Makena Withdrawal Dilemma: Advisory Cmte. Split Offers No Clear Direction For US FDA
Nine of 16 advisory committee members favored withdrawal of AMAG’s preterm birth drug because substantial evidence of efficacy is lacking and clinical benefit has not been confirmed; seven panelists favored keeping the drug on the market but requiring a new trial.
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The company offered to stipulate that findings from the PROLONG trial do not verify clinical benefit of the preterm birth prevention drug; the US FDA’s drugs center opposed a stipulation, saying failure of a confirmatory trial to verify clinical benefit is an independent ground for withdrawing accelerated approval and an advisory committee should vote on the question.
By proposing to stipulate that findings from the PROLONG study do not verify Makena’s clinical benefit on neonatal morbidity and mortality from complications of preterm birth, Covis could avoid what would likely be a highly negative vote on the first question posed to the advisory committee at the 17-19 October public hearing on withdrawal of the application.
Presiding officer Celia Witten denies Covis’ request for an in-person hearing, saying it is unclear at this time how COVID would affect a proceeding in the fall. Hearing agenda spans two-and-a-half days and is modeled, in part, on the Avastin hearing, but with twice the time for public comment.