FDA ‘Complete Response’ on Portola Anticoagulant Reverser
FDA has issued Portola Pharmaceuticals a complete response letter on its BLA for AndexXa (andexanet alfa), indicated for reversing anticoagulant activity of both direct and indirect Factor Xa inhibitors. The letter asks the company provide additional information related to manufacturing, and additional data to support inclusion of edoxaban and enoxaparin in the label. It also says the agency needs to finalize its review of the clinical amendments to Portola’s post-marketing commitments that recently were submitted.
Portola says the therapy should be used to reverse anticoagulation, such as in life-threatening or uncontrolled bleeding or for emergency surgery and urgent procedures. The submission is based on data from the company’s ANNEXA (Andexanet Alfa a Novel Antidote to the Anticoagulant Effects of FXa Inhibitors) studies. It also included limited efficacy and safety data from initial patients enrolled in anongoing Phase 4 ANNEXA-4 study, an open-label confirmatory study in patients receiving apixaban, rivaroxaban, edoxaban and who present to the hospital with an acute major bleed.