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Mission Therapeutics authorised first clinical trial for kidney disease

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March 31, 2022 – “Mission Therapeutics (“Mission”), a drug discovery and development company focused on protein homeostasis by selectively inhibiting deubiquitylating enzymes (DUBs) announced it has been granted approval to take its lead USP30 DUB inhibitor, MTX652, into clinical study.

Mitochondria are essential for energy production and cellular health. When they become damaged or stop working properly, they are labelled with ubiquitin, marking them for degradation.

The mitochondrial-associated DUB, USP30, removes this ubiquitin and thereby inhibits the degradation, which can affect cell health. 

Mission has developed MTX652 to inhibit USP30 with the aim to enable appropriate degradation of dysfunctional mitochondria to preserve and improve cellular health.

Specific kidney cells are rich in mitochondria and highly vulnerable to injury if those mitochondria are not working correctly. Mitochondrial dysfunction is strongly implicated in kidney injury and chronic kidney disease (CKD). In addition to kidney diseases, mitochondrial quality is implicated in a range of other poorly treated conditions such as idiopathic pulmonary fibrosis, muscular dystrophy and primary mitochondrial disease. Mission is also investigating the potential of USP30 inhibitors to treat these diseases.

Following candidate nomination last year, MTX652 has successfully advanced through preclinical regulatory toxicology studies and is ready to be progressed into the clinic.

The planned initial clinical trial will evaluate the safety, tolerability and pharmacokinetics of MTX652 in over 60 participants given either a single or multiple doses.

The trial is due to start in April 2022.

Dr Suhail Nurbhai, CMO of Mission Therapeutics, commented: “We are delighted that our lead programme is entering the clinic.

Mission has built a groundbreaking platform for the discovery and development of first-in-class small molecule drugs that selectively target DUBs.

MTX652 entering the clinic is a major milestone for the Company and a tremendous achievement. We are excited to be taking this important next step.”

Kidney diseases are a major global health problem and are reported by the US CDC as a leading cause of death in the US.

CKD affects an estimated 780 million people around the world.

The attributable UK NHS costs in 2009/10 were around £1.5 billion and the estimated US Medicare costs for CKD are greater than US$87 billion.

Acute kidney injury (AKI) and CKD are increasingly viewed as a continuum of kidney disease and increase risk to patients of damage to non-renal organs, cardiovascular disease, and early death. Preventing these conditions is therefore an important unmet medical need.”

https://missiontherapeutics.com/mission-therapeutics-authorised-to-initiate-first-clinical-trial-for-lead-dub-program-mtx652-in-kidney-disease/

WHO urges quality care for women and newborns in critical first weeks after childbirth

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 March 30, 2022: “The World Health Organization launched its first ever global guidelines to support women and newborns in the postnatal period – the first six weeks after birth.

This is a critical time for ensuring newborn and maternal survival and for supporting healthy development of the baby as well as  the mother’s overall mental and physical recovery and wellbeing.

Worldwide, more than 3 in 10 women and babies do not currently receive postnatal care in the first days after birth – the  period  when most maternal and infant deaths occur.

Meanwhile the physical and emotional consequences of childbirth – from injuries to recurring pain and trauma – can be debilitating if unmanaged, but are often highly treatable when the right care is given at the right time.

The need for quality maternity and newborn care does not stop once a baby is born,” said Dr Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent Health and Ageing at WHO. 

Indeed, the birth of a baby is a life-changing moment, one that is bound by love, hope and excitement, but it can also cause unprecedented stress and anxiety.

Parents need strong health care and support systems, especially women, whose needs are too often neglected when the baby comes.”

In addition to addressing immediate health concerns, these first weeks after birth are crucial for building relationships and establishing behaviours that affect long-term infant development and health.

The guidelines include recommendations for breastfeeding counselling – to aid attachment and positioning as breastfeeding is established – and to support parents in providing responsive care for their newborns.

Over 60 recommendations that help shape a positive postnatal experience for women, babies and families.

These include:

  • High quality care in health facilities for all women and babies for at least 24 hours after birth, with a minimum of three additional postnatal checkups in the first six weeks.
  • These additional contacts should include home visits if feasible, so that the health worker can support the transition to care in the home. In the case of a home birth, the first postnatal contact should occur as early as possible, and no later than 24 hours after birth
  • Steps to identify and respond to danger signs needing urgent medical attention in either the woman or the baby;
  • Treatment, support and advice to aid recovery and manage common problems that women can experience after childbirth, such as perineal pain and breast engorgement ;
  • Screening of all newborns for eye abnormalities and hearing impairment, as well as vaccination at birth;
  • Support to help families interact and respond to babies’ signals, providing them with close contact, warmth and comfort;
  • Exclusive breastfeeding counselling, access to postnatal contraception and health promotion, including for physical activity;
  • Encouragement of partner involvement, by being part of checkups, for instance, as well as providing support to the woman and attending to the newborn;
  • Screening for postnatal maternal depression and anxiety, with referral and management services where needed.

