FDA Denies Synergy Pharmaceuticals’ Linzess Petition

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FDA has denied a 2/26/18 Synergy Pharmaceuticals petition asking that the agency require specified revisions to the approved package insert for Forest Laboratories’ Linzess (linaclotide) capsules. The petition asked that FDA: 

  •          convert the Trial 5 safety data for the Linzess 72 mcg dose in patients treated for chronic idiopathic constipation (CIC) from narrative to tabular form;
  •          add an additional column to Table 2 to reflect adverse events for the 290 mcg dose with a specified footnote;
  •          add an additional paragraph to the Adverse Reactions Leading to Discontinuations section with wording specified in the petition; and
  •          add an asterisk to Tables 1 and 2 as well as the additional table proposed in the petition to reflect adverse events in Trial 5 with wording specified in the petition.

Synergy said that based on its review of publicly available information on the Linzess clinical trial protocols and clinical trial data it had determined that the prescribing information failed to include adequate information for the drug’s use because it misrepresented or obfuscated the incidence of adverse events from the clinical trials in several respects.

FDA responded that based on its review and on information submitted by Allergan in response to the petition, it did not agree with Synergy on any of its concerns and thus denied the petition.

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