

U.S. Important Safety Information for ULTOMIRIS^®
(ravulizumab-cwvz)
ULTOMIRIS is a medicine that affects the
immune system. ULTOMIRIS can lower the ability of the immune system to
fight infections. ULTOMIRIS increases the chance of getting serious and
life-threatening meningococcal infections. Meningococcal infections may
quickly become life-threatening and cause death if not recognized and
treated early.

Meningococcal vaccines must be received at least 2 weeks before the
first dose of ULTOMIRIS if one has not already had this vaccine. If
one’s doctor decided that urgent treatment with ULTOMIRIS is needed,
meningococcal vaccination should be administered as soon as possible. If
one has not been vaccinated and ULTOMIRIS therapy must be initiated
immediately, 2 weeks of antibiotics should also be administered with the
vaccinations. If one had a meningococcal vaccine in the past, additional
vaccination might be needed before starting ULTOMIRIS. Call one’s doctor
or get emergency medical care right away if any of these signs and
symptoms of a meningococcal infection occur: headache with nausea or
vomiting, headache with a stiff neck or stiff back, fever and a rash,
muscle aches with flu-like symptoms, headache and fever, fever,
confusion, and eyes sensitive to light.

ULTOMIRIS is only available through a program called the ULTOMIRIS
REMS.

ULTOMIRIS may also increase the risk of other types of serious
infections. People who take ULTOMIRIS may have an increased risk of
getting infections caused by Streptococcus pneumoniae and Haemophilus
influenzae. Certain people may also have an increased risk of
gonorrhea infection. To find out if one is at risk for gonorrhea
infection, about gonorrhea prevention, and regular testing, talk to the
healthcare provider. Call the healthcare provider right away if one has
any new signs or symptoms of infection.

Before one receives ULTOMIRIS, tell the doctor about all of the medical
conditions, including if one: has an infection or fever, is pregnant or
plans to become pregnant, and is breastfeeding or plans to breastfeed.
It is not known if ULTOMIRIS will harm an unborn baby. It is not known
if ULTOMIRIS passes into the breast milk. One should not breast feed
during treatment and for 8 months after one’s final dose of ULTOMIRIS.

Tell the doctor about all the medicines one takes, including
prescription and over-the-counter medicines, vitamins, and herbal
supplements. ULTOMIRIS and other medicines can affect each other causing
side effects. Know the medications one takes and the vaccines one
receives. Keep a list of them to show the doctor and pharmacist when one
gets a new medicine.

If one stops receiving ULTOMIRIS, the doctor will need to monitor
closely for at least 16 weeks after one stops ULTOMIRIS. Stopping
ULTOMIRIS may cause breakdown of the red blood cells due to PNH.
Symptoms or problems that can happen due to red blood cell breakdown
include: drop in the number of the red blood cell count, tiredness,
blood in the urine, stomach-area (abdomen) pain, blood clots, shortness
of breath, trouble swallowing, and erectile dysfunction (ED) in males.

ULTOMIRIS can cause serious side effects including infusion reactions.
Infusion reactions may happen during one’s ULTOMIRIS infusion. Symptoms
of an infusion reaction with ULTOMIRIS may include lower back pain, pain
with the infusion, or feeling faint. Tell the doctor or nurse right away
if these symptoms develop, or any other symptoms during the ULTOMIRIS
infusion that may mean one is having a serious infusion reaction,
including: chest pain, trouble breathing or shortness of breath,
swelling of the face, tongue, or throat, and feel faint or pass out.
One’s doctor will treat the symptoms as needed. The most common side
effects of ULTOMIRIS are upper respiratory infection and headache.

For more information, please see the full U.S. Prescribing
Information and Medication
Guide for ULTOMIRIS, including Boxed WARNING regarding serious and
life-threatening meningococcal infections/sepsis, also available at: www.ultomiris.com.

