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Signifor approved in US

Published on 17/12/12 at 10:42am
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Novartis’ injection Signifor has been approved by the FDA to treat Cushing’s disease, a rare but serious endocrine disorder affecting one to two people per million each year.

The disease occurs when a non-cancerous tumour of the pituitary (an endocrine gland) makes too much of the adrenocorticotropic hormone, which in turn stimulates the adrenal glands to grow and to release excessive amounts of cortisol into the blood.

This causes a set of symptoms including weight gain (particularly in the face and neck), easy bruising, weakening of the muscles and bones and high blood pressure.

The first line is to remove the tumour, but Signifor (pasireotide) has been authorised to treat adults with Cushing’s for whom pituitary surgery is not an option or has not worked.

It is the first medicine to be authorised for the disease, which tends to affect women aged 20 to 50 years, in the US: Signifor was approved in Europe earlier this year.

“The FDA approval of Signifor for Cushing’s disease brings a novel pituitary-directed therapy to patients with limited treatment options,” said Hervé Hoppenot, president of Novartis Oncology.

Patients require two subcutaneous injections each day, although the drug is being studied now as a long-acting release, once-monthly intramuscular injection.

The FDA decision was based on data from the Phase III PASPORT-CUSHINGS trial, which found a sustained decrease in mean urinary-free cortisol (UFC), the key measure of control of the disease.

In the trial, patients with UFC levels greater than 1.5 times the upper limit of normal were randomized to receive Signifor 0.9 mg or 0.6 mg.

Mean UFC levels were normalized in 26% and 15% of the patients randomized to receive Signifor 0.9 mg and 0.6 mg, respectively, at month six. 

Median reduction in mean UFC from baseline to month six was 47% in both dose groups, with reductions in UFC observed after one month of treatment and sustained in most patients.

Also, 34% and 41% of patients experienced a reduction in mean UFC from baseline in the 0.6 mg and 0.9 mg groups, respectively.

Adam Hill

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