Source: AP Images

In an­oth­er blow to In­ter­cept, the FDA is in­ves­ti­gat­ing Ocali­va for po­ten­tial risk of liv­er dis­or­der

Just a month be­fore hand­ing In­ter­cept Phar­ma­ceu­ti­cals a CRL for Ocali­va in NASH, the FDA be­gan eval­u­at­ing the drug for a po­ten­tial risk of liv­er dis­or­der in pri­ma­ry bil­iary cholan­gi­tis (PBC) pa­tients. The probe, which launched in May, was dis­closed by the com­pa­ny deep down in their lat­est quar­ter­ly re­port filed with the SEC, and had not oth­er­wise been com­mu­ni­cat­ed pub­licly by In­ter­cept un­til re­ports sur­faced this week.

The FDA has no­ti­fied us that in the course of its rou­tine safe­ty sur­veil­lance, in May 2020 the FDA be­gan to eval­u­ate a new­ly iden­ti­fied safe­ty sig­nal re­gard­ing liv­er dis­or­der for Ocali­va which the FDA clas­si­fied as a po­ten­tial risk.

Ocali­va was ap­proved in 2016 to treat PBC, a chron­ic dis­ease that af­fects the liv­er’s bile ducts. In­ter­cept spokesman Christo­pher Frates said the biotech is work­ing with the FDA on what will like­ly be a 12-month eval­u­a­tion.

An FDA spokesper­son de­clined to of­fer any ad­di­tion­al in­for­ma­tion aside from what was post­ed in FAERS, the agency’s ad­verse event re­port­ing sys­tem, which states they are “eval­u­at­ing the need for reg­u­la­to­ry ac­tion.”

The probe is the lat­est blow to In­ter­cept in the last few months. In June, the FDA re­ject­ed its NDA for obeti­cholic acid, the ac­tive in­gre­di­ent in Ocali­va, for the treat­ment of NASH. In­ter­cept said reg­u­la­tors want­ed longer term da­ta from their Phase III tri­al to back the sur­ro­gate end­point, re­duc­tion in liv­er fi­bro­sis. Com­pa­ny ex­ec­u­tives ar­gued then that they were blind­sided.

CEO Mark Pruzan­s­ki had said in a state­ment:

At no point dur­ing the re­view did the FDA com­mu­ni­cate that OCA was not ap­prov­able on an ac­cel­er­at­ed ba­sis, and we strong­ly be­lieve that the to­tal­i­ty of da­ta sub­mit­ted to date both meet the re­quire­ments of the Agency’s own guid­ance and clear­ly sup­port the pos­i­tive ben­e­fit-risk pro­file of OCA.

In a Sep­tem­ber SEC fil­ing, In­ter­cept an­nounced that 170 jobs were on the chop­ping block, equal to rough­ly 25% of its staff, in or­der to save cash for its con­tin­ued pur­suit of NASH ap­proval. In­ter­cept shares were down 8% yes­ter­day when news of the FDA probe be­came wide­ly known. An in­vestor on Twit­ter first no­ticed the buried dis­clo­sure.

Back in 2018, the FDA slapped Ocali­va with a black box warn­ing, due to the drug be­ing “in­cor­rect­ly dosed” dai­ly in­stead of week­ly. “To en­sure cor­rect dos­ing and re­duce the risk of liv­er prob­lems, we are clar­i­fy­ing the cur­rent rec­om­men­da­tions for screen­ing, dos­ing, mon­i­tor­ing, and man­ag­ing PBC pa­tients with mod­er­ate to se­vere liv­er dis­ease tak­ing Ocali­va,” it an­nounced.

BY­OD Best Prac­tices: How Mo­bile De­vice Strat­e­gy Leads to More Pa­tient-Cen­tric Clin­i­cal Tri­als

Some of the most time- and cost-consuming components of clinical research center on gathering, analyzing, and reporting data. To improve efficiency, many clinical trial sponsors have shifted to electronic clinical outcome assessments (eCOA), including electronic patient-reported outcome (ePRO) tools.

In most cases, patients enter data using apps installed on provisioned devices. At a time when 81% of Americans own a smartphone, why not use the device they rely on every day?

Image: Shutterstock

Eli Lil­ly asks FDA to re­voke EUA for Covid-19 treat­ment

Eli Lilly on Friday requested that the FDA revoke the emergency authorization for its Covid-19 drug bamlanivimab, which is no longer as effective as a combo therapy because of a rise in coronavirus variants across the US.

“With the growing prevalence of variants in the U.S. that bamlanivimab alone may not fully neutralize, and with sufficient supply of etesevimab, we believe now is the right time to complete our planned transition and focus on the administration of these two neutralizing antibodies together,” Daniel Skovronsky, Lilly’s CSO, said in a statement.

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Ex­clu­sive in­ter­view: Pe­ter Marks on why full Covid-19 vac­cine ap­provals could be just months away

Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, took time out of his busy schedule last Friday to discuss with Endpoints News all things related to his work regulating vaccines and the pandemic.

Marks, who quietly coined the name “Operation Warp Speed” before deciding to stick with his work regulating vaccines at the FDA rather than join the Trump-era program, has been the face of vaccine regulation for the FDA throughout the pandemic, and is usually spotted in Zoom meetings seated in front of his wife’s paintings.

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J&J faces CDC ad­vi­so­ry com­mit­tee again next week to weigh Covid-19 vac­cine risks

The CDC’s Advisory Committee on Immunization Practices punted earlier this week on deciding whether or not to recommend lifting a pause on the administration of J&J’s Covid-19 vaccine, but the committee will meet again in an emergency session next Friday to discuss the safety issues further.

