FDA decisions 2023: AstraZeneca, Viatris, Outlook and more
FDA decisions 2023: AstraZeneca, Viatris, Outlook and more
Published: Sep 07, 2023
By BioSpace Editorial Staff
The FDA was on a roll in the first half of 2023, approving more than two dozen novel treatments. And if the first six months is any indication, the biopharma industry should expect several more novel therapies to be greenlit, including a few more first-in-class treatments. But it’s not always good news that companies have to deliver to their stakeholders; the year has already seen its fair share of Complete Response Letters.
BioSpace looks forward to keeping you up to date on all the FDA’s action as we launch our FDA Decision Tracker.
September
Sept 6:
AstraZeneca will have to wait to add another indication to the label of blockbuster drug Ultomiris, as the FDA rejected the company’s supplemental application in neuromyelitis optica spectrum disorder (NMOSD), a rare autoimmune disease particularly affecting the optic nerve.
In its complete response letter, the regulator requested that AstraZeneca improve Ultomiris’ Risk Evaluation and Mitigation Strategy (REMS) strategy to further validate patients’ meningococcal vaccination status or prophylactic administration of antibiotics prior to treatment with the C5 complement inhibitor. The FDA did not cite any issues with Ultomiris’ efficacy or safety data from the Phase III CHAMPION-NMOSD trial.
Sept 5:
The FDA gave tentative approval to Viatris’ abacavir 60 mg/dolutegravir 5 mg/lamivudine 30 mg tablets to treat pediatric HIV patients. The nod came through President Joe Biden’s Emergency Plan for AIDS Relief (PEPFAR) program, and indicates that the formulation meets the FDA’s quality, safety and efficacy standards, according to Viatris’ press release. The Pennsylvania–based company has signed a licensing agreement for pediatric dolutegravir with the Medicines Patent Pool and a development agreement with ViiV Healthcare and the Clinton Health Access Initiative to produce and distribute the fixed-dose combination of abacavir/ dolutegravir/lamivudine.
While children account for 4% of people living with HIV, they made up 13% of AIDS-related deaths in 2022 due to a lack of antiretroviral therapy, Viatris stated in the same press release.
August
Aug 30:
Outlook Therapeutics lost nearly three-quarters of its market share after the FDA declined to approve ONS-5010, an investigational ophthalmic formulation of the cancer drug bevacizumab being developed for wet age-related macular degeneration (AMD). In its complete response letter (CRL), the FDA cited “several CMC issues, open observations from pre-approval manufacturing inspections and a lack of substantial evidence,” according to Outlook.
The New Jersey–based biopharma intends to request a formal meeting with the FDA to “further understand the BLA deficiencies and how best to resolve them,” Russell Trenary, the company’s president and CEO, said in a statement.
ONS-5010 is an ophthalmic formulation of bevacizumab, a VEGF inhibitor sold by Roche’s Genentech as Avastin for several types of cancer. In eye diseases, it prevents the interaction of VEGF with its receptors on the surface of endothelial cells, reducing endothelial cell proliferation, vascular leakage and the formation of new blood vessels in the retina.
Aug 29:
In what could be a major boon to its $4 billion–plus sales aspirations, BMS scored first-line status for Reblozyl in adult patients with anemia in low- to intermediate-risk myelodysplastic syndromes (MDS) who may require blood transfusions. First approved to treat MDS-related anemia in 2020 in patients who failed to respond to an erythropoiesis-stimulating (ESA) agent—the established front-line treatment—the treatment will now be available to patients who have not received ESA therapy.
The first-line nod was backed by interim data from the Phase III COMMANDS trial, which pitted Reblozyl against the ESA standard of care treatment, Amgen and Johnson & Johnson’s Epogen/Procrit. More than 58% of patients receiving BMS’s drug achieved transfusion independence versus 31% of the comparator. And while Reblozyl was previously only available to patients exhibiting ring sideroblasts—blood cells with iron deposits circling the nucleus—it is now approved to treat those with and without this common symptom.
Aug 24:
Sandoz, the generics and biosimilars arm of Novartis, has earned FDA approval for the first biosimilar drug to treat multiple sclerosis. Tyruko (natalizumab-sztn) is a biosimilar of Biogen’s treatment Tysabri (natalizumab), a monotherapy used to treat adults with relapsing forms of MS. The biosimilar is also approved to treat adults with Crohn’s disease, another approved indication for Tysabri. Both drugs come with the risk of opportunistic viral infection progressive multifocal leukoencephalopathy and will carry a boxed warning about the potentially severe complication.
