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FDA Issues Stronger Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Warning

Michele B. Kaufman, PharmD, CGP, RPh  |  Issue: October 2015  |  October 14, 2015

The FDA is also reviewing tofacitinib 10 mg and 5 mg twice-daily tablets for treating adults with moderate to severe chronic plaque psoriasis who are candidates for systemic therapy or phototherapy. Tofacitinib is an oral Janus kinase inhibitor.

Abaloparatide-SC Trials

Abaloparatide-SC is a synthetic peptide analog of human parathyroid hormone-related protein (hPTHrP) with a subcutaneous (SC) delivery system currently
completing Phase 3 clinical trials.3 This SC delivery system is designed to be a self-administered, daily injection for patients with postmenopausal osteoporosis at high risk of fracture.

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Previously, the ACTIVE Phase 3 trial data that were reported included patients attaining the primary endpoint of new vertebral fraction reduction of 86% and non-vertebral fracture reduction of 43% (the secondary endpoint), both statistically significant. Other secondary endpoints met were BMD increases at the total hip (3.44%), femoral neck (2.9%) and spine (9.2%), all statistically significant (P < 0.0001).

Recently reported are results of ACTIVExtend, which include patients from ACTIVE having no new vertebral fractures with combined abaloparatide-SC and
alendronate within six months.

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From the beginning of the ACTIVE trial through this trial (a 25-month duration), these patients had an 87% reduction in new vertebral fractures, a 52% reduction in non-vertebral fractures, a 48% reduction in clinical fractures and a 58% reduction in major orthopedic fractures. Over 25 months, combination-treated patients had average BMD increases at the total hip (5.5%), femoral neck (4.5%) and lumbar spine (5.5%). Adverse events included arthralgia, dyspepsia, upper respiratory infections, urinary tract infections and bone pain.

FDA’s New Safety Website

The FDA has launched a new website for risk evaluation and mitigation strategies (REMS) at www.fda.gov/REMS called REMS@FDA. On July 13, 2015, the old site was archived.4 The FDA Amendments Act of 2007 gave the Administration authority to require REMS from manufacturers, ensuring that drug or biological product benefits outweigh their risks.5

The new site aims to provide more up-to-date and timely information on drug safety, REMS, requirements and more. At REMS@FDA users can sign up to receive approved REMS alerts. Users can also go to the site for information on approved REMS, shared REMS and updated REMS.


Michele B. Kaufman, PharmD, CGP, RPh, is a freelance medical writer based in New York City and a pharmacist at New York Presbyterian Lower Manhattan Hospital.

References

  1. U.S. Food and Drug Administration. Safety Alerts: Non-aspirin nonsteroidal antiinflammatory Drugs (NSAIDs): Drug Safety Communication—FDA strengthens warning of increased chance of heart attack or stroke. 2015 Jul 9.
  2. Pfizer Inc. News Release: Pfizer announces FDA acceptance for review of new drug application for a once-daily formulation of xeljanz (tofacitinib citrate) modified release tablets. 2015 Jul 2.
  3. Radius Health Inc. News release: Radius announces positive top-line data from ACTIVExtend trial, including combined 25 month results. 2015 June 17.
  4. Thulin L. FDA launches new REMS website. Drug Store News. 2015 June 17.
  5. U.S. Food & Drug Administration. Approved risk evaluation and mitigation strategies (REMS). 2015 Jun 22.

Editor’s note: These briefs were previously published on our website. Visit http:// www.the-rheumatologist.org for the most recent drug and safety updates.

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Filed under:ConditionsDrug UpdatesOther Rheumatic ConditionsResearch Rheum Tagged with:abaloparatideadverse eventsanti-inflammatoryclinical trialsdrugFDAMIMyocardial infarctionnonsteroidal anti-inflammatory drugsNSAIDsoutcomeResearchrheumatologyriskSafetystroketofacitinib citrate

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