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Medicure is committed to building a stronger future for families affected by PNPO deficiency. Our mission is to advance high-quality, science-driven therapies that support patients and the clinicians who care for them.
The journey behind MC-1 is rooted in the dedication of parents, clinicians, and researchers who have tirelessly worked to bring attention to PNPO deficiency - a rare genetic condition that can cause drug-resistant neonatal seizures and demands prompt, reliable treatment. Their advocacy continues to highlight the urgent need for dependable therapeutic options.
Medicure is proud to stand with this community. With clinical experience in more than 3,000 patients treated with MC-1 for various other indications, and by applying our scientific expertise, manufacturing capabilities, and regulatory experience, we are working to create a more reliable path forward for patients who depend on P5P. As MC-1 progresses through Phase 3 clinical evaluation and benefits from FDA orphan drug and rare pediatric disease designations, our focus remains clear: science with purpose, quality with compassion, and innovation that puts families first.
Pyridox (am) ine 5'-phosphate oxidase (PNPO) deficiency is an inborn error of vitamin B6 metabolism, which causes an epileptic encephalopathy. This deficiency is caused by mutations in the PNPO gene encoding this enzyme. Intractable neonatal epileptic encephalopathy within the neonatal period is the classical presentation of PNPO deficiency. Intractable neonatal epileptic encephalopathy is characterized by the onset, shortly after birth, of drug-resistant seizures associated with severe neurological dysfunction.
MC-1 has received both Rare Pediatric Disease Designation and Orphan Drug Designation from the FDA for the treatment of seizures associated with PNPO deficiency. Additionally, the European Medicines Agency ("EMA") has granted an Orphan Drug Designation to MC-1 for the treatment of PNPO deficiency. Medicure also received fast track designation for use of MC-1 for the treatment of PNPO deficiency, which will facilitate the review of Medicure's New Drug Application ("NDA") by the FDA.
If MC-1 is approved, Medicure may be eligible for a Priority Review Voucher (PRV) a highly valuable asset that can accelerate the review of a future therapy or be sold to support Medicure's continued growth and rare-disease research efforts.
Medicure is conducting a Phase 3, prospective, open-label, multi-center study to assess the safety and efficacy of MC-1 in patients with confirmed PNPO deficiency via genetic analysis (MEND-PNPO). For more information about this study, please visit clinicaltrials.gov
View our Expanded Access Policy for MC-1
Laura Cole, PhD
Project Manager
Telephone: 204-487-7412
Email: lcole@medicure.com
In 1997, I founded Medicure with a vision to bring our investigational therapy MC-1 from the bench to patients who might benefit from it. Early clinical studies showed promise, and MC-1 progressed into large-scale evaluation, including the Phase 3 MEND-CABG II trial involving more than 3,000 patients undergoing coronary artery bypass graft (CABG) surgery. Although the trial did not meet its primary endpoint, the experience shaped who we are today.
Over a decade later, thanks to the dedication of parents, clinicians, and researchers raising awareness of PNPO deficiency-and supported by U.S. initiatives that encourage the development of therapies for ultra-rare diseases-we returned to MC-1 with renewed purpose. Today, MC-1 is again in Phase 3 clinical evaluation, this time for patients with PNPO deficiency, with FDA Fast Track, Orphan Drug, and Rare Pediatric Disease designations guiding the path forward.
We are deeply committed to completing the MEND-PNPO study and learning what MC-1 may offer this community.

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