Aug 24:
Gilead Sciences’ antiviral drug Veklury (remdesivir) earned a label expansion from the FDA, now cleared for COVID-19 patients with all stages of liver disease. The dose will be the same as it was for its originally approved uses in adult and pediatric patients with mild to moderate COVID-19 who are at high risk for progression to severe COVID-19. Veklury was the first drug to get full FDA approval for COVID-19. In July, the FDA approved another supplemental NDA that allowed it to be used across all stages of renal disease.
The FDA based its expansion for all stages of liver disease on the data from a Phase I trial that showed no new safety signals. Hepatic laboratory testing is recommended for all patients and the drug may need to be discontinued if alanine transaminase levels hit 10 times the high end of the normal range or liver inflammation develops.
Aug 21:
Pfizer’s respiratory syncytial virus vaccine Abrysvo won FDA approval for use in pregnant women to prevent RSV-associated lower respiratory tract disease in infants. Abrysvo is an unadjuvanted bivalent RSV prefusion F vaccine composed of two proteins that were selected specifically to optimize against the RSV A and B strains.
The vaccine was first approved in June 2023 for use in adults aged 60 years and above. However, the shot can now also be administered to pregnant women at 32 through 36 weeks of gestation to elicit immunity in their infants.
Data from the Phase III MATISSE trial supported the FDA’s approval. At the study’s prespecified interim analysis, Abrysvo had a vaccine efficacy of 81.8% for preventing medically attended severe RSV-associated lower respiratory tract disease (LRTD) 90 days after birth. This waned slightly to 69.4% at 180 days. The findings were published in The New England Journal of Medicine in April 2023.
Aug 18:
Neurocrine Biosciences got FDA approval to expand Ingrezza’s (valbenazine) label to include chorea in Huntington’s disease. Approved in 2017 to treat tardive dyskinesia, Ingrezza is a selective vesicular monoamine transporter 2 inhibitor.
In the company’s supplemental NDA, Neurocrine included data from the Phase III KINECT-HD trial and the ongoing KINECT-HD2 open-label study to establish the safety and efficacy of Ingrezza in the proposed indication. Data in a Lancet Neurology publication in May showed that Ingrezza treatment significantly reduced scores in the Unified Huntington’s Disease Rating Scale Total Maximal Chorea score by 3.2 units versus placebo, an effect that was statistically significant.
Ingrezza also outperformed placebo on secondary endpoints, including the Clinical Global Impression of Change and Patient Global Impression of Change response status. In clinical studies of Huntington’s disease, treatment-emergent adverse events included somnolence and sedation, urticaria, rash and insomnia.
Aug 18:
Regeneron Pharmaceuticals’ Veopoz (pozelimab) secured FDA approval as the first and only treatment indicated specifically for CHAPLE disease, also known as CD55-deficient protein-losing enteropathy, an ultra-rare hereditary disease that can cause potentially life-threatening gastrointestinal and cardiovascular symptoms. A fully human monoclonal antibody, Veopoz is approved for the treatment of adult and pediatric CHAPLE patients 1 year of age and older.
In February 2023, the FDA gave Priority Review to Regeneron’s investigational antibody, which works by binding to the C5 complement factor, thereby disrupting the complement cascade and preventing associated diseases. Regeneron presented Phase II/III data in its application for regulatory approval showing “rapid and sustained normalization” of albumin, one of the key markers of CHAPLE disease, in all 10 patients at 24 weeks. The treatment also eased symptoms such as increased bowel movements and abdominal pain.
Aug 18:
The FDA has expanded the label of Regeneron’s blockbuster eye therapy Eylea (aflibercept), allowing the administration of a higher 8-mg dose. Under the new high-dose regimen, Eylea injections will be given every four weeks for the first three months across all indications.
In diabetic retinopathy, the treatment can be administered every eight to 12 weeks thereafter, while the dosing interval can stretch up to 16 weeks in patients with wet age-related macular degenerationand diabetic macular edema. Eylea was previously approved in these indications but was limited to 2-mg doses.
Aug 16:
After two prior setbacks, Ipsen’s palovarotene finally earned FDA approval to treat fibrodysplasia ossificans progressive (FOP), the first treatment for the ultra-rare bone disease. Now to be sold under the brand name Sohonos, the oral medication is indicated for the reduction of heterotrophic ossification in adults and children with FOP.
