FDA Approves Intercept Pharma’s Ocaliva for Liver Disorder
FDA has granted Intercept Pharmaceuticals accelerated approval for Ocaliva (obeticholic acid) for treating primary biliary cholangitis in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA, or as a single therapy in adults unable to tolerate UDCA. The condition causes the small bile ducts in the liver to become inflamed, damaged and ultimately destroyed, which causes bile to remain in the liver and leads to cirrhosis.
Ocaliva was shown to bind to the farnesoid X receptor (FXR), found in the nucleus of cells in the liver and intestine, according to an FDA release. “FXR is a key regulator of bile acid metabolic pathways,” it says. “Ocaliva increases bile flow from the liver and suppresses bile acid production in the liver, thus reducing the exposure of the liver to toxic levels of bile acids.”
Approval was based on a reduction in the level of the biomarker alkaline phosphatase (ALP), a surrogate endpoint which the agency says could be relied upon to be reasonably likely to predict clinical benefit, including an improvement in transplant free-survival. Clinical data from 216 participants showed that after twelve months, the proportion of participants achieving reductions in ALP levels was higher among Ocaliva-treated participants compared to those on placebo, it says.