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FDA approves Brincidofovir to treat smallpox

The US FDA has approved Chimerix’s brincidofovir (BCV, Tembexa) to treat smallpox. Fearful of a possible bioweapon attack, the United States has been steadily preparing a defense through the Biomedical Advanced Research and Development Authority. BCV is neither a new nor unknown drug. It is a lipid conjugate of cidofovir, a drug used to treat cytomegalovirus (CMV) in patients with AIDS.

Dose:

≥48 kg (tablet or oral suspension): 200 mg PO qWeek x 2 doses (on Days 1 and 8)
<48 kg (oral suspension): 4 mg/kg PO qWeek x 2 doses (on Days 1 and 8)

Adverse Effect: Diarrhea (8%), Nausea (5%), Vomiting (4%), Serum creatinine elevated (>1.5-3x ULN) (4%), Abdominal pain (3%), ALT elevated (>3 to 20x ULN) (2-3%), Total bilirubin elevated (>1.5 to 10x ULN) (1-3%), AST elevated (>3 to 20x ULN) (1-2%)

Tecovirimat was the first drug for smallpox, approved in 2018.

Source: FDA

Clinic Hours In Article, FDA Updates

FDA approves new drug treatment for chronic weight management

The US FDA approved Wegovy (semaglutide) injection a GLP-1 receptor agonists (2.4 mg once weekly SC) for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced-calorie diet and increased physical activity.

The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater.

Side effects: nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation (belching), hypoglycemia in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis and GERD.

Warning: risk of thyroid C-cell tumors, not to be used in patients with a personal or family history of medullary thyroid carcinoma or in patients with a rare condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Source: FDA

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Gene variant confirmed as strong predictor of lung disease in RA

Patients with rheumatoid arthritis who carry a specific allele of the gene MUC5B have about double the risk of developing interstitial lung disease when compared with noncarriers, according to a large Finnish biobank study presented at the annual European Congress of Rheumatology.

The gain-of-function MUC5B variant, which encodes mucin 5B, was first linked to RA-associated interstitial lung disease (ILD) more than 3 years ago. At that time, it was already a known genetic risk factor for idiopathic pulmonary fibrosis in the general population. The new data confirm the association in a longitudinal analysis of a large biobank and suggest the association might have clinical utility.

Source: Medscape

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Use belimumab after rituximab in patients with SLE

Using belimumab after rituximab to treat patients with systemic lupus erythematosus (SLE) refractory to conventional therapy not only significantly decreased levels of serum IgG anti-dsDNA antibody levels but also prolonged the time before severe flares of disease occurred in the phase 2b BEAT-LUPUS (Belimumab after B cell depletion in SLE) study.

Source: Medscape

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Toripalimab improves survival in nasopharyngeal cancer

Toripalimab is a monoclonal antibody that blocks programmed cell death protein 1 (PD-1), developed in China and recently approved there for the third-line treatment of NPC, among other indications. The US FDA has granted it a breakthrough therapy designation for recurrent/metastatic NPC, as well as fast-track and orphan drug status for other tumor types.

Source: Medscape

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India variant shows resistance to antibody drugs & vaccines

Antibody drugs and COVID-19 vaccines are less effective against a coronavirus variant that was first detected in India, researchers say. The variant, B.1.617.2, has mutations that make it more transmissible. It is now predominant in some parts of India and has spread to many other countries.

Antibodies in blood from unvaccinated COVID-19 survivors and from people who received both doses of the Pfizer/BioNTech vaccine were 3-fold to 6-fold less potent against the India variant than against the UK variant and a variant first identified in South Africa, according to a report posted on bioRxiv ahead of peer review.

The two-dose AstraZeneca vaccine, which does not protect against the South Africa variant, is likely to be ineffective against the India variant as well, the authors said. Antibodies from people who had received their first dose “barely inhibited” this India variant, said study co-author Olivier Schwartz of Institut Pasteur.

The study, Schwartz added, shows that the rapid spread of the India variant is associated with its ability to “escape” the effect of neutralizing antibodies.

Source: Medscape

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Lifileucel promising against unresponsive malignant melanoma

Lifileucel shows promise in metastatic-melanoma patients whose disease had progressed on standard immune-checkpoint inhibitors (ICI) and other therapies, according to a small open-label trial. “Lifileucel is a ground-breaking form of cellular immunotherapy that utilizes the immune cells of patients derived from their own tumors as a treatment,

Source: Reuters Health

Clinic Hours In Article, FDA Updates

FDA approves first drug for lung cancer with KRAS mutation

Sotorasib (Lumakras), specifically targets the KRAS G12C mutation, which accounts for about 13% of NSCLC mutations. KRAS mutations are the most common mutations to occur in NSCLC tumors, accounting for about 25% of them, but for a long time, they appeared to be resistant to drug therapy.

Dose: 960 mg once daily

Side effects: The most common adverse reactions (≥ 20%) were diarrhea, musculoskeletal pain, nausea, fatigue, hepatotoxicity, and cough. The most common laboratory abnormalities (≥ 25%) were decreased lymphocytes, decreased hemoglobin, increased aspartate aminotransferase, increased alanine aminotransferase, decreased calcium, increased alkaline phosphatase, increased urine protein, and decreased sodium.

Contraindications: Interstitial lung disease, CLD, along with drugs that are substrates of the P-glycoprotein.

Source: FDA

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Hybrid therapy for H. pylori infection

A 14-day course of hybrid therapy was as effective as 10-day bismuth quadruple therapy, but with fewer side effects, according to results of a randomized trial conducted in Taiwan.

In a prospective, randomized comparative study published in 2017, the eradication rates (93.9%) in patients receiving 14-day bismuth quadruple therapy (pantoprazole, bismuth subcitrate, tetracycline, and metronidazole) were comparable with eradication rates (92.8%) with 14-day hybrid therapy (dual therapy with pantoprazole plus amoxicillin for 7 days, followed by quadruple therapy with pantoprazole, amoxicillin, clarithromycin, and metronidazole for 7 days).

Source: Medscape

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FDA approves Ozanimod for Ulcerative Colitis

The US FDA has approved ozanimod (Zeposia) for adults with moderately to severely active ulcerative colitis (UC), the company has announced. Ozanimod (0.92 mg), an oral medication taken once daily, is the first sphingosine-1-phosphate (S1P) receptor modulator approved for UC.

In March 2020, the FDA approved ozanimod for adults with relapsing forms of multiple sclerosis

The approval, awarded to Bristol Myers Squibb, was based on the data from a placebo-controlled phase 3 trial dubbed True North. In the study, researchers evaluated ozanimod as a single, daily oral therapy for both adults and pediatric patients at least 12 years old with moderately to severely active ulcerative colitis.

More Info: FDA