The FDA approval is the culmination of a long and bumpy road for Ipsen’s FOP drug. The biotech first tried for an approval in 2021 but voluntarily withdrew its application in August of that year after the regulator asked for more data. Ipsen filed a resubmission a few months later, which the FDA rejected in December 2022 and requested additional information regarding the data that the company had already provided.
The FDA’s approval this week was backed by data from the Phase III MOVE trial, which according to Ipsen is the first and largest multicenter, open-label study in this space involving both adult and pediatric patients. In the trial, palovarotene reduced the annualized heterotrophic ossification by 54% compared with standard of care without introducing new safety signals.
Aug 14:
Following a nearly decade-long effort, Delcath Systems finally won the FDA’s greenlight for its Hepzato Kit for the liver-directed treatment of adult patients with metastatic uveal melanoma. Hepzato is a drug-device combination of melphalan—a well-established chemotherapeutic agent—and the company’s Hepatic Delivery System, which can directly administer the drug to the liver.
Delcath first sought FDA approval in August 2012. More than a year later, in September 2013, the regulator rejected the application, asking the company to perform another well-controlled randomized trial to better determine the safety and efficacy of the investigational product. In February 2023, nearly 10 years later, Delcath resubmitted its NDA.
The application contained data from the Phase III FOCUS study, a single-arm, open-label trial which enrolled 91 patients who were treated every six to eight weeks for up to a maximum of six cycles. FOCUS found that the drug-device combination had an overall response rate of 36.3%, including seven complete responders and 26 partial responders, with treatment response lasting for a median of 14 months. Patients treated with Hepzato saw a 73.6% disease control rate.
Aug 14:
In what is expected to become a multibillion-dollar blockbuster, Pfizer’s BCMAxCD3 bispecific antibody Elrexfio (elranatamab-bcmm) has secured an FDA accelerated approval as another off-the-shelf treatment option for patients with relapsed or refractory multiple myeloma (RRMM) who have received at least four prior lines of therapy. Elrexfio is being touted by Pfizer as the first off-the-shelf, ready-to-use fixed-dose subcutaneous therapeutic that targets the BCMA protein.
The FDA’s accelerated approval was supported by data from the Phase II MagnetisMM-3 study, which found that in heavily pretreated RRMM patients who had not yet received BCMA-directed therapy, Elrexfio had an overall response rate of 58%, with around 82% of responders maintaining improvements for at least nine months. In those with prior exposures to BCMA-directed therapies, Elrexfio elicited an overall response rate of 33%. The therapy comes with a boxed warning for cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome.
Aug 14:
Biotech company Revance Therapeutics has received its first therapeutic indication for Daxxify (daxibotulinumtoxinA-lanm) for the treatment of cervical dystonia in adults. Revance won approval based on data from the Phase III ASPEN 1 and ASPEN OLS trials in which Daxxify was found to be safe and effective at two separate injected doses with a median duration of effect of 24 and 20.3 weeks for the respective groups.
Daxxify, a neuromuscular blocking agent and acetylcholine release inhibitor that’s positioned as a rival to AbbVie’s Botox, was approved in September 2022 for the temporary improvement of moderate to severe frown lines in adults. According to Revance, the total U.S. therapeutic neuromodulator market opportunity for Daxxify is $2.5 billion, including the $345 million cervical dystonia market.
Aug 11:
J&J’s Janssen got the FDA’s greenlight for its PARP inhibitor Akeega (niraparib and abiraterone acetate), which is now authorized to treat BRCA-mutated metastatic castration-resistant prostate cancer. Akeega is the first dual-action tablet that combines the activity of a PARP inhibitor with abiraterone acetate, an androgen biosynthesis inhibitor sold by the company under the brand name Zytiga.
The approval covers a combination regimen of Akeega with prednisone and is based on data from the Phase III MAGNITUDE study, a randomized, double-blinded and placebo-controlled trial with 765 participants. Compared with Zytiga plus prednisone, the Akeega-based regimen significantly improved radiographic progression-free survival by 47% in BRCA-positive patients.
Aug 10:
Janssen also won the FDA’s accelerated approval for its first-in-class bispecific T cell engager Talvey (talquetamab) as a treatment for relapsed or refractory multiple myeloma. By targeting both the CD3 and the GPRC5D proteins, Talvey works by bringing together T cells and myeloma cells, allowing the body’s immune system to exert its anti-cancer effects.
