FDA Rejects Pharming Expanded Use for Ruconest

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FDA has issued Pharming Group a complete response letter on its supplemental BLA for Ruconest [C1 esterase inhibitor (recombinant)] to expand the current indication to include prophylaxis in patients with hereditary angioedema. Based on the agency review, FDA has requested an additional clinical trial to further evaluate the effectiveness of Ruconest for the proposed indication. The 11/2017-submitted application included data from two Phase 2 studies, an open-label study and a randomized, double-blind, placebo-controlled trial with 4-8 week treatment periods, which the company says showed consistent efficacy and safety results.


Ruconest, the first recombinant C1-esterase inhibitor product for treating acute attacks in adult and adolescent patients with hereditary angioedema, was originally approved in 2014. The therapy is purified from the milk of genetically modified (transgenic) rabbits, according to an agency news release. “Ruconest is intended to restore the level of functional C1-esterase inhibitor in a patient’s plasma, thereby treating the acute attack of swelling.”

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