US FDA advisors question usefulness of Sanofi’s combination diabetes therapy

pharmafile | May 24, 2016 | News story | Manufacturing and Production, Research and Development, Sales and Marketing Sanofi, US FDA, diabetes, drug trial, regulation 

US Food and Drug Administration staff questioned the benefits of French drugmaker Sanofi’s (Euronext: SAN) diabetes drug candidate as well as raised doubts over the results of clinical trials showing superiority over insulin.

The combination treatment involves Sanofi’s Lyxumia (lixisenatide) with Lantus (insulin glargine), which imitates a hormone called GLP-1 to stimulate natural insulin production. The combination treatment is approved in Europe but not in the US. A final decision from the FDA regarding approval for the treatment is expected by August 23.

The FDA reviewers said the dosing mechanism of the product may cause some patients to receive insufficient doses of Lyxumia noting that the pen used to deliver the treatment could lead to dosing errors. ​The FDA staff also indicated that clinical trials may not have been correctly designed to demonstrate the benefit of iGlarLixi over Lantus alone, with the combination not compared to the most effective doses of Lantus in some patients. The report was released ahead of the meeting on Wednesday to vote on whether to recommend approving the combination drug.

In addition, patients already being treated with Lyxumia or Lantus alone can’t easily switch to the combined product, FDA reviewers said, and also questioned the efficacy of putting patients on two medications when one may suffice.

The report said: “Inadequate dosing of the insulin in the studies could have biased the estimate of efficacy in favour of the combination product. This would further confound interpretability of a clinical superiority claim for the combination against the insulin comparator.”

Sanofi’s application for iGlarLixi was accepted for accelerated appraisal by the FDA in February. If approved, analysts forecast sales of $574 million for the drug by 2020.

Diabetes affects about 29 million people in the US and is the seventh-leading cause of death, according to statistics.

Anjali Shukla

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