The accelerated approval was based on a Phase II study in which an overall response rate of 73.6% was seen in patients with at least four prior lines of therapy. Response was durable for a median of 9.5 months in the lower dosing group. Median duration of response was not yet reached in the higher dose arm. Like Pfizer’s Elrexfio, Talvey comes with a boxed warning for cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome.
Aug 9:
Nearly three years after first winning accelerated FDA approval of Gavreto (pralsetinib) in metastatic non-small cell lung cancer (NSCLC) with RET fusions, Genentech (Roche) and Blueprint Medicines announced the drug’s conversion to full approval.
RET fusions are present in just 1-2% of NSCLC cases, according to Genentech. The original FDA nod was based on an overall response rate (ORR) of 57% and median duration of response (DoR) that had not yet been reached in 114 patients in the Phase I/II ARROW study. The conversion to traditional approval was granted based on an additional 123 patients and 25 months of further follow-up. Treatment-naïve patients saw a median DoR of 13.4 months with a 78% ORR, while patients previously treated with platinum-based chemotherapy had an ORR of 63% and DoR of 38.8 months.
Aug 9:
Shares of Galera Therapeutics plummeted more than 80% Wednesday after the FDA rejected the company’s application for avasopasem manganese (avasopasem). The drug was being proposed to treat severe oral mucositis (SOM)—or mouth sores—resulting from radiotherapy in patients with head and neck cancer.
In its Complete Response Letter, FDA said results from the Phase III ROMAN trial, in combination with the GT-201 trial, were “not sufficiently persuasive to establish substantial evidence of avasopasem’s effectiveness and safety” in reducing these mouth sores. Galera will need to provide results from an additional clinical trial in order to resubmit the application, the Malvern, Penn–based company said in a press release. Impacts for the company’s workforce were swift, as Galera announced it would reduce its numbers by approximately 70% in order to extend its cash runway.
Aug 4:
In another milestone moment, the FDA approved Biogen and Sage Therapeutics’ zuranolone—henceforth Zurzuvae—as the first pill for postpartum depression (PPD). Zurzuvae is only the second treatment for this indication and the first pill that can be taken at home. The drug—a neuroactive steroid that works as a positive allosteric modulator of GABA-A receptors—also acts much more quickly than other approved depression treatments, with improved symptoms seen in trials in as few as three days.
Despite the significance of the approval, Sage and Biogen had sought a much larger slice of the depression market, but this will have to wait as the FDA rejected zuranolone for the treatment of major depressive disorder (MDD). In its Complete Response Letter, the FDA stated that the application did not provide “substantial evidence of effectiveness” to support its approval and that further research would be required. On a conference call following the decision, Sage CEO Barry Greene said only that the companies are “reviewing the feedback and evaluating next steps.”
Aug 4:
Mesoblast will have to provide more data before the FDA may approve its BLA for remestemcel-L for the treatment of pediatric steroid-refractory acute graft versus host disease (SR-aGVHD). In response to the FDA’s complete response letter (CRL), announced Friday by Mesoblast, the New York–based biopharma will “conduct a targeted, controlled study in the highest-risk adults with the greatest mortality.” Mesoblast noted that the adult study is in line with its overall commercial strategy, which involves a progression from pediatric to adult SR-aGVHD indications. This is the second rejection for remestemcel-L, after the FDA first turned down Mesoblast’s application in 2020, despite a 9-1 advisory committee vote in its favor.
Aug 3:
In 2019, the FDA approved the first vaccine for Ebola, a deadly viral hemorrhagic fever, for adults 18 years and older. Now, that vaccine—Ervebo, developed by Merck—is available to children 12 months and older. The FDA’s decision follows a recommendation on July 20 by the European Medicines Agency’s Committee for Medicinal Products for Human Use to expand Ervebo’s label to children one year and older. The vaccine is only FDA-approved to protect against the Zaire ebolavirus and not other species of Ebola or Marburgvirus and the duration of protection is unknown, according to Merck.
Aug 2:
Taiho Oncology picked up a label expansion for its cancer drug Lonsurf (tipiracil), alone or as part of a combination regimen with Roche’s Avastin (bevacizumab) in metastatic colorectal cancer (mCRC). The nod came nearly eight years after Lonsurf first won approval as a monotherapy for mCRC in Sept. 2015. The expansion pertains to patients who had previously been treated with an anti-VEGF biologic agent and fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy. Patients whose cancer has the wild-type RAS protein and who have previously received an anti-EGFR therapy are also eligible for the new combination.
