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Boehringer and Roche IPF drugs win FDA approval

Published on 16/10/14 at 11:02am
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The FDA has approved both Roche’s Esbriet (pirfenidone) and Boehringer Ingelheim’s Ofev (nintedanib) for the treatment of the fatal lung disease Idiopathic Pulmonary Fibrosis (IPF).

These new drugs are the first treatments for IPF available in the US. Esbriet previously became the first marketed drug for IPF globally when it was approved in Europe in 2011, and has since been shown the green light in Norway, Iceland and Canada.

“Today’s approval expands the available treatment options for patients with idiopathic pulmonary fibrosis,” says Mary Parks, deputy director of the Office of Drug Evaluation at the FDA. “Providing healthcare professionals and patients with additional treatment options helps enable appropriate care decisions based on a patient’s need.”

Esbriet was developed by InterMune who were then acquired by Roche in September. It is believed to work by interfering with proteins involved in inflammation and cell growth, and was initially rebuffed by the FDA who asked for more trial data. The regulator eventually granted it breakthrough designation earlier this year.

Ofev, meanwhile, works by blocking growth factor receptors involved in IPF and also previously received breakthrough designation from the FDA.

In trials both drugs have been shown to significantly reduce the decline in forced vital capacity – the amount of air that can be forcibly exhaled from the lungs – and have been racing each other to be first to market in the US. Both gained orphan product, fast-track and priority review designations on their route to approval.

The simultaneous go-aheads arrive well ahead of the FDA’s intended decision dates of 2 January 2015 for Ofev, and 23 November this year for Esbriet, and so they will now be pitted against each other earlier in the marketplace.

The drugs are likely to be expensive, however, but both companies have apparently set up financial assistance programmes in response to this – namely ‘CareConnect’ from Roche and ‘Open Doors’ from Boehringer.

IPF is characterised by scarring of the lung tissue, but its exact cause is still unknown. Patients have a poor prognosis, typically living only three to five years after diagnosis. This has led to it being a disease area of much interest for pharma firms, and it was a key focus of the European Respiratory Society Annual Congress last month.

The symptoms of IPF – including shortness of breath and coughing – mean that it is often misdiagnosed. The disease affects slightly more men than women and predominantly occurs in older adults over the age of 50, especially those with a history of smoking.

There is still no known cure however, and these new drugs can only slow the progression of the disease. Other current treatments for IPF include oxygen therapy, pulmonary rehabilitation, and lung transplants.

Ofev has also recently received a positive opinion from the EMA for the treatment of non-small cell lung cancer after trial results suggested it could increase overall survival rates to more than a year when combined with docetaxel.

George Underwood

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