About SOLIRIS^® (eculizumab)
SOLIRIS^®
is a first-in-class complement inhibitor that works by inhibiting the C5
protein in the terminal part of the complement cascade, a part of the
immune system. The terminal complement cascade, when activated in an
uncontrolled manner, plays a role in severe rare and ultra-rare
disorders like paroxysmal nocturnal hemoglobinuria (PNH), atypical
hemolytic uremic syndrome (aHUS), and anti-acetylcholine receptor (AchR)
antibody-positive myasthenia gravis (MG). SOLIRIS is approved in the
U.S., EU, Japan and other countries as a treatment for adult patients
with PNH and for adults and children with aHUS. SOLIRIS is not indicated
for the treatment of patients with Shiga-toxin E. coli-related hemolytic
uremic syndrome (STEC-HUS). In the U.S., SOLIRIS is also approved for
the treatment of adult patients with generalized MG (gMG) who are
anti-AchR antibody-positive, in the EU as the first and only treatment
of refractory gMG in adults who are anti-AchR antibody-positive and in
Japan for the treatment of patients with gMG who are AChR
antibody-positive and whose symptoms are difficult to control with
high-dose intravenous immunoglobulin (IVIG) therapy or plasmapheresis
(PLEX).

SOLIRIS has received Orphan Drug Designation (ODD) for the treatment of
patients with PNH in the U.S., EU, Japan and many other countries, for
the treatment of patients with aHUS in the U.S., EU, and many other
countries, for the treatment of patients with MG in the U.S. and EU and
for the treatment of patients with refractory gMG in Japan. Alexion and
SOLIRIS have received some of the pharmaceutical industry’s highest
honors for the medical innovation in complement inhibition: the Prix
Galien USA (2008, Best Biotechnology Product) and France (2009, Rare
Disease Treatment).

U.S. Indication of SOLIRIS^® (eculizumab)
SOLIRIS
is a prescription medicine called a monoclonal antibody. SOLIRIS is used
to treat patients with a disease called Paroxysmal Nocturnal
Hemoglobinuria (PNH). It is not known if SOLIRIS is safe and effective
in children with PNH.

U.S. Important Safety Information for SOLIRIS^®
(eculizumab)
SOLIRIS is a medicine that affects the immune
system. SOLIRIS can lower the ability of the immune system to fight
infections. SOLIRIS increases the chance of getting serious and
life-threatening meningococcal infections. Meningococcal infections may
quickly become life-threatening and cause death if not recognized and
treated early.

Meningococcal vaccines must be received at least 2 weeks before the
first dose of SOLIRIS if one has not already had this vaccine. If one’s
doctor decided that urgent treatment with SOLIRIS is needed,
meningococcal vaccination should be administered as soon as possible. If
one has not been vaccinated and SOLIRIS therapy must be initiated
immediately, 2 weeks of antibiotics should also be administered with the
vaccinations. If one had a meningococcal vaccine in the past, additional
vaccination might be needed before starting SOLIRIS. Call one’s doctor
or get emergency medical care right away if any of these signs and
symptoms of a meningococcal infection occur: headache with nausea or
vomiting, headache and fever, headache with a stiff neck or stiff back,
fever, fever and a rash, confusion, muscle aches with flu-like symptoms,
and eyes sensitive to light.

SOLIRIS is only available through a program called the SOLIRIS
REMS.

SOLIRIS may also increase the risk of other types of serious infections.
If one’s child is treated with SOLIRIS, make sure that the child
receives vaccinations against Streptococcus pneumoniae and Haemophilus
influenzae type b (Hib). Certain people may be at risk of serious
infections with gonorrhea. Talk to the doctor about whether one is at
risk for gonorrhea infection, about gonorrhea prevention, and regular
testing. Certain fungal infections (Aspergillus) may also happen if one
takes SOLIRIS and has a weak immune system or a low white blood cell
count.

Before one receives SOLIRIS, tell the doctor about all of the medical
conditions, including if one: has an infection or fever, is pregnant or
plans to become pregnant, and is breastfeeding or plans to breastfeed.
It is not known if SOLIRIS will harm an unborn baby. It is not known if
SOLIRIS passes into the breast milk.

Tell the doctor about all the medicines one takes, including
prescription and over-the-counter medicines, vitamins, and herbal
supplements. SOLIRIS and other medicines can affect each other causing
side effects.