The FDA’s decision was supported by the Phase III SUNLIGHT trial, where the Lonsurf–Avastin combination led to a median overall survival of 10.8 months versus 7.5 months on Lonsurf monotherapy, for a 39% reduction in risk of death.
July
July 31:
GSK’s Jemperli (dostarlimab-gxly) won FDA approval as a frontline treatment for primary advanced or recurrent endometrial cancer. The regulatory nod is the first new frontline treatment for patients whose cancer is mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H) in decades, according to GSK. Jemperli is also the first immuno-oncology treatment and PD-1 inhibitor to be authorized for frontline use in this patient population.
Jemperli, an anti-PD-1 antibody, was first approved in April 2021 for recurrent or advanced dMMR endometrial cancer. The FDA accepted the supplemental BLA to move the drug into the frontline setting on June 6 and set a target action date of Sept. 23, meaning Monday’s approval came nearly two months ahead of schedule.
July 29:
Citius Pharmaceuticals’ plans to bring a reformulated version of Eisai’s withdrawn cancer drug Ontak were put on hold on Saturday after the FDA rejected its BLA for Lymphir (denileukin diftitox). Citius acquired the drug from Dr. Reddy’s Laboratories in Sept. 2021.
An engineered IL-2-diphtheria toxin fusion protein being developed to treat relapsed or refractory cutaneous T-cell lymphoma (CTCL), Lymphir specifically binds to IL-2 receptors to precisely deliver its toxic payload, thereby preventing protein synthesis in malignant T cells. The drug also targets the immunosuppressive regulatory T cells, which allows the body to mount a stronger immune response against the cancer.
In its announcement of the Complete Response Letter, Citius said the FDA will require it to “incorporate enhanced product testing and additional controls” into the BLA. No clinical efficacy or safety issues were raised and Citius stated it will continue working toward FDA approval of Lymphir.
July 28:
The FDA approved RiVive, a 3 milligram (mg) naloxone hydrochloride nasal spray manufactured by Harm Reduction Therapeutics, as the second over-the-counter (OTC) naloxone rescue option for opioid overdose. The approval comes just four months after the regulator greenlit Narcan, a 4-mg naloxone hydrochloride nasal spray, as the first OTC naloxone product. Narcan is manufactured by Emergent BioSolutions. Naloxone rapidly reverses the effects of opioid overdose—a long-running epidemic that claimed the lives of more than 105,000 people in the U.S. in the year ending in February 2023, according to the FDA.
In a press release announcing RiVive’s approval, FDA Commissioner Robert Califf stated the regulator’s commitment to making naloxone accessible and encouraged other manufacturers of these products to discuss potential nonprescription development programs with the FDA.
July 26:
Octapharma secured approval for Balfaxar (prothrombin complex concentrate) for the reversal of the blood-thinner Warfarin in emergency surgery and invasive procedures. Warfarin increases the risk of bleeding—a serious complication during surgery. Balfaxar works to quickly increase blood levels of key clotting factors and antithrombotic proteins. A lyophilized powder, it is reconstituted in a device developed by Octapharma.
While Balfaxar met the primary endpoint of hemostatic efficacy in a Phase III study and was non-inferior to the comparator, Kcentra, fatal and non-fatal arterial and venous thromboembolic complications were observed in clinical trials and post-marketing studies, and healthcare providers are advised to monitor patients for signs of thromboembolic events.
The approval is the third for Balfaxar, which is already marketed in Canada and the EU as octaplex.
July 25:
People with an eyelid disease called demodex blepharitis now have a treatment option as the FDA approved Tarsus Pharmaceuticals’ Xdemvy. A prescription eyedrop, Xdemvy aims to eradicate the root cause of the disease—demodex mites that burrow in the eyelash follicles of sufferers. Xdemvy is the first therapy approved for the condition.
Approval for Xdemvy was granted based on two randomized, multicenter, double-masked, vehicle-controlled studies of 833 patients, in which 415 patients received the treatment. A significant improvement was seen in each study by day 43, Tarsus stated in its approval announcement, adding that the therapy was “generally safe and well-tolerated.”
Tarsus will have a significant market for Xdemvy as demodex blepharitis affects around 25 million people in the U.S. and accounts for more than two-thirds of all blepharitis cases, according to Tarsus.
