Labeling Changes Approved for 2 Hedgehog Inhibitors

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FDA says it has approved labeling changes for vismodegib (Genentech’s Erivedge) and glasdegib maleate (Pfizer’s Daurismo) to include information on musculoskeletal adverse reactions and recommendations to obtain baseline serum creatine kinase (CK) and monitoring of CK levels. The announcement of the labeling changes is in the agency’s response to an 8/31/2020 petition submitted by Dr. Meenal Kheterpal seeking such changes in all currently approved Hedgehog inhibitor drug products and any approved in the future.

Hedgehog inhibitors, an important class of anti-cancer drugs, are defined as small molecules that inhibit the activity of a component of what is known as the Hedgehog signaling pathway. The pathway takes its name from its polypeptide ligand, an intracellular signaling molecule called Hedgehog found in some fruit flies. Inhibition of the Hedgehog signaling pathway is said to be a potentially useful strategy for restricting tumor growth and for preventing the recurrence of the disease post-treatment.

FDA granted the petition in part and denied it in part because one Hedgehog inhibitor, Sun Pharma’s Odomzo (sonidegib phosphate) already had the information in its labeling. “To align the labeling more closely across the Hedgehog inhibitor class,” the letter says, “today we approve the labeling for vismodegib and glasdegib maleate to include further information on musculoskeletal adverse reactions and CK monitoring.”

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