The recommendations detail the minimum length of hospital stay after birth and provide guidance on discharge criteria, but note that the time needed will depend on individual women and babies, social context, birth experience, and any health concerns.

Additional postnatal contacts are recommended for healthy women and newborns between 48 and 72 hours, between seven and 14 days, and during week six after birth.

If health risks are identified, more contacts will likely be required, with treatment needed potentially well beyond the first six weeks.

Evidence shows that women and their families want and need a positive ostnatal experience that helps them navigate the immense physical and emotional challenges that occur after their babies are born, while building their confidence as parents,” said Dr Mercedes Bonet, Medical Officer with WHO’s Department of Sexual and Reproductive Health and Research and the UN Special Programme, HRP.

Dedicated postnatal services should provide vital physical and mental health support, while helping caregivers thrive in providing the right care for their newborns.”

These recommendations complete a trilogy of guidelines from WHO for quality maternity care through pregnancy and during and after childbirth, centred on meeting the needs of all those who give birth and their babies.

These uphold the rights to a positive healthcare experience, where people are treated with dignity and respect and can participate actively in healthcare decisions.”

https://www.who.int/news/item/30-03-2022-who-urges-quality-care-for-women-and-newborns-in-critical-first-weeks-after-childbirth

Ondexxya approved in Japan for reversal of acute major bleeds in patients on Factor Xa inhibitors

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March 29, 2022: “Ondexxya (andexanet alfa)has been approved in Japan for patients treated with the Factor Xa (FXa) inhibitors apixaban, rivaroxaban or edoxaban, when reversal of anticoagulation is needed due to life-threatening or uncontrolled bleeding.

The approval by the Japanese Ministry of Health, Labour and Welfare was based on positive results from the  ANNEXA-4  Phase III clinical trial showing Ondexxya rapidly and markedly reversed anti-FXa activity in patients with acute major bleeding.

Ondexxya is the first approved medicine in Japan to specifically reverse the anticoagulant effect of FXa inhibitors apixaban, rivaroxaban or edoxaban in patients experiencing a life-threatening or uncontrolled bleed. 

Japan is also the first country to provide full regulatory approval of Ondexxya for use with all three of the FXa inhibitors currently available

FXa inhibitors are increasingly used for the prevention and treatment of thrombotic events, including deep vein thrombosis and pulmonary embolism, or in patients at high risk of a stroke due to an irregular heart rate (atrial fibrillation).

While they prevent unwanted clots from forming, they can also increase the risk of major bleeding, which can be life-threatening.

Masahiro Yasaka, MD, PhD, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan, said: “FXa inhibitors are essential medicines for people prone to developing blood clots, but they can also present a risk of uncontrolled bleeding and related complications, which can be fatal if left untreated. 

Ondexxya’s rapid reversal of the anticoagulating effects of apixaban, rivaroxaban and edoxaban effectively reduces the bleeding and is a major advancement in patient care.”

Mene Pangalos, Executive Vice President, BioPharmaceuticals R&D, AstraZeneca, said: “With the approval of Ondexxya in Japan, we are working to make this important medicine available as quickly as possible for the small proportion of patients with life-threatening or uncontrolled bleeding who are on FXa inhibitors and who have not previously had an approved reversal agent treatment option.”

Ondexxya received approval by the US Food and Drug Administration under the accelerated approval pathway in May 2018 and conditional approval by the European Commission in April 2019for adults treated with FXa inhibitors apixaban and rivaroxaban. In the US, Ondexxya is marketed under the trade name Andexxa [coagulation factor Xa (recombinant), inactivated-zhzo].

Notes

Life-threatening bleeding
There is an urgent need for a specific reversal agent for patients treated with FXa inhibitors hospitalised with a major bleed. Millions of patients worldwide depend on FXa inhibitors every day to prevent harmful blood clots from forming; however, these agents increase the risk of major bleeding.

Major bleeding can be very serious and life-threatening, and can happen inside the body and may not be visible. As prescriptions for FXa inhibitors increase, the potential for serious bleeding hospital admissions grows.

ANNEXA-4
The approval of Ondexxya is supported by data from the ANNEXA-4 Phase III trial, which evaluated the haemostatic efficacy  and safety of Ondexxya in patients receiving a FXa inhibitor who were experiencing an acute major bleed.

In the trial, Ondexxya markedly reversed anti-FXa activity within minutes, with 80% of patients having excellent or good haemostatic efficacy sustained at 12 hours following administration. 

During the trial, 10.4% of patients experienced at least one thrombotic event, the majority of which occurred in patients who delayed or did not restart anticoagulation during the follow-up period.

Consistent with previous trial results in patients who are at increased risk of thrombosis, 15.7% of patients died during the trial.