July 24:
The FDA has approved the first treatment for adults and children two years and older with molluscum contagiosum, a viral skin infection that affects around 6 million people in the U.S. every year. A topical solution developed by Verrica Pharmaceuticals, YCANTH is a drug-device combination that contains a GMP-controlled formulation of cantharidin, a substance derived from the blister beetle Cantharis vesicatoria. It works by causing a blister to form on the wart or growth, eventually lifting it off the skin.
YCANTH’s approval is based on data from two randomized, double-blind, multicenter Phase III trials. In each trial, a clinically and statistically significant number of patients treated with YCANTH achieved complete clearance of all treatable molluscum lesions, meeting the primary endpoint. No serious adverse reactions were reported in either trial. The company expects to make YCANTH available to patients and caregivers by September, Ted White, Verrica’s president and CEO, said in a statement.
July 20:
Four years after it was rejected by the FDA due to safety concerns, Daiichi Sankyo’s Vanflyta (quizartinib) won approval to treat patients with acute myeloid leukemia that has a FLT3-ITD gene mutation. In 2019, an FDA advisory committee voted that the benefit conferred by quizartinib did not outweigh the safety risks. Thursday’s approval comes with a Boxed Warning for three heart disorders: QT prolongation, torsades de pointes and cardiac arrest, and will only be available through a restricted Risk Evaluation and Mitigation Strategy (REMS) program.
Daiichi Sankyo supported its NDA, accepted last Fall, with data from a Phase III trial that showed the quizartinib regimen—combined with standard induction and consolidation chemotherapy and continued as a single agent)—reduced the risk of death by 22.4% compared to patients on chemotherapy alone. After 39.2 months of follow-up, quizartinib more than doubled the overall survival advantage, the company stated in a press release.
July 20:
Emergent BioSolutions secured approval for Cyfendus, a vaccine intended for use after exposure to bacillus anthracis, a bacterium that causes anthrax. Cyfendus is required to be used in combination with “recommended” antibacterial drugs, according to Emergent’s announcement. The approval was based on a series of studies, including a pivotal Phase III trial assessing the vaccine’s consistency, immunogenicity and safety in healthy adults. Even before the approval, Emergent had been supplying Cyfendus to the U.S. Department of Health and Human Services under pre-Emergency Use Authorization for four years.
July 17:
Infants and children at severe risk of RSV have another treatment option after the FDA approved Sanofi and AstraZeneca’s Beyfortus (nirsevimab). A monoclonal antibody, Beyfortus is just the second RSV drug authorized in the U.S. for high-risk children, the other being Synagis (palivizumab), which was approved in 1998. The companies’ bid for approval was backed by three late-stage trials that demonstrated the antibody’s safety and efficacy. Beyfortus will be available in the U.S. ahead of the 2023/2024 RSV season for children entering their first RSV season and those at severe risk up to 24 months, Sanofi stated in a press release.
July 13:
The FDA approved Perrigo Company’s Opill (norgestrel)—a progestin-only daily oral contraceptive—as the first-ever birth control pill available over the counter in the U.S. Perrigo expects Opill to be available online and in-person at drug stores, convenience stores and grocery stores in the first quarter of 2024. In a prepared statement, Perrigo President and CEO Patrick Lockwood-Taylor said the approval “marks a truly momentous day for women’s health nationwide.”
July 6:
A short workweek in the U.S. ended with big news as the FDA granted traditional approval to the first anti-amyloid antibody—and the first disease-altering drug—for Alzheimer’s disease. The accelerated approval for Eisai and Biogen’s Leqembi (lecanemab) was converted to a full approval based on results from the confirmatory Clarity-AD trial, which the FDA said in its statement verified the drug’s benefit. With the approval, Medicare coverage for Leqembi is expected to begin right away, with the requirement of a patient registry intended to collect further information on the effectiveness of this drug class in Alzheimer’s.
July 3:
Amneal Pharmaceuticals received a Complete Response Letter for IPX203—a novel oral formulation of carbidopa/levodopa (CD/LD), a well-established combination for the management of Parkinson’s disease. In its rejection letter, the FDA said that while Amneal was able to adequately establish the safety of levodopa, it was not able to sufficiently do so for carbidopa. The regulator has requested additional pharmacokinetic data. The New Jersey–based company stated it plans to meet with the FDA to determine the best path forward for the treatment.