The timing of the meeting likely means that the J&J vaccine will not return to the US market before the end of next week as the FDA looks to work hand-in-hand with the CDC to ensure the benefits of the vaccine still outweigh the risks for all age groups.

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Osman Kibar (Samumed, now Biosplice)

Os­man Kibar lays down his hand at Sa­mumed, step­ping away from CEO role as his once-her­ald­ed an­ti-ag­ing biotech re­brands

Samumed made quite the entrance back in 2016, when it launched with some anti-aging programs and a whopping $12 billion valuation. That level of fanfare was nowhere to be found on Thursday, when the company added another $120 million to its coffers and quietly changed its name to Biosplice Therapeutics.

Why the sudden rebrand?

“We did that for obvious reasons,” CFO and CBO Erich Horsley told Endpoints News. “The name Biosplice echoes our science much more than Samumed does.”

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Near­ly a year af­ter Au­den­tes' gene ther­a­py deaths, the tri­al con­tin­ues. What hap­pened re­mains a mys­tery

Natalie Holles was five months into her tenure as Audentes CEO and working to smooth out a $3 billion merger when the world crashed in.

Holles and her team received word on the morning of May 5 that, hours before, a patient died in a trial for their lead gene therapy. They went into triage mode, alerting the FDA, calling trial investigators to begin to understand what happened, and, the next day, writing a letter to alert the patient community so they would be the first to know. “We wanted to be as forthright and transparent as possible,” Holles told me late last month.

The brief letter noted two other patients also suffered severe reactions after receiving a high dose of the therapy and were undergoing treatment. One died a month and a half later, at which point news of the deaths became public, jolting an emergent gene therapy field and raising questions about the safety of the high doses Audentes and others were now using. The third patient died in August.

“It was deeply saddening,” Holles said. “But I was — we were — resolute and determined to understand what happened and learn from it and get back on track.”

Eleven months have now passed since the first death and the therapy, a potential cure for a rare and fatal muscle-wasting disease called X-linked myotubular myopathy, is back on track, the FDA having cleared the company to resume dosing at a lower level. Audentes itself is no more; last month, Japanese pharma giant Astellas announced it had completed working out the kinks of the $3 billion merger and had restructured and rebranded the subsidiary as Astellas Gene Therapies. Holles, having successfully steered both efforts, departed.

Still, questions about precisely what led to the deaths of the 3 boys still linger. Trial investigators released key details about the case last August and December, pointing to a biological landmine that Audentes could not have seen coming — a moment of profound medical misfortune. In an emerging field that’s promised cures for devastating diseases but also seen its share of safety setbacks, the cases provided a cautionary tale.

Audentes “contributed in a positive way by giving a painful but important example for others to look at and learn from,” Terry Flotte, dean of the UMass School of Medicine and editor of the journal Human Gene Therapy, told me. “I can’t see anything they did wrong.”

Yet some researchers say they’re still waiting on Astellas to release more data. The company has yet to publish a full paper detailing what happened, nor have they indicated that they will. In the meantime, it remains unclear what triggered the events and how to prevent them in the future.

“Since Audentes was the first one and we don’t have additional information, we’re kind of in a holding pattern, flying around, waiting to figure out how to land our vehicles,” said Jude Samulski, professor of pharmacology at UNC’s Gene Therapy Center and CSO of the gene therapy biotech AskBio, now a subsidiary of Bayer.

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Pascal Soriot (AstraZeneca via YouTube)

Af­ter be­ing goad­ed to sell the com­pa­ny, Alex­ion's CEO set some am­bi­tious new goals for in­vestors. Then Pas­cal So­ri­ot came call­ing

Back in the spring of 2020, Alexion $ALXN CEO Ludwig Hantson was under considerable pressure to perform and had been for months. Elliott Advisers had been applying some high public heat on the biotech’s numbers. And in reaching out to some major stockholders, one thread of advice came through loud and clear: Sell the company or do something dramatic to change the narrative.

In the words of the rather dry SEC filing that offers a detailed backgrounder on the buyout deal, Alexion stated: ‘During the summer and fall of 2020, Alexion also continued to engage with its stockholders, and in these interactions, several stockholders encouraged the company to explore strategic alternatives.’

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PDU­FA VII to ex­pand FDA’s re­al-time on­col­o­gy re­views to sup­ple­ments for all ther­a­peu­tic ar­eas

The FDA’s popular program to speed up its reviews of new oncology drugs and supplemental applications by months will be expanded into a larger program for efficacy supplements across all therapeutic areas.

The new program, to be known as Split Real-Time Application Review (STAR), first came to light in the minutes of a December meeting of the premarket subgroup working on the negotiation of the latest iteration of the Prescription Drug User Fee Act (PDUFA VII).

Emmanuel Hanon (Viome)

Glax­o­SmithK­line’s head of vac­cine R&D is jump­ing to a well­ness com­pa­ny con­cen­trat­ing on the mi­cro­bio­me as re­ports of an ex­o­dus start to spread

Back in the fall of 2019, GlaxoSmithKline vaccine R&D chief Emmanuel Hanon had plenty of good things to say about a wellness company called Viome and CEO Naveen Jain. He was particularly interested in Viome’s technology for analyzing the gut microbiome and how that could intersect with new vaccine research.

Today, Hanon is jumping ship to join his collaborator as R&D chief as reports circulate of an exodus at GSK’s big vaccine group.

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