FDA Turns Down Opko NDA for Rayaldee After Inspection
Opko Health has received an FDA complete response letter (CRL) on an NDA for Rayaldee (calcifediol) as a treatment for secondary hyperparathyroidism in patients with Stage 3 or 4 chronic kidney disease and vitamin D insufficiency. The letter cited manufacturing deficiencies at Opko’s third-party contract manufacturer found during a 3/14 agency inspection. “The CRL did not cite any safety, efficacy or labeling issues with regard to Rayaldee, nor did it request any additional studies to be conducted prior to FDA approval,” the company says.
Opko says that, in the letter, FDA has re-confirmed the acceptance of the proprietary name Rayaldee. It also notes that both parties have reached agreement on an approvable package insert and all container labeling.
The NDA was accepted by FDA 7/2015, and is supported by data from three randomized, double-blind, placebo-controlled studies and one open-label extension study conducted in the targeted patient population at a total of 105 U.S. sites. The studies met all primary efficacy and safety endpoints, according to the company.
Rayaldee is an oral vitamin D prohormone treatment. “It has a proprietary modified-release formulation designed to gradually and reliably raise serum total 25-hydroxyvitamin D (prohormone) concentrations to targeted levels (at least 30 ng/mL) while avoiding upregulation of CYP24A1, a cytochrome P-450 enzyme which interferes with the desired parathyroid hormone (PTH)-lowering effect,” Opko says. “Gradual elevation of serum total 25-hydroxyvitamin D is intended to prevent excessive elevation of serum calcium and related vascular and renal calcification.”