June
June 29:
Capping a busy week, the FDA approved BioMarin’s Roctavian (valoctocogene roxaparvovec-rvox) as the first gene therapy for adults with severe hemophilia A. Hemophilia is a rare genetic bleeding disorder caused by a mutation in the gene that encodes factor VIII (FVIII), which is necessary for blood to clot. A one-time gene therapy, Roctavian contains a healthy gene for factor VIII. Delivered through an adeno-associated virus (AAV) vector, the gene is expressed in the liver to increase blood levels of FVIII, thereby reducing the risk of uncontrolled bleeding.
June 28:
The FDA notched another milestone with the approval of the first cellular therapy for type 1 diabetes. Lantidra (donislecel) developed by Chicago-based CellTrans, is a cell therapy made from the pancreatic islet cells of deceased donors. It is intended for adult patients whose repeated hypoglycemic episodes leave them unable to hit average blood glucose levels. In a clinical trial of 30 patients, 21 were insulin-free for at least a year; 11 didn’t require insulin for between one and five years and 10 were insulin-free for more than five years. Five patients failed to achieve any days of insulin independence.
June 28:
Pfizer’s bet on OPKO Health’s human growth hormone analog paid off as the FDA approved the treatment—which will be marketed as Ngenla—to treat children whose production of growth hormones is impaired. Pfizer purchased exclusive global commercialization rights for the then-experimental treatment in December 2014 for $295 million upfront and a promise of up to $275 million in milestones. This was the partners’ second try for FDA approval after the regulator rejected Ngenla’s first bid in January 2022. Pfizer and OPKO did not state the reasons for the initial denial.
June 28:
The FDA declined to approve Eton Pharmaceuticals’dehydrated alcohol injection for the treatment of methanol poisoning, citing concerns related “primarily to Chemistry Manufacturing and Controls.” This is the second Complete Response Letter issued to Eton for this proposed treatment. In the first, issued in March 2021, the FDA indicated that travel restrictions due to the COVID-19 pandemic prevented a timely inspection of the company’s European contract manufacturing site.
June 27:
The FDA approved UCB’s Rystiggo (rozanolixizumab), a subcutaneously administered humanized IgG4 monoclonal antibody, to treat generalized myasthenia gravis, a rare muscle-wasting autoimmune disease. Rystiggo is the only treatment approved to treat patients who are anti-acetylcholine receptor- or anti-muscle-specific tyrosine kinase antibody-positive. The regulatory green light was based on a Phase III trial that showed Rystiggo led to significant improvements in symptoms related to breathing, talking, swallowing and rising from a chair.
June 23:
The FDA greenlit Pfizer’s Litfulo (ritlecitinib) for the treatment of patients as young as 12 years with severe alopecia areata, an autoimmune disease characterized by patchy or complete hair loss on the scalp, face or body. Litfulo inhibits Janus kinase 3 and the tyrosine kinase and is believed to work by blocking the signaling of cytokines and cytolytic activity of T cells, which are implicated in alopecia areata.
June 22:
In one of the year’s most-anticipated regulatory decisions, the FDA approved Sarepta’s Elevidys—formerly SRP-9001—for children 4 to 5 years with Duchenne muscular dystrophy. Elevidys is the first-ever gene therapy for DMD, a neuromuscular disease characterized by progressive muscle weakness and atrophy that strikes primarily young boys. The gene therapy was approved via the FDA’s accelerated approval pathway based on data that established it increased the expression of the Elevidys micro-dystrophin protein.
June 21:
Eli Lilly and Boehringer Ingleheim’s Jardiance (empagliflozin) and Synjardy (empagliflozin and metformin hydrochloride) picked up another indication, becoming the first and only SGLT2 inhibitors approved for children 10 years and older with type 2 diabetes. Previously, there had only been one oral drug for this indication: metformin, which was approved in 2000.
June 20:
Argenx will bring to market the first subcutaneous injectable for generalized myasthenia gravis (gMG), a rare muscle-wasting autoimmune disease. Vyvgart (efgartigimod) was first approved in 2021 as a one-hour intravenous infusion. Vyvgart is an antibody fragment that binds to the neonatal Fc receptor to prevent recycling of immunoglobulin G back into the blood. This includes a reduction in abnormal AChR antibodies, which are present in approximately 85% of gMG patients. AChR antibodies block the acetylcholine receptors from being able to receive signals from the nerve to stimulate a muscular response. Their normalization should ostensibly improve muscular function.
Source: BioSpace
