Whereas the trail for any drug to go from lab analysis to commercialization takes years, Intercept Prescription drugs now stands as one other instance {that a} product’s market exit may also be lengthy and winding. Practically a decade after Intercept’s drug for a uncommon liver illness acquired accelerated FDA approval, the corporate is withdrawing the product.
Intercept mentioned Thursday its withdrawal of the drug, Ocaliva, is voluntary. However the firm famous its determination follows an FDA request. Intercept additionally mentioned the regulator has positioned a medical maintain on all medical trials involving the lively pharmaceutical ingredient within the product.
Ocaliva was developed to deal with main biliary cholangitis, or PBC. This uncommon illness develops when the immune system mistakenly assaults the bile ducts of the liver, resulting in irritation within the organ. For many years, normal remedy has been ursodiol, an previous gallstone-dissolving treatment that expanded its label to PBC in 1997. Ocaliva’s primary pharmaceutical ingredient, obeticholic acid, is an analog of a bile acid present in people. The oral small molecule binds to and prompts FXR, a receptor within the liver and intestines that performs a task in regulating bile acid and irritation.
Ursodiol doesn’t work for all PBC sufferers. Ocaliva’s accelerated FDA approval in 2016 made the capsule a second-line remedy for these whose illness doesn’t reply to first-line ursodiol remedy. However the Intercept drug has had a rocky regulatory historical past since. In 2021, the FDA added a black field warning to Ocaliva’s label flagging the chance of extreme liver problems in sufferers who’ve liver cirrhosis.
Ocaliva’s accelerated approval required the corporate to conduct a confirmatory medical trial. Final yr, the FDA rejected Intercept’s software in search of to transform the drug’s standing to full approval in PBC. Quickly after, the company issued a security communication for Ocaliva warning of the chance of extreme liver damage in sufferers with out cirrhosis. In Europe, the place Ocaliva was marketed by companion Advanz Pharma, the European Fee revoked the product’s conditional advertising authorization.
Intercept additionally stumbled in its efforts to increase Ocaliva to different indications. The FDA twice rejected the Intercept drug as a remedy for the fatty liver illness now often called metabolic dysfunction-associated steatohepatitis (MASH). After the second rejection in 2023, Intercept restructured after which was acquired by Alfasigma, a privately held firm primarily based in Italy.
PBC remedy choices have expanded since Ocaliva first entered the market. Final yr, the FDA awarded accelerated approvals to 2 new PBC medicine: Ipsen’s Iqirvo and Gilead Sciences’ Livdelzi. These merchandise convey a special mechanism of motion to the illness. The regulatory selections cowl use of the medicines as second-line therapies, placing them on par with Ocaliva. However the Ipsen and Gilead medicine don’t have black field warnings on their labels. With safer remedy alternate options now accessible to PBC sufferers, the FDA apparently now not sees the necessity for Ocaliva to stay available on the market beneath accelerated approval standing.
Executives for Intercept, which continues to operates as a U.S.-based subsidiary of Alfasigma, mentioned they imagine the totality of medical and real-world proof helps Ocaliva in PBC. However the firm is finished clashing with the FDA in regards to the matter.
“Whereas our view of Ocaliva’s benefit-risk profile differs from FDA’s, we respect its request and have made this troublesome determination to supply clear steerage for sufferers and prescribers,” Vivek Devaraj, U.S. president at Intercept, mentioned in a ready assertion.
Picture: Sakramir, Getty Photos
