Confirmatory Evidence in Non-Oncologic Rare Diseases
FDA researchers say most non-oncologic rare disease marketing applications approved between 2020 and 2023 used a single adequate and well-controlled trial plus confirmatory evidence to demonstrate effectiveness. Writing in Clinical Pharmacology and Therapeutics, the researchers say that although different types of confirmatory evidence were used in different applications, mechanistic or pharmacodynamic evidence was used to support 77.5% of recent rare disease marketing applications that were approved based on one trial plus confirmatory evidence.
“The quantity of confirmatory evidence necessary to support effectiveness may vary across development programs,” the researchers write. “Early and frequent discussions with the agency to align on the developmental plan will facilitate efficient drug development and regulatory assessment.”