Ondexxya
Ondexxya (andexanet alfa)is a recombinant protein specifically designed to bind to FXa inhibitors and rapidly reverse their anticoagulant effect. 

Ondexxya is a modified form of the human FXa molecule, an enzyme that helps blood clot. Ondexxya works by acting as a decoy for oral and injectable FXa inhibitors, which target and bind to FXa, allowing them to exert their anticoagulant effect.

When Ondexxya is given through an intravenous infusion to a patient with FXa inhibitor-related bleeding, it binds with high affinity to the FXa inhibitor, prevents it from inhibiting the activity of FXa and reverses the anticoagulant effects of the inhibitor. 

AstraZeneca in CVRM
Cardiovascular, Renal and Metabolism (CVRM), part of BioPharmaceuticals, forms one of AstraZeneca’s three disease areas and is a key growth driver for the Company.

By following the science to understand more clearly the underlying links between the heart, kidneys and pancreas, AstraZeneca is investing in a portfolio of medicines for organ protection and improving outcomes by slowing disease progression, reducing risks and tackling co-morbidities.

The Company’s ambition is to modify or halt the natural course of CVRM diseases and potentially regenerate organs and restore function, by continuing to deliver transformative science that improves treatment practices and CV health for millions of patients worldwide.”

https://www.astrazeneca.com/content/astraz/media-centre/press-releases/2022/ondexxya-approved-in-japan-for-fxai-reversal.html

FDA Authorizes Second Booster Dose of Two COVID-19 Vaccines for Older and immunocompromised Individuals

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March 29, 2022: “The U.S. Food and Drug Administration authorized a second booster dose of either the Pfizer-BioNTech or the Moderna COVID-19 vaccines for older people and certain immunocompromised individuals.

The FDA previously authorized a single booster dose for certain immunocompromised individuals following completion of a three-dose primary vaccination series.

This action will now make a second booster dose of these vaccines available to other populations at higher risk for severe disease, hospitalization and death.

Emerging evidence suggests that a second booster dose of an mRNA COVID-19 vaccine improves protection against severe COVID-19 and is not associated with new safety concerns.

The agency amended the emergency use authorizations as follows: 

  • A second booster dose of the Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 Vaccine may be administered to individuals 50 years of age and older at least 4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine.
  • A second booster dose of the Pfizer-BioNTech COVID-19 Vaccine may be administered to individuals 12 years of age and older with certain kinds of immunocompromise at least 4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine.

    These are people who have undergone solid organ transplantation, or who are living with conditions that are considered to have an equivalent level of immunocompromise.
  • A second booster dose of the Moderna COVID-19 Vaccine may be administered at least 4 months after the first booster dose of any authorized or approved COVID-19 vaccine to individuals 18 years of age and older with the same certain kinds of immunocompromise.

“Current evidence suggests some waning of protection over time against serious outcomes from COVID-19 in older and immunocompromised individuals.

Based on an analysis of emerging data, a second booster dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine could help increase protection levels for these higher-risk individuals,” said Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research.

“Additionally, the data show that an initial booster dose is critical in helping to protect all adults from the potentially severe outcomes of COVID-19. So, those who have not received their initial booster dose are strongly encouraged to do so.”

Today’s action applies only to the Pfizer-BioNTech and Moderna COVID-19 vaccines and the authorization of a single booster dose for other age groups with these vaccines remains unchanged.

The agency will continue to evaluate data and information as it becomes available when considering the potential use of a second booster dose in other age groups. 

The FDA-authorized Pfizer-BioNTech COVID-19 Vaccine and the FDA-approved Comirnaty can be used to provide the authorized booster dose(s).

Similarly, the FDA-authorized Moderna COVID-19 Vaccine and the FDA-approved Spikevax are authorized to provide the authorized booster dose(s).

Information to Support Authorization of a Second COVID-19 Booster Dose

The FDA has determined that the known and potential benefits of a second COVID-19 vaccine booster dose with either of these vaccines outweigh their known and potential risks in these populations.

The evidence considered for authorization of a second booster dose following primary vaccination and first booster dose included safety and immune response information provided to the agency as well as additional information on effectiveness submitted by the companies. 

A summary of safety surveillance data provided to the FDA by the Ministry of Health of Israel on the administration of approximately 700,000 fourth (second booster) doses of the Pfizer-BioNTech COVID-19 Vaccine given at least 4 months after the third dose in adults 18 years of age and older (approximately 600,000 of whom were 60 years of age or older) revealed no new safety concerns. 

The safety of Moderna COVID-19 Vaccine, when administered as a second booster dose, is informed by experience with the Pfizer-BioNTech COVID-19 Vaccine and safety information reported from an independently conducted study in which the Moderna COVID-19 Vaccine was administered as a second booster dose to 120 participants 18 years of age and older who had received a two-dose primary series and a first booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 4 months prior.

No new safety concerns were reported during up to three weeks of follow up after the second booster dose.

