Amylin Pharmaceuticals Inc., Eli Lilly and Company and Alkermes, Inc. announced that the companies have submitted their reply to a complete response letter issued in October 2010 by the US Food and Drug Administration (FDA) regarding Bydureon (exenatide extended-release for injectable suspension), an investigational medication for type 2 diabetes. The companies expect to receive an updated Prescription Drug User Fee Act (PDUFA) action date from the FDA within the next two weeks. Since the reply included additional data, it will likely be categorized as a Class 2 resubmission requiring up to six months for review.
The reply submission includes results from the recently completed thorough QT (tQT) study, which showed that exenatide, at and above therapeutic levels, did not prolong the corrected QT interval in healthy individuals as defined by the FDA's published guidance. The reply also contains results from the DURATION-5 study, which compared the commercial formulation of Bydureon to Byetta (exenatide) injection. Additionally, it includes an update of safety information from studies ongoing or completed since the last submission, as is standard practice in a complete response scenario.
“We worked expeditiously to complete the requested tQT study and consulted with the FDA throughout the process,” said Christian Weyer, MD, senior vice president, research and development, Amylin Pharmaceuticals. “We are confident that the study results and our detailed submission have addressed the requirements outlined by the FDA, and we remain committed to making Bydureon available to patients in the US as soon as possible.”
Bydureon is the proposed brand name for exenatide extended-release for injectable suspension. It is an investigational medication for type 2 diabetes designed to deliver continuous therapeutic levels of exenatide in a single weekly dose. Bydureon is a once-weekly formulation of exenatide, the active ingredient in Byetta, which has been available in the US since June 2005 and is used in more than 70 countries worldwide to improve glycemic control in adults with type 2 diabetes. Bydureon and Byetta belong to the Glucagon-Like Peptide-1 (GLP-1) receptor agonist class of medications.
The New Drug Application (NDA) for Bydureon was submitted in May 2009. It is based on safety and efficacy data from the DURATION clinical trial program and the Byetta NDA, as well as post-marketing experience with Byetta. The FDA issued complete response letters to the companies in March 2010 and October 2010.
Bydureon received marketing authorization in the European Union in June 2011. It is available in the UK and will launch in other major European countries as soon as possible.
Diabetes affects nearly 26 million people in the US and an estimated 347 million adults worldwide. Approximately 90-95 percent of those affected have type 2 diabetes. In the US, diabetes costs more than $ 174 billion per year in direct and indirect medical expenses.
According to the Centres for Disease Control and Prevention's National Health and Nutrition Examination Survey, approximately 60 percent of people with diabetes do not achieve their target blood sugar levels with their current treatment regimen. In addition, 85 percent of type 2 diabetes patients are overweight and 55 percent are considered obese. Data indicate that weight loss (even a modest amount) supports patients in their efforts to achieve and sustain glycemic control.
Byetta was the first Glucagon-Like Peptide-1 (GLP-1) receptor agonist to be approved by the FDA for the treatment of type 2 diabetes. Byetta exhibits many of the same effects as the human incretin hormone GLP-1. GLP-1 improves blood sugar after food intake through multiple effects that work in concert on the stomach, liver, pancreas and brain.
Byetta is an injectable prescription medicine that may improve blood sugar (glucose) control in adults with type 2 diabetes mellitus, when used with a diet and exercise program. It is not insulin and should not be taken instead of insulin. It is not currently recommended to be taken with insulin. It is not for people with type 1 diabetes or people with diabetic ketoacidosis. Byetta has not been studied in people who have pancreatitis.
Byetta provides sustained A1C control and low incidence of hypoglycaemia when used alone or in combination with metformin or a thiazolidinedione, with potential weight loss (Byetta is not a weight-loss product). Byetta was approved in the US in April 2005 and in Europe in November 2006 and has been used by more than 1.8 million patients since its introduction.
Based on post-marketing data Byetta has been associated with acute pancreatitis, including fatal and non-fatal haemorrhagic or necrotizing pancreatitis. Patients should be observed for signs and symptoms of pancreatitis after initiation or dose escalation of Byetta. The risk for getting low blood sugar is higher if Byetta is taken with another medicine that can cause low blood sugar, such as a sulfonylurea. It should not be used in people who have severe kidney problems and should be used with caution in people who have had a kidney transplant.
Patients should talk with their healthcare provider if they have severe problems with their stomach, such as delayed emptying of the stomach (gastroparesis) or problems with digesting food. Antibodies may develop with use of Byetta. Patients who develop high titers to exenatide could have worsening or failure to achieve adequate glycemic control. Consider alternative therapy if this occurs. Severe allergic reactions can happen with Byetta. There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with Byetta or any other anti-diabetic drug.
The most common side effects with Byetta include nausea, vomiting, diarrhoea, dizziness, headache, feeling jittery, and acid stomach. Nausea most commonly happens when first starting Byetta, but may become less over time.
These are not all the side effects from use of Byetta. A healthcare provider should be consulted about any side effect that is bothersome or does not go away.
Amylin and Lilly partnered to develop and market Bydureon, which is based on proprietary technology for long-acting medications developed by Alkermes, Inc. Bydureon is approved in the EU and is under regulatory review in the US.
Amylin Pharmaceuticals is a biopharmaceutical company dedicated to improving lives of patients through the discovery, development and commercialization of innovative medicines.
Through a long-standing commitment to diabetes care, Lilly provides patients with breakthrough treatments that enable them to live longer, healthier and fuller lives. Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations.
Alkermes, Inc. is a fully integrated biotechnology company committed to developing innovative medicines to improve patients' lives.