It is important that one: has all recommended vaccinations before
starting SOLIRIS, receives 2 weeks of antibiotics if one immediately
starts SOLIRIS, and stays up-to-date with all recommended vaccinations
during treatment with SOLIRIS. Know the medications one takes and the
vaccines one receives. Keep a list of them to show the doctor and
pharmacist when one gets a new medicine.

If one has PNH, the doctor will need to monitor closely for at least 8
weeks after stopping SOLIRIS. Stopping treatment with SOLIRIS may cause
breakdown of the red blood cells due to PNH. Symptoms or problems that
can happen due to red blood cell breakdown include: drop in the number
of the red blood cell count, drop in the platelet counts, confusion,
kidney problems, blood clots, difficulty breathing, and chest pain.

SOLIRIS can cause serious side effects including serious allergic
reactions. Serious allergic reactions can happen during one’s SOLIRIS
infusion. Tell the doctor or nurse right away if one gets any of these
symptoms during the SOLIRIS infusion: chest pain, trouble breathing or
shortness of breath, swelling of the face, tongue, or throat, and
feeling faint or pass out. If one has an allergic reaction to SOLIRIS,
the doctor may need to infuse SOLIRIS more slowly, or stop SOLIRIS. The
most common side effects in people with PNH treated with SOLIRIS
include: headache, pain or swelling of the nose or throat
(nasopharyngitis), back pain, and nausea.

For more information, please see the accompanying full U.S. Prescribing
Information and Medication
Guide for SOLIRIS, including Boxed WARNING regarding serious and
life-threatening meningococcal infections, also available at: www.soliris.net.

About Alexion
Alexion is a global biopharmaceutical company
focused on serving patients and families affected by rare diseases
through the discovery, development and commercialization of
life-changing therapies. As the global leader in complement biology and
inhibition for more than 20 years, Alexion has developed and
commercializes two approved complement inhibitors to treat patients with
paroxysmal nocturnal hemoglobinuria (PNH) as well as the first and only
approved complement inhibitor to treat atypical hemolytic uremic
syndrome (aHUS) and anti-acetylcholine receptor (AchR) antibody-positive
generalized myasthenia gravis (gMG), and is also developing it for
patients with neuromyelitis optica spectrum disorder (NMOSD). Alexion
also has two highly innovative enzyme replacement therapies for patients
with life-threatening and ultra-rare metabolic disorders,
hypophosphatasia (HPP) and lysosomal acid lipase deficiency (LAL-D). In
addition, the company is developing several mid-to-late-stage therapies,
including a second complement inhibitor, a copper-binding agent for
Wilson disease and an anti-neonatal Fc receptor (FcRn) antibody for rare
Immunoglobulin G (IgG)-mediated diseases as well as several early-stage
therapies, including one for light chain (AL) amyloidosis and a second
anti-FcRn therapy. Alexion focuses its research efforts on novel
molecules and targets in the complement cascade and its development
efforts on the core therapeutic areas of hematology, nephrology,
neurology, and metabolic disorders. Alexion has been named to the Forbes
list of the World’s Most Innovative Companies seven years in a row and
is headquartered in Boston, Massachusetts’ Innovation District. The
company also has offices around the globe and serves patients in more
than 50 countries. This press release and further information about
Alexion can be found at: www.alexion.com.

[ALXN-G]