Immunogenicity data from an ongoing, open-label, non-randomized clinical study in healthcare workers at a single center in Israel were reported in a publication provided to the FDA.

In this study, individuals 18 years of age and older who had received primary vaccination and a first booster dose with Pfizer-BioNTech COVID-19 Vaccine were administered a second booster dose of Pfizer-BioNTech COVID-19 Vaccine (154 individuals) or Moderna COVID-19 Vaccine (120 individuals) at least four months after the first booster dose.

Among these individuals, increases in neutralizing antibody levels against SARS-CoV-2 virus, including delta and omicron variants were reported two weeks after the second booster as compared to 5 months after the first booster dose.

The amendments to the EUAs to include a second booster dose for these populations were granted to Pfizer Inc. and ModernaTX Inc.”

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-second-booster-dose-two-covid-19-vaccines-older-and

Sanofi and IGM Biosciences Collaborates for Oncology, Immunology and Inflammation Targets

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March 29, 2022 – Sanofi and IGM Biosciences, Inc. announced the signing of an exclusive worldwide collaboration agreement to create, develop, manufacture, and commercialize IgM antibody agonists against three oncology targets and three immunology/inflammation targets.

Engineered IgM antibodies represent a new class of potential therapeutics that combine the multi-valency of IgM antibodies possessing 10 binding sites compared to conventional IgG antibodies having only 2 target binding sites.

John Reed, M.D., Ph.D.
Global Head of Research and Development, Sanofi
“We look forward to this collaboration with IGM Biosciences, a pioneer in a new class of antibody medicines for the treatment of cancer, immunology, and inflammatory diseases.

The IGM Biosciences technology platform offers an exciting approach to developing high-avidity IgM antibodies that can efficiently bind and stimulate the activity of cell surface receptors.

This unique platform has the potential to overcome historical limitations of conventional IgG antibodies when seeking agonists of some classes of receptors.”

Fred Schwarzer
Chief Executive Officer of IGM Biosciences
Sanofi is a global leader in the development and commercialization of innovative therapies, and we welcome the addition of their extensive expertise and resources in expanding and accelerating the development of our IgM antibody platform across multiple areas of high unmet need. 

This partnership builds on an existing research collaboration with Sanofi and is a key step towards our goal of unlocking the full breadth of potential for this important new class of therapeutics.

We are pleased to share this vision with Sanofi and look forward to working together on these six potentially first- and best-in-class programs.”

Terms of the Collaboration
Under the terms of the agreement, IGM will receive a $ 150 million upfront payment. Sanofi has also expressed an interest in purchasing up to $100M of IGM non-voting common stock in a public financing.

For each oncology target collaboration program, IGM will lead research and development activities, and assume related costs, through approval of the first biologics license application (BLA) for a product directed to that oncology target by the FDA or EMA in exchange for up to $940 million in development and regulatory milestones per oncology target.

After receipt of the first marketing approval for a product directed to an oncology target, Sanofi will lead all subsequent development and commercialization activities for that oncology target.

For each oncology target, the companies will share profits 50:50 in certain major markets, and IGM will be eligible to receive tiered royalties on net sales in the rest of world.

For each immunology/inflammation target collaboration program, IGM will lead research and development activities, and assume related costs, through the completion of Phase 1 clinical trial for up to two constructs directed to each immunology/inflammation target, after which Sanofi will be responsible for all future development and related costs, in exchange for up to $1,065 million in aggregate development and regulatory and commercial milestones per immunology/inflammation target.

Following the completion of Phase 1 clinical trial for each immunology/inflammation target, Sanofi will be responsible for subsequent development activities, commercialization efforts, and related costs.

IGM is eligible to receive tiered high single-digit to low-teen royalties on global net sales.

Closing of the collaboration is contingent on completion of review under antitrust laws, including the Hart-Scott-Rodino (HSR) Antitrust Improvements Act of 1976 in the U.S., and customary closing conditions.

About IGM Biosciences, Inc.
Headquartered in Mountain View, California, IGM Biosciences is a clinical-stage biotechnology company focused on creating and developing engineered IgM antibodies.

Since 2010, IGM Biosciences has worked to overcome the manufacturing and protein engineering hurdles that have limited the therapeutic use of IgM antibodies.

Through its efforts, IGM Biosciences has created a proprietary IgM technology platform for the development of IgM antibodies for those clinical indications where their inherent properties may provide advantages as compared to IgG antibodies.”

https://www.sanofi.com/en/media-room/press-releases/2022/2022-03-29-07-00-00-2411497

FDA Seeks $8.4 Billion to Further Investments in Critical Public Health Modernization

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March 28, 2022: “The U.S. Food and Drug Administration announced it is requesting a total budget of $8.4 billion as part of the President’s fiscal year (FY) 2023 budget – a nearly 34% ($2.1 billion) increase over the agency’s FY 2022 appropriated funding level for investments in critical public health modernization, core food safety and medical product safety programs and other vital public health infrastructure.

