Sequana Medical announces additional alfapump data supporting strong and durable clinical profile; PMA on track for year-end submission

19 October 2023, 07:00 am CEST

  • One-year alfapump data from POSEIDON shows safety and strong efficacy profile is maintained at 12 months
  • Patient preference study indicates that US patients have a strong preference for the alfapump vs large volume paracentesisi
  • Matched interim analysis of patients from NACSELDii registry and POSEIDON pivotal cohort indicates that alfapump safety profile is comparable to standard of care
  • Positive pre-PMAiii meeting held with FDA to align on clinical data and benefit-risk analysis for the submission package
  • On track for PMA submission by year end

Conference call with live webcast by Sequana Medical today at 03:00 pm CEST / 09:00 am EST

Ghent, Belgium – 19 October 2023 – Sequana Medical NV (Euronext Brussels: SEQUA) (the "Company" or "Sequana Medical"), a pioneer in the treatment of fluid overload in liver disease, heart failure and cancer, today announces additional positive data supporting i) maintenance of alfapump’s safety and strong efficacy profile at 12 months, ii) safety in line with a matched cohort of patients from the NACSELD registry, and iii) strong preference amongst US patients for alfapump versus standard of care, as well as completion of a positive meeting with the FDA to align on clinical data and benefit-risk analysis for the PMA submission package which is on track for year end.

Gijs Klarenbeek, Senior Medical Advisor of Sequana Medical, commented: “These data are very positive and demonstrate that the alfapump continues to transform the lives of patients with recurrent or refractory ascites at one year post-implantation, maintaining the virtual elimination of needle paracentesis and clinically meaningful improvement in quality of life. The comparison of POSEIDON patients to a matched cohort of subjects in the NACSELD registry is reassuring as it reaffirms alfapump’s safety profile.”

Ian Crosbie, Chief Executive Officer at Sequana Medical, added: “We are delighted with these additional insights into alfapump’s long term benefit as well as the encouraging results from our patient preference study which indicates a strong preference amongst US patients for the alfapump. We are greatly encouraged by our recent pre-PMA meeting with the FDA, where we discussed the reported clinical data from our alfapump studies and benefit-risk analysis for the submission package. We look forward to submitting our PMA application by year end and continuing our preparations for launching the alfapump in the US and Canada."

One-year follow-up data from POSEIDON study

As seen in months 0-6 post implant, patients maintained the 100% median reduction in therapeutic paracentesis in the 7-12 month post-implant period vs the three month pre-implant period (n = 19). These data show that the alfapump has a sustained effect on controlling ascites, virtually eliminating the need for therapeutic paracentesis.

During the 7-12 month post-implant period, two patients had the alfapump explanted, one due to a urinary tract infection and one due to wound dehiscence and the number of Major Adverse Events (MAEsiv) and serious infections were in line with expectations. Importantly, creatine and eGFRv levels of alfapump-treated patients over 12-month follow-up indicated a stable renal function. Overall, these safety data indicate that the alfapump has a robust safety profile over long-term follow-up.

Quality of life, assessed through the physical component score of SF36 (a general health quality of life measure) and the Ascites Q score (a quality of life measure specific for patients with ascites), maintained a clinically meaningful improvement at 12 months post-implant vs three months pre-implant, despite disease progression.

The overall trend in survivalvi in patients implanted with the alfapump remained positive over a longer term, with a Kaplan-Meier estimate indicating over 70% survival probability at 12 and 18 months post-implant. This compares favourably with the published literature reporting a predicted survival probability for refractory ascites patients with a similar MELDvii score and receiving paracentesis of approximately 17% at 12 months and 5% at 18 monthsviii.

Data from the POSEIDON study will be submitted for publication in a peer-reviewed journal. The Company will update the market as soon as it is published.

Outcome Patient Preference study

The patient preference study was conducted by RTI Health Solutions, thought leaders in the field. The rigorous study design was pre-discussed with the FDA and utilizes a discrete-choice experiment (DCEix) methodology to elicit preferences of US patients with a physician-confirmed diagnosis of recurrent or refractory ascites due to liver cirrhosis for attributes of an implantable pump as a novel interventional treatment for ascites. Patients were surveyed for the risk of treatment-related adverse events they would be willing to accept (risk tolerance) to achieve specific improvements in treatment efficacy (desired benefits). In total, 125 US patients with a comparable patient profile as the Pivotal Cohort in the POSEIDON study, completed the survey.

Top-line results presented in the table below indicate that, on average, patients are willing to accept levels of risks greater than those observed in the POSEIDON study in exchange for improvements in treatment efficacy less than or equal to those observed in the POSEIDON study.

Risk tolerance (over 6 months)

Patient preference study

Maximum acceptable risk

POSEIDON pivotal cohort

Observed rate

Major surgery or death



Minor procedure



Serious infection or AKI resulting in hospitalization



Desired benefits

Patient preference study

POSEIDON pivotal cohort

Reduction in frequency of paracentesis


100% (median)

Additional ascites good health days each month


>10 (mean)

Reduction in paracentesis frequency and additional ascites good health days are important attributes for a novel interventional treatment for ascites. On average, patients responded with a 65% likelihood of selecting a treatment profile like the alfapump vs regular paracentesis procedures and no implanted pump.

These data support the premise that alfapump is a desirable treatment option for the majority of patients.

Matched interim analysis of NACSELD registry and POSEIDON pivotal cohort

The North American Consortium for the Study of End Stage Liver Disease (NACSELD) is a consortium of tertiary-care hepatology centers in North America formed to study patients with cirrhosis. NASCELD-III is an IRBx approved registry of outpatients with cirrhosis which was initiated in 2019 at ten centers in North America.

A matched cohort analysis was conducted by an independent group comparing outcomes of decompensated cirrhosis patients from the NACSELD-III registry to those from the POSEIDON study. Forty decompensated ascites patients from NACSELD-III were matched to the forty patients from the Pivotal Cohort in the POSEIDON study, using baseline Ascites-Q score (reflecting burden of disease before alfapump implantation) and sex. Patients were also comparable for age and baseline MELD score after matching.

Results for all cause hospitalization and death within six months were similar between the NACSELD-III registry matched patients and the POSEIDON pivotal cohort.

Six month dataxi

NACSELD-III Registry Matched Patients

POSEIDON Pivotal Cohortxii

Any Death or Hospitalization

55.0% (22/40)

55.0% (22/40)


12.5% (5/40)

12.5% (5/40)


42.5% (17/40)

42.5% (17/40)

Median # of hospitalizations (min, max)

1 (0, 5)

1 (0, 4)

Liver Transplant

7.5% (3/40)

5.0% (2/40)

This analysis indicates that the safety profile of the alfapump is in line with expectations and comparable to standard paracentesis procedures.

Data from the matched cohort analysis together with the positive data from the POSEIDON study indicate that patients implanted with the alfapump benefit from significantly reduced number of paracentesis procedures and an improved quality of life without an increased risk of death or hospitalization compared to standard of care.

Details Conference Call and Webcast by Sequana Medical

Sequana Medical management will host a conference call with a live webcast presentation today at 03:00 pm CEST / 09:00 am EST.

  • Registration webcast: please click here
  • Registration conference call (only if you wish to participate in the Q&A): please click here. Once registered, you will receive dial-in numbers and a confirmation code.

The webcast and conference call will be conducted in English and a replay will be available on Sequana Medical’s website shortly after.