FDA Rejects Lipocine NDA for Testosterone Drug

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FDA has issued Lipocine a complete response letter on its NDA for Tlando, an oral testosterone product candidate for hormone replacement therapy in adult males for conditions associated with hypogonadism. The letter said Lipocine’s drug efficacy trial did not meet the three secondary endpoints for maximal testosterone concentrations (Cmax), the company says. It also says that FDA did not identify any specific issues relating to the chemistry, manufacturing and controls.

 

This was the third NDA review for Tlando. In 2017, the agency sent a complete response letter that identified NDA deficiencies related to the dosing algorithm for the label, noting that the titration scheme for clinical practice was significantly different from the titration scheme used in the Phase 3 trial, leading to discordance in titration decisions between the trial and real-world clinical practice.

 

That NDA submission went before an advisory committee meeting in 2018 (see story) and panel members voted not to recommend approval. In briefing materials, FDA reviewers said it appeared that Tlando had cardiovascular safety concerns because during clinical trials it appeared to raise heart rate and increase systolic blood pressure. Agency cardiologists recommended that Lipocine perform an ambulatory blood pressure monitoring study to further assess the effects of Tlando on blood pressure and heart rate.

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