The request includes $3.7 billion in budget authority – including an increase of $356 million, and $3 billion in user fees – an increase of $153 million.

The request also includes $1.6 billion in mandatory funding to support the FDA’s ability to prepare for future pandemics.

“The funding outlined in this year’s FDA budget request is critical to fulfilling the agency’s mission as we continue our work on a wide range of COVID-19 and non-COVID priorities.

The FDA has focused our budget request on some of today’s most urgent needs such as human and animal food safety, medical device security and e-cigarette oversight.

We also continue to look ahead at our role in public health, including at ways to modernize our efforts to keep pace with evolving science, technology and potential public health emergencies,” said FDA Commissioner Robert M. Califf, M.D.

“Additional funding brings new ways to leverage opportunities to protect and advance the health of every American with reliable and science-based information.

We look forward to continuing our work with Congress to help meet the critical public health challenges ahead.”

The FY 2023 request, which covers the period from Oct. 1, 2022, through Sept. 30, 2023, fully funds initiatives previously requested in the FY 2022 budget request and includes new efforts for high priority program areas. Highlights of the agency’s request include: 

Pandemic Preparedness

  • $1.6 billion over five years to support the FDA’s contributions to the HHS Pandemic Preparedness Plan. The FY 2023 Budget makes transformative investments in pandemic preparedness and biodefense across the U.S. Department of Health and Human Services’ public health agencies to enable an agile, coordinated and comprehensive public health response to future threats and protect American lives, families and the economy.

    This budget increase would allow the FDA to modernize its regulatory capacity by strengthening its IT and laboratory infrastructure.

    The agency will also focus on evaluation of vaccines and therapeutics to respond to any future pandemic or high consequence biological threat, facilitation of rapid development of diagnostics and work to support efforts to expand the personal protective equipment supply chain. 

Food Safety & Nutrition Modernization

  • $43 million in additional investments in food safety modernization, including animal food safety oversight. 
    The budget builds on the successes of human and animal food safety modernization activities and supports the agency’s continued implementation of the New Era of Smarter Food Safety and other core food safety efforts to enable the FDA to strengthen data-driven approaches to protecting consumers, allocating regulatory oversight resources based on risk and improving the FDA’s capacity to quickly respond to ongoing and evolving public health challenges.

    Building on the modernized food safety regulatory framework created by the FDA Food Safety Modernization Act, this funding will allow the agency to improve prevention-oriented food safety practices, strengthen data sharing and predictive analytics capabilities and enhance traceability to more quickly respond to outbreaks and recalls for human and animal food.

    The budget request advances mutual reliance efforts as part of the New Era of Smarter Food Safety by providing significant funding to state animal food programs.

    In partnership with states, the FDA will expand efforts to modernize, harmonize and transform the U.S. animal food inspection system to become more comprehensive and prevention oriented.
  • $14 million to improve health equity through nutrition. Through the Healthy and Safe Food for All initiative, the budget includes additional funding to reduce exposure to harmful chemicals and toxins in food.

    Additional funding and legislative proposals will focus specifically on better protecting mothers, infants and young children through contamination limits in food, product testing requirements, notification of anticipated significant interruptions in the supply of infant formula or essential medical foods, as well as modernization of dietary supplement regulation.

Advancing Access to Safe and Effective Medical Products

  • $20 million for the FDA’s efforts as part of Cancer Moonshot to speed progress in cancer research and improve cancer outcomes. 
    The budget request provides a one-time infusion of funding to advance a variety of research, external collaborations and educational outreach programs and continue to support development and regulation of oncology medical products through the Oncology Center of Excellence.

    The agency will build upon existing programs to advance Moonshot goals. 
  • $5 million increase toward improving the safety and security of medical devices. 
    Developing a more comprehensive cybersecurity program for medical devices will help to identify and mitigate vulnerabilities that could compromise medical systems or disrupt device manufacturing or consumer use, placing national security at risk.

    Dedicated base funding for a cybersecurity program will allow for FDA to hire additional staff to recruit and develop greater cyber expertise within the devices program, as well as administer grants and contracts to develop infrastructure geared towards addressing emerging cybersecurity challenges.
  • $5 million in additional funding to boost review capacity for premarket animal drug submissions. Continuing to meet performance commitments, including reduced application review times for animal drug reviews, is a priority for the agency. The number of animal drug submissions received have steadily increased over time and therefore more effort is needed to review the additional submissions within agreed upon user fee timeframes and subsequently increasing the availability of safe and effective animal drug products. 
  • $30 million in additional funds to advance the goal of ending the opioid crisis. Funding will address four priority areas of the epidemic including decreasing exposure and preventing new addiction, supporting the treatment of those with opioid use disorder, fostering the development of novel pain treatment therapies and improving enforcement and assessing benefit-risk.

