Outlook Refiles BLA for Wet AMD Drug

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FDA has accepted for review an Outlook Therapeutics BLA resubmission for ONS-5010 (bevacizumab-vikg), an investigational ophthalmic formulation of bevacizumab for treating wet age-related macular degeneration (wet AMD), a serious eye condition where abnormal blood vessels grow under the retina, potentially leaking blood or fluid and causing rapid vision loss. The agency has set an 8/27 user fee review action target date.

In 8/2023, FDA issued the original BLA a complete response letter that cited several chemistry, manufacturing and control (CMC) issues, open observations from pre-approval manufacturing inspections, and a lack of substantial evidence, according to the company. It says the resubmission is based on the efficacy and safety demonstrated in the NORSE EIGHT clinical trial, as well as additional CMC information requested by the agency. In earlier Type A meetings with FDA, the company was given the option to conduct a non-inferiority study evaluating ONS-5010 versus ranibizumab in a 12 week study in treatment naïve patients (NORSE EIGHT) to satisfy the substantial evidence requirement, Outlook says.

Bevacizumab is a recombinant humanized monoclonal antibody (mAb) that “selectively binds with high affinity to all isoforms of human vascular endothelial growth factor (VEGF) and neutralizes VEGF’s biologic activity through a steric blocking of the binding of VEGF to its receptors Flt-1 (VEGFR-1) and KDR (VEGFR-2) on the surface of endothelial cells,” Outlook says. “Following intravitreal injection, the binding of bevacizumab to VEGF prevents the interaction of VEGF with its receptors on the surface of endothelial cells, reducing endothelial cell proliferation, vascular leakage, and new blood vessel formation in the retina.”

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