Forward-Looking Statement
This press release contains
forward-looking statements that involve risks and uncertainties relating
to future events and the future performance of Alexion, including
statements related to: the final European Commission decision on the
potential approval of ULTOMIRIS^® in adults with PNH is
anticipated in June 2019; the Company’s goal is to bringing ULTOMIRIS to
patients with PNH in the EU; ULTOMIRIS has the potential to become the
new standard of care for patients with PNH; the expected timing of the
final decision of the European Commission with respect to pharmaceutical
product approval including ULTOMIRIS for PNH; Alexion’s future plans for
submitting supplemental Biologics License Application and similar
applications to the applicable regulatory authorities for ULTOMIRIS as a
therapy for certain indications, including the anticipated timing of
certain filings in the US, EU and Japan later in 2019; ULTOMIRIS is a
potential treatment for patients with generalized MG (gMG); the Company
is planning to initiate a Phase 3 clinical trial in patients with NMOSD;
ULTOMIRIS can provide meaningful benefits for patients with PNH and
their families; the anticipated timing of the review and decision of
regulatory agencies with respect to the potential approval of ULTOMIRIS
as a treatment for PNH in certain jurisdictions; future plans for the
evaluation and clinical trials of ULTOMIRIS in additional indications
and patient populations; and the potential medical benefits of ULTOMIRIS
for the treatment of PNH and other diseases. Forward-looking statements
are subject to factors that may cause Alexion’s results and plans to
differ materially from those expected by these forward looking
statements, including for example: our inability to facilitate the
timely conversion of PNH patients (and any future indications) from
Soliris to ULTOMIRIS; payer, physician and patient acceptance of
ULTOMIRIS as an alternative to Soliris; ULTOMIRIS does not gain market
acceptance and/or does not become the standard of care for patients with
PNH and/or is not recognized by patients and physicians as the standard
of care for patients with PNH; the benefits (including safety and
efficacy) of ULTOMIRIS evidenced in clinical trials are not witnessed in
a broader patient population; any potential post-approval restrictions
that the FDA or any other regulatory agency may impose on ULTOMIRIS;
ULTOMIRIS does not gain regulatory approval from the EMA or Japanese
regulatory authority as a treatment for PNH; ULTOMIRIS does not gain
approval from regulatory agencies as a treatment for indications beyond
PNH; delays (expected or unexpected) in the time it takes regulatory
agencies to review and make determinations on applications for the
marketing approval of our products (including ULTOMIRIS as a treatment
for PNH); inability to timely submit (or failure to submit) future
applications for regulatory approval for our products and product
candidates; inability to timely initiate (or failure to initiate) future
clinical trials due to safety issues, IRB decisions, expense or
unfavorable results from earlier trials (among others); our dependence
on sales from our principal product (SOLIRIS); future competition from
biosimilars and other products; decisions of regulatory authorities
regarding the adequacy of our research, marketing approval or material
limitations on the marketing of our products; delays or failure of
product candidates (including ULTOMIRIS) to obtain regulatory approval;
delays or the inability to launch product candidates due to regulatory
restrictions, anticipated expense or other matters; interruptions or
failures in the manufacture and supply of our products and our product
candidates; failure to satisfactorily address matters raised by the FDA
and other regulatory agencies; results in early stage clinical trials
may not be indicative of full results or results from later stage or
larger clinical trials (or broader patient populations) and do not
ensure regulatory approval; the possibility that results of clinical
trials are not predictive of safety and efficacy and potency of our
products (or we fail to adequately operate or manage our clinical
trials) which could cause us to halt trials, delay or prevent us from
making regulatory approval filings or result in denial of approval of
our product candidates; future product improvements may not be realized
due to expense or feasibility; uncertainty of long-term success in
developing, licensing or acquiring other product candidates or
additional indications for existing products; the possibility that
current rates of adoption of SOLIRIS in PNH, aHUS, gMG or other diseases
(and ULTOMIRIS in PNH in the US) are not sustained; the adequacy of our
pharmacovigilance and drug safety reporting processes; failure to
protect and enforce our data, intellectual property and proprietary
rights and the risks and uncertainties relating to intellectual property
claims and challenges against us (including intellectual property
lawsuits relating to ULTOMIRIS brought by third parties against Alexion
and inter partes review petitions submitted by third parties); the risk
that third party payers (including governmental agencies) will not
reimburse or continue to reimburse for the use of our products at
acceptable rates or at all; failure to realize the benefits and
potential of investments, collaborations, licenses and acquisitions;
delay of collection or reduction in reimbursement due to adverse
economic conditions or changes in government and private insurer
regulations and approaches to reimbursement; uncertainties surrounding
legal proceedings (including intellectual property suits initiated
against Alexion and our products), company investigations and government
investigations, including investigations of Alexion by the U.

Contacts

Alexion Pharmaceuticals, Inc.
Media
Arne Naeveke, PhD, +1
857-338-8597
Lauren Cettier, +41 44 457 4323
Or
Investors
Susan
Altschuller, PhD, +1 857-338-8788

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