Core Operations

  • $68 million in further investments in Data Modernization and Enhanced Technologies. 

    The budget provides increases to core programs and infrastructure aligned to the food and medical product programs as well as critical enterprise technology capabilities.

    Data-informed capabilities, such as artificial intelligence, machine learning and state-of-the-art solutions like blockchain, will be critical to support the FDA’s public health priorities.

    Data modernization will also allow the FDA to review large volumes of data more quickly to identify critical safety signals or emerging outbreaks. 
  • $100 million increase in user fees to support the FDA’s mission of reducing the use and harms of tobacco. 
    The request includes funding to enhance the FDA’s ongoing oversight of e-cigarettes and other ENDS products, which remains a high priority and is critical to the agency’s public health mission, especially, to protecting kids from the dangers of nicotine addiction and other harmful health consequences.

    The budget proposes the additional user fees and requests authority to include manufacturers and importers of all deemed products among the tobacco product classes for which the FDA assesses tobacco user fees.
  • $24 million to optimize inspections and enhance inspectional capacity. The budget request increases support for the recruitment and training of new FDA investigators to improve the efficiency of the agency’s human and animal food and medical product inspectional operations.

    With additional personnel, as well as expanding the use of new and existing inspectional tools, the FDA will enhance its inspectional capacity and build on the efforts to keep pace with rapidly expanding industry including medical counter measures and advanced manufacturing. 
  • $5 million in new funding for a comprehensive strategy for new, alternative methods for product testing. The budget includes funding to support a new, FDA-wide New Alternative Methods Program to reduce animal testing through the development of qualified alternative methods and spur the adoption of methods for regulatory use that can replace, reduce and refine animal testing. New alternative methods have the potential to provide both more timely and more predictive information to accelerate product development and enhance emergency preparedness. 

To complement the funding requests the agency’s budget proposal also includes a package of legislative proposals designed to bolster the FDA’s authorities to further its mission to protect and promote public health. Notable proposals include efforts to: 

  • Modernize dietary supplement regulation, seeking to require annual listing with the FDA of individual dietary supplement products, including basic information about each unique product.

    It is estimated the current supplement market is between 50,000 and 80,000 products.

    Additionally, the agency seeks to clarify its authorities over marketed dietary supplement products to better facilitate enforcement against unlawfully marketed products, allowing the FDA to know when new products are introduced, quickly identify dangerous or illegal products on the market and take appropriate action to protect consumers.
     
  • Require firms to notify the FDA of anticipated significant interruptions in the supply of infant formula or essential medical foods for patients with certain inborn errors of metabolism.

    This proposal would ensure the agency routinely receives timely and accurate information about likely or confirmed shortages in the U.S. and help the FDA to take steps to promote the continued availability of these foods.

    Additionally, the FDA is seeking authority to require firms to provide shortage notification for other FDA-designated categories of food during a declared public health emergency.  
  • Enhance drug and biologic accelerated approval provisions to help ensure that the confirmatory studies will progress in a timely manner and reap high-quality, interpretable results.

    This will help minimize the time that a product is marketed before its clinical benefit can be confirmed.

    The FDA is also proposing a technical fix to revise the accelerated approval withdrawal standard.
  • Amend the Hatch-Waxman 180-day patent challenge exclusivity provisions, so that the FDA can approve subsequent generic drug applications unless and until a first applicant begins commercial marketing of a drug and triggers the exclusivity period, at which point approval of subsequent applications would be blocked by 180 days.

    This would ensure that the exclusivity only lasts 180 days, as intended, rather than multiple years.

    This would substantially increase the likelihood that generic versions of patent-protected drugs come into the market in a timely fashion and would allow multiple versions of generic products to be approved quickly leading to significant cost savings. 
  • Require the destruction of imported products by their owner or consignee that have been refused and pose a significant risk to public health.

    The FDA believes this new authority would prevent the potential re-importation of these products and would deter owners and consignees from importing products they know to pose a significant public health risk.

    This authority could also increase efficiencies when Customs and Border Protection seizes an FDA-regulated product.
  • Assure a more resilient domestic supply chain for medical devices.

    This would include authority to require certain firms to provide notification of potential shortages with production volume information.

    In addition, it would establish a requirement for device manufacturers to perform risk assessments, implement risk management plans and identify alternate suppliers and manufacturing sites.

    The FDA is also proposing the temporary importation of unapproved devices, with appropriate scientific and regulatory controls, when needed to prevent or mitigate a shortage.”

https://www.fda.gov/news-events/press-announcements/fda-seeks-84-billion-further-investments-critical-public-health-modernization-core-food-and-medical

Federal judge enters consent decree against New Jersey raw animal food manufacturer

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March 28, 2022: “The U.S.FDA announced that Bravo Packing, Inc., an animal food manufacturing company of Carney’s Point, New Jersey, has agreed to stop selling, manufacturing and distributing raw pet food and come into compliance with the Federal Food, Drug, and Cosmetic Act (FD&C Act).

Today’s action marks the first consent decree of permanent injunction against an animal food manufacturer for violating public safety standards under Part 507 (Current Good Manufacturing Practice (CGMP) requirements) of the Food Safety Modernization Act (FSMA) Preventive Controls for Animal Food Regulation.

Part 507 requires, among other things, that animal food facilities take adequate precautions to prevent animal food from becoming contaminated and that all animal food manufacturing, processing, packing, and holding is conducted under the conditions necessary to minimize the potential for the growth of undesirable microorganisms to protect against the contamination of animal food. 

“The food we give our pets should be safe for them to eat and safe for people to handle,” said Steven Solomon, DVM, MPH, director of FDA’s Center for Veterinary Medicine.

“The FDA has taken this action to protect public health because, despite multiple inspections, notifications of violations, and recalls, this firm continued to operate under insanitary conditions and produce pet food contaminated with harmful bacteria.

We will not tolerate firms that put people or animals at risk and will take enforcement actions when needed.”

The FDA conducted inspections in 2019 and 2021 and issued a warning letter to the facility in 2020.

During these inspections, the FDA found evidence of significant food safety violations including grossly insanitary conditions and the failure to follow CGMP regulations for animal food.

Multiple samples of finished raw pet food products collected during the inspections tested positive for Salmonella.

Pet food that is contaminated with Salmonella can lead to illness in both the pets consuming the food, as well as humans, who handle the food and care for the pets.

Some of these finished samples as well as environmental samples from the two inspections also tested positive for Listeria monocytogenes.

The consent decree of permanent injunction entered by U.S. District Judge Noel L. Hillman between the FDA and Bravo Packing, Inc., along with the company’s owner and secretary, Joseph Merola, and its president, Amanda Lloyd, prohibits the defendants from receiving, preparing, processing, packing, holding, labeling, and/or distributing pet food unless and until the company completes corrective actions.

The decree also allows the FDA to order a shutdown, recall, or other corrective action in the event of future violations and requires the defendants to pay the costs of inspections performed pursuant to the decree.

Failure to abide by the agreement can also lead to civil or criminal penalties.

Consumers who think they or their pets may have been sickened by these products should seek the assistance of a health care professional and contact the FDA to report problems with this or any FDA-regulated product.

The U.S. Department of Justice filed the complaint on behalf of the FDA.”

https://www.fda.gov/news-events/press-announcements/federal-judge-enters-consent-decree-against-new-jersey-raw-animal-food-manufacturer

Jazz Pharma Announces Significant New Investment in UK Manufacturing

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March 25, 2022: “Construction begins on a new state-of-the-art manufacturing facility at Kent Science Park designed to support the manufacture of regulatory approved cannabis-based medicines

This represents a significant commitment to the UK by GW Pharmaceuticals, now part of Jazz Pharmaceuticals, investing $100 million (£75m) and creating more than 100 highly skilled jobs

LONDON, March 25, 2022 /PRNewswire/ — Jazz Pharmaceuticals plc and its subsidiary, GW Pharmaceuticals (“GW”) – a world leader in discovering, developing and delivering regulatory approved cannabis-based medicines –announced the official initiation of construction of its new, state-of-the-art manufacturing facility at Kent Science Park (KSP) in Sittingbourne.”

http://investor.jazzpharma.com/news-releases/news-release-details/jazz-pharmaceuticals-announces-significant-new-investment-uk

Poolbeg Pharma presents new deal with AI in developing new RSV drugs

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Poolbeg Pharma PLC  Jeremy Skillington joins Proactive London to talk about their new deal – using a state of the art artificial intelligence tool to find new drug targets for respiratory syncytial virus (RSV).

Under the terms of a deal with OneThree Biotech, it will screen for putative treatments that focus in on the immune-response pathways, have a higher probability of clinical success and have the potential to prevent and/or treat infectious diseases. 

Skillington says their ‘OneThree Biotech’s AI analysis tools will allow us to break new ground in data-driven drug discovery, by allowing us to evaluate and interrogate human challenge trial data like never before’.

https://www.proactiveinvestors.co.uk/companies/news/975001/poolbeg-pharma-s-jeremy-skillington-presents-new-deal-with-ai-in-developing-new-rsv-drugs-975001.html

AZ’s Evusheld combination recommended for prevention of COVID-19

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March 24, 2022: “AstraZeneca’s Evusheld (tixagevimab co-packaged with cilgavimab), a long-acting antibody combination, has been recommended for marketing authorisation in the European Union EU for the pre-exposure prophylaxis (prevention) of COVID-19 in a broad population of adults and adolescents aged 12 years and older weighing at least 40 kg.

People not adequately protected by a COVID-19 vaccine may particularly benefit from pre-exposure prophylaxis with Evusheld.

This includes about three million people in the EU who are immunocompromised or being treated with immunosuppressive medicines.

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency based its positive opinion on a review of Evusheld data, including results from the PROVENT Phase III pre-exposure prophylaxis trial, which showed a 77% reduction in the risk of developing symptomatic COVID-19 compared to placebo at the primary analysis and an 83% reduction at a six month median analysis, with protection from the virus continuing for at least six months.

Evusheld was generally well-tolerated in the trial.2-4

Hugh Montgomery, Professor of Intensive Care Medicine at University College London, UK and Evusheld investigator said: “Despite the success of vaccinations, we still need additional measures to prevent the spread of COVID-19 infections in Europe, where the number of cases of the highly transmissible BA.2 subvariant is rapidly increasing and where public health safety measures have been relaxed in many countries.

This broad recommendation for Evusheld will allow health authorities in the EU to identify priority, high-risk populations needing additional protection such as people with cancer, transplant patients, or anyone taking immunosuppressive medicines, as well as those at increased risk of exposure.”

Mene Pangalos, Executive Vice President, BioPharmaceuticals R&D, AstraZeneca, said: “Today’s positive CHMP recommendation represents a significant step forward in our ongoing efforts to introduce additional, important preventative measures for people in Europe at higher risk of developing COVID-19. 

Evusheld has the potential to provide long-lasting protection to vulnerable populations such as the immunocompromised who can’t mount an adequate response to a COVID-19 vaccine, and we’ll continue to work with governments in Europe to make Evusheld available as quickly as possible.”

The recommended dose of Evusheld in Europe is 150mg of tixagevimab and 150mg of cilgavimab, administered as two separate sequential intramuscular (IM) injections.

There is a growing body of evidence from multiple independent in vitro and in vivo (animal model) studies supporting the potential of Evusheld to protect against the BA.1, BA.1.1 and BA.2 Omicron SARS-CoV-2 subvariants in circulation around the world.

New data from Washington University School of Medicine demonstrated Evusheld retained potent neutralising activity against the emerging and highly transmissible BA.2 subvariant, which is the dominant strain in many European countries and currently accounts for nearly 60% of COVID-19 infections in Europe.  

This study also showed Evusheld reduced viral burden and limited inflammation in the lungs (in vivo) across all Omicron variants.

Evusheld is authorised for emergency use for pre-exposure prophylaxis of COVID-19 in the US and in six countries in Europe. Evusheld has also been granted conditional marketing authorisation by the Medicines and Healthcare products Regulatory Agency (MHRA) in Great Britain for pre-exposure prophylaxis of COVID-19.

AstraZeneca anticipates that the European Commission will shortly complete its review of the CHMP positive opinion to determine whether to grant marketing authorisation.

Evusheld is the only long-acting antibody combination with positive Phase III data in the prevention and treatment of COVID19.

AstraZeneca is progressing with filings around the globe for potential emergency use authorisation or marketing approval of Evusheld in both COVID-19 prophylaxis and treatment.”

https://www.astrazeneca.com/content/astraz/media-centre/press-releases/2022/evusheld-long-acting-antibody-combination-recommended-for-approval-in-the-eu-for-the-pre-exposure-prophylaxis-prevention-of-covid-19.html

First ever country level estimates of unintended pregnancy and abortion

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March 24, 2022: “The Guttmacher Institute, the World Heath Organization and the UN’s Human Reproduction Programme (HRP) released the first-ever model-based estimates of unintended pregnancy and abortion rates for 150 countries, highlighting major disparities in access to sexual and reproductive health care.

The study, published in BMJ Global Health, analyzes rates from 2015 to 2019, with the aim of providing deeper insights into access to sexual and reproductive health services in countries of all income levels across the globe. 

To build sexual and reproductive health policies that are truly inclusive and equitable, we need to understand what is happening at a country level,” said Dr Herminia Palacio, President and CEO of the Guttmacher Institute.

Having current and reliable data at hand will not only help identify and find solutions to disparities, but also make a case for smarter investments that deliver impact.” 

Alongside the estimates, Guttmacher has published more detailed country profiles to allow decision makers and health advocates to better understand and act on sexual and reproductive health needs in their countries, particularly for family planning, including contraception and comprehensive abortion care. 

Regional averages mask large disparities in unintended pregnancy and abortion rates

The new estimates indicate that unintended pregnancy and abortion rates vary widely between countries—even within the same region or geographic area.

The greatest variations were found in Latin America and sub-Saharan Africa, where for instance, unintended pregnancy rates in countries ranged from 41 to 107 per 1000 women, and 49 to 145 per 1000 women respectively.

These disparities are not shaped purely by income-level: in Europe, for example, most countries with higher unintended pregnancy rates than the regional average are classified as high-income, while the two countries with the lowest estimates are middle-income.

This finding reflects how barriers to accessing and using effective sexual and reproductive healthcare exist in settings with greater as well as fewer resources.

These variations speak to the need for investