Posaconazole

The European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) signed off on six new drugs as well as a clutch of approved drugs that received positive opinions for new indications. In the latest bunch of recommendations from the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP), Novo Nordisk’s semaglutide for severe liver disease could be soon off to the European market under a new name, while Eli Lilly’s Mounjaro didn’t quite make the cut for a new cardiovascular indication and Amgen’s approved Tavneos is up for a second look as concerns emerge on the data integrity of the drug’s pivotal trial.Novo’s Wegovy (semaglutide) made headlines last summer as the second drug in the U.S. approved to treat adult metabolic dysfunction-associated steatohepatitis (MASH) in certain patients. The FDA’s conditional nod made for Wegovy’s third indication, along with obesity and cardiovascular risk reduction, validating Novo’s continued pursuance of the tough-to-treat condition after previous let downs.The CHMP has now agreed with the FDA, recommending a conditional marketing authorization for the med, which will be branded separately from Wegovy in Europe under the name Kayshild. In other GLP-1 decisions, Eli Lilly’s Mounjaro also received news from the CHMP, as the agency has finalized its assessment of Lilly’s bid to extend the drug’s use to cover chronic heart failure with preserved ejection fraction (HFpEF) in adults with obesity.Although the EMA did not ultimately recommend a separate indication for the new use, it agreed to include “relevant data” from the Mounjaro study in this indication in the drug’s label, ensuring “up-to-date data on the effects of Mounjaro in adults with chronic HFpEF and obesity.” The regulator opted against a wholly new indication based on “uncertainty” remaining as to whether the positive results seen in the study is a “weight-loss-independent effect of Mounjaro,” the EMA explained in a release (PDF).Elsewhere, six new medicines, including Kayshild, earned positive CHMP opinions. UCB’s thymidine kinase 2 deficiency (TK2d) drug Kygevvi stood out as a positive opinion issued under “exceptional circumstances,” since the rarity of the disease means that the company had to use a single arm, 39-patient study and a retrospective chart review in its drug application. If approved, the drug would be the first treatment option for the rare genetic disease, and UCB would have to comply with yearly post-marketing obligations.“This positive CHMP opinion marks a turning point in the treatment of TK2d, offering a new chapter of hope and a meaningful step forward for patients, families, and clinicians alike,” UCB’s chief medical officer, Donatello Crocetta, commented in a company release. Sanofi, meanwhile, came out with two wins with a CHMP recommendation for its recombinant, quadrivalent flu vaccine Supemtek and for its Rezurock, which would be a new treatment option for adults and children with chronic graft-versus-host disease (GVHD). Sanofi had requested a re-review of Rezurock after a negative opinion was adopted by CHMP in October. The French pharma is making a commitment to conduct a new post-approval confirmatory study given the “limited late-line treatment options available for EU patients living with chronic GVHD and the body of Rezurock clinical evidence generated,” EVP of Sanofi’s general medicines unit, Olivier Charmeil, explained in a company release.The prior negative opinion was made because it “was difficult to quantify” the effect Rezurock had on patients relative to other treatments, the CHMP said at the time. Rezurock is already approved in 20 countries, including the U.S.Rounding out the wave of positive opinions, the CHMP also signed off on a hormone replacement therapy for menopause called Fylrevy (estetrol) made by Hungarian pharma Gedeon Richter and a radiolabeling product made by Shine that’s called Ilumira.Johnson & Johnson’s Akeega, Neurocrine’s Efmody, ARS’s Eurneffy (sold as Neffy in the U.S.), Incyte’s Inclusig, AstraZeneca’s Imfinzi, Bayer’s Kerendia, Merck’s Noxafil, Bristol Myers Squibb’s Opdivo and Incyte’s Zynyz all are up for label expansions based on positive CHMP opinions.Zynyz in particular would be Europe’s first immunotherapy-based treatment for squamous cell carcinoma of the anal canal (SCAC), the most common type of anal cancer. If approved, the drug could be a “new standard-of-care for patients living with this rare and difficult-to-treat cancer,” head of Incyte International Lee Heeson said in a company statement.All of CHMP’s recommendations are now off to the European Commission for final approval. Tavneos re-reviewTucked in with the positive opinions was negative news for Amgen’s complement inhibitor Tavneos, which CSL Vifor markets in Europe. Amgen took on the drug through its ChemoCentryx buyout in 2022. In January of that year, European regulators signed off on the drug to treat granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA), two rare inflammatory blood vessel conditions. The initial approval hinged on results from ChemoCentryx’s Advocate study, which compared Tavneos to high-dose corticosteroids in 331 patients and found that the med was as effective at prompting remission as the corticosteroids. But concerns about the trial have been mounting since 2021, when the FDA flagged several efficacy and safety issues in the study. Although Tavneos eventually got its FDA nod with a narrower label than anticipated, investors with money tied up in the debacle filed a lawsuit in 2022 alleging that the company knew about the FDA’s concerns but downplayed the situation to its shareholders. As the legal feud continued, additional evidence emerged last year pointing to a larger data integrity issue in the trial. Nonetheless, ChemoCentryx emerged victorious in a securities fraud complaint last summer and the FDA hasn’t taken action that would impact its U.S. approval. The EMA, however, will now “review all available data” to assess if the “emerging information” impacts the drug’s risk/benefit profile, the agency said in a Jan. 30 alert. The review was initiated at the request of the European Commission.“The concerns relate to how the company handled the data for the Advocate study before Tavneos was authorised, which may have impacted the findings on the medicine’s effectiveness,” the EMA explained.After the review, the agency will decide if the drug's marketing approval should be kept, suspended, amended or pulled altogether, it said. Despite the years-long legal back-and-forth, Tavenos garnered $256 million in revenue for Amgen during 2024, in 111% growth year over year.

EU regulators have refused to greenlight Eli Lilly’s weight loss drug Mounjaro as a treatment for a type of heart failure, while giving the go-ahead for Novo Nordisk’s semaglutide in liver disease. Lilly failed to get support from the European Medicines Agency’s human medicines committee, or CHMP, on Friday for Mounjaro to treat chronic heart failure with preserved ejection fraction in adults with obesity. HFpEF is when the heart becomes too stiff to pump enough blood around the body. The committee said Mounjaro didn’t reduce the number of patient deaths due to heart problems in patients with obesity and HFpEF. While the drug did reduce the number of heart failure-related hospitalizations, it’s unclear whether that was due to the weight loss-independent effect of Mounjaro, CHMP said. Lilly had also been angling after the heart failure label expansion in the US, but withdrew the application for Mounjaro — marketed as Zepbound for weight loss — from the FDA in May. Despite declining to expand Mounjaro’s label for heart failure, the committee said it would include the data from Lilly’s Phase 3 SUMMIT study in the drug’s product information. Meanwhile, Novo Nordisk won the panel’s go-ahead for semaglutide, branded as Kayshild, to be used as a treatment for patients with non-cirrhotic metabolic dysfunction-associated steatohepatitis (MASH) with liver fibrosis stages F2 to F3. Semaglutide is already available in the US to treat patients with MASH, after securing FDA approval in August. CHMP also gave positive opinions for four other new therapies: The agency also gave recommendations to extend the labels of nine therapies: