Reviewers Question Intercept’s Liver Drug
FDA is asking the Gastrointestinal Drugs Advisory Committee to weigh the benefits and risks of Intercept Pharmaceuticals’ obeticholic acid (OCA) to treat pre-cirrhotic liver fibrosis due to nonalcoholic steatohepatitis (NASH). In a briefing document released in advance of the committee’s 5/19 meeting, agency medical reviewers say there are currently no approved medical treatments for NASH in the U.S.
The report says that in the pivotal trial, OCA 25 mg compared to placebo met only one of the two pre-specified primary endpoints, while the 10 mg dose failed to meet either endpoint. However, the reviewers write, “the adverse reactions experienced with OCA 25 mg suggest that treatment with this dose exacerbates co-morbidities or creates new ones for a patient population at risk for metabolic syndrome and its manifestations.”
The document lists six questions for the committee to discuss, ending with whether the members recommend approval of OCA 25 mg via the accelerated approval pathway based on a surrogate histologic marker.