FDA seeks with­draw­al of heart­burn drugs due to new car­cino­gen con­cerns

The FDA on Wednes­day re­quest­ed that all man­u­fac­tur­ers of drugs con­tain­ing ran­i­ti­dine (com­mon­ly known as Zan­tac and used for heart­burn) re­move all pre­scrip­tion and over-the-counter (OTC) ver­sions from the mar­ket be­cause the car­cino­gen N-Ni­troso­di­methy­lamine (ND­MA) has now been found to in­crease sig­nif­i­cant­ly in sam­ples stored at high­er tem­per­a­tures.

The an­nounce­ment is the most se­ri­ous in a chain of FDA safe­ty ad­vi­sories re­lat­ed to ND­MA in ran­i­ti­dine med­i­cines fol­low­ing a se­ries of re­calls of Zan­tac and oth­er ran­i­ti­dine drugs, and as the agency said last No­vem­ber that the ND­MA lev­els in such drugs “are sim­i­lar to the lev­els you would ex­pect to be ex­posed to if you ate com­mon foods like grilled or smoked meats.”

Now, new FDA test­ing and eval­u­a­tion prompt­ed by in­for­ma­tion from third-par­ty lab­o­ra­to­ries “con­firmed that ND­MA lev­els in­crease in ran­i­ti­dine even un­der nor­mal stor­age con­di­tions, and ND­MA has been found to in­crease sig­nif­i­cant­ly in sam­ples stored at high­er tem­per­a­tures, in­clud­ing tem­per­a­tures the prod­uct may be ex­posed to dur­ing dis­tri­b­u­tion and han­dling by con­sumers,” FDA said.

“The test­ing al­so showed that the old­er a ran­i­ti­dine prod­uct is, or the longer the length of time since it was man­u­fac­tured, the greater the lev­el of ND­MA. These con­di­tions may raise the lev­el of ND­MA in the ran­i­ti­dine prod­uct above the ac­cept­able dai­ly in­take lim­it,” the agency added.

Janet Wood­cock

FDA al­so pre­vi­ous­ly told com­pa­nies to vol­un­tar­i­ly with­draw ran­i­ti­dine and niza­ti­dine prod­ucts that do not meet the agency’s ND­MA thresh­old (96 nanograms per day or 0.32 ppm).

But now FDA is is­su­ing this im­me­di­ate mar­ket with­draw­al re­quest for all man­u­fac­tur­ers, which means ran­i­ti­dine prod­ucts will not be avail­able for new or ex­ist­ing pre­scrip­tions or OTC use in the US.

“Ran­i­ti­dine prod­ucts will stay off the mar­ket un­less a man­u­fac­tur­er can show that their prod­uct is sta­ble while stored and does not gen­er­ate ex­cess ND­MA,” CDER Di­rec­tor Janet Wood­cock said on Twit­ter.

As far as oth­er heart­burn med­i­cines, FDA says that its test­ing has not found ND­MA in famo­ti­dine (Pep­cid), cime­ti­dine (Taga­met), es­omepra­zole (Nex­i­um), lan­so­pra­zole (Pre­vacid) or omepra­zole (Prilosec).

FDA and the Eu­ro­pean Med­i­cines Agency be­gan in­ves­ti­gat­ing the pres­ence of ND­MA in ran­i­ti­dine med­i­cines last Sep­tem­ber.

FDA Re­quest


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UP­DAT­ED: Mer­ck pulls Keytru­da in SCLC af­ter ac­cel­er­at­ed nod. Is the FDA get­ting tough on drug­mak­ers that don't hit their marks?

In what could be an early shot in the battle against drugmakers that whiff on confirmatory studies to support accelerated approvals, the FDA ordered Bristol Myers Squibb late last year to give up Opdivo’s approval in SCLC. Now, Merck is next on the firing line — are we seeing the FDA buckling down on post-marketing offenders?

Merck has withdrawn its marketing approval for PD-(L)1 inhibitor Keytruda in metastatic small cell lung cancer as part of what it describes as an “industry-wide evaluation” by the FDA of drugs that do not meet the post-marketing checkpoints on which their accelerated nods were based, the company said Monday.

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Bob Nelsen (Photo by Michael Kovac/Getty Images)

With stars aligned and cash in re­serve, Bob Nelsen's Re­silience plans a makeover at 2 new fa­cil­i­ty ad­di­tions to its drug man­u­fac­tur­ing up­start

Bob Nelsen’s new, state-of-the-art drug manufacturing initiative is taking shape.

Just 3 months after gathering $800 million of launch money, a dream team board and a plan to shake up a field where he found too many bottlenecks and inefficiencies for the era of Covid-19, Resilience has snapped up a pair of facilities now in line for a retooling.

The company has acquired a 310,000-square-foot plant in Boston from Sanofi along with a 136,000-square-foot plant in Ontario to add to a network which CEO Rahul Singhvi says is just getting started on building his company’s operations up. The Sanofi deal comes with a contract to continue manufacturing one of its drugs.

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Fi­bro­Gen shares skid low­er as a sur­prise ad­comm rais­es risks on roxa OK

FibroGen will likely have to delay its US rollout for roxadustat once again.

In an unexpected move, the FDA is convening its Cardiovascular and Renal Drugs Advisory Committee to review the NDA in an advisory committee meeting. The date is yet to be confirmed.

Just a few weeks ago, SVB Leerink analyst Geoffrey Porges predicted that the roxa approval could come ahead of the PDUFA date on March 20 — effusive despite already being let down once by the FDA’s extension of its review back in December. AstraZeneca, which is partnered with FibroGen on the chronic kidney disease-related anemia drug, disclosed regulators had requested further clarifying analyses of clinical data.

Pascal Soriot, AstraZeneca CEO (AP Images)

Pas­cal So­ri­ot cash­es in As­traZeneca’s chips on Mod­er­na for $1.2B cash in­jec­tion

While still working to prove its own Covid-19 vaccine, AstraZeneca has reportedly capitalized on the success of another.

The company has sold off its 7.7% stake in Moderna and turned it into $1.2 billion in cash, according to the Times, beefing up the reserves just as Pascal Soriot is wrapping up his $39 billion acquisition of Alexion and its rare disease pipeline.

AstraZeneca’s stock sale follows a similar move by Merck in December. But like its pharma brethren, the British giant is keeping its R&D collaborations with Moderna.

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Amit Munshi, Arena

One of Are­na's top drugs flops in a PhI­Ib study for IBS pain. But re­searchers tease out a pos­si­ble path for­ward as CEO ex­plores 's­trate­gic op­tion­s'

Four years ago, when Arena CEO Amit Munshi cut its ties to a troubled weight drug and doubled down on the pipeline, a cannabinoid receptor 2 agonist figured prominently in the biotech’s future. On Tuesday evening, however, Munshi’s high hopes for the drug took a nasty hit after it failed a Phase IIb study for patients with irritable bowel syndrome pain.

Put through a randomized pace with 273 patients, researchers said it flat failed the primary endpoint among the large group with abdominal pain. But they quickly went on to highlight subgroup data, always a tricky and controversial ploy, where they spotlighted a positive p value for patients with moderate to severe pain who received the high dose of the drug — one of 3 provided in the study.

UP­DAT­ED: Feds clear the road for J&J to start de­liv­er­ing mil­lions of dos­es of their Covid-19 vac­cine — but frets linger about run­ner-up sta­tus

All the pieces needed to trigger a third wave of Covid-19 vaccine supply to start washing over the US fell neatly into place over the weekend.

After providing for a brief mime of regulatory judiciousness, the FDA stamped their emergency approval on J&J’s Covid-19 vaccine Saturday, adding to the Biden administration’s plan aimed at ending the pandemic in the near term — at least in the US. The CDC came through on Sunday with its stamp of approval and J&J is reportedly expected to start delivering vaccine sometime in the next few days.

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Af­ter bail­ing on Covid-19 vac­cines, Mer­ck will team up with J&J to pro­duce its shot as part of un­usu­al Big Phar­ma pact

Merck took a big gamble when it opted to jump into the Covid-19 vaccine race late, and made an equally momentous decision to back out in late January. Now, looking to chip in on the effort, Merck reportedly agreed to team up with one of the companies that has already crossed the finish line.

President Joe Biden on Tuesday is expected to announce a partnership between drugmakers Merck and Johnson & Johnson to jointly produce J&J’s recombinant protein Covid-19 vaccine that received the FDA’s emergency use authorization Saturday, the Washington Post reported.

Ab­b­Vie tees up a biotech buy­out af­ter siz­ing up their Parkin­son's drug spun out of Ke­van Shokat's lab

AbbVie has teed up a small but intriguing biotech buyout after looking over the preclinical work it’s been doing in Parkinson’s disease.

The company is called Mitokinin, a Bay Area biotech spun out of the lab of UCSF’s Kevan Shokat, whose scientific explorations have formed the academic basis of a slew of startups in the biotech hub. One of Shokat’s PhD students in the lab, Nicholas Hertz, co-founded Mitokinin using their lab work on PINK1 suggesting that amping up its activity could play an important role in regulating the mitochondrial dysfunction contributing to Parkinson’s disease pathogenesis and progression.

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Paul Sekhri

The next big biotech su­per­star? Paul Sekhri has some thoughts on that

It occasionally occurs to Paul Sekhri that if they pull this off, his company will be on the front page of the New York Times and a lead story in just about every major news outlet on the planet. He tries not to dwell on it, though.

“I just want to be laser-focused on getting to that point,” Sekhri says, before acknowledging, “Yes, it absolutely crossed my mind.”

Sekhri, a longtime biopharma executive with tenures at Sanofi and Novartis, is now entering year three as CEO of eGenesis, the biotech that George Church protégé Luhan Yang founded to genetically alter pigs so that they can be used for organ transplants. He led them through one megaround and has just closed another, raising $125 million from 17 different investors to push the first-ever (humanized) pig to human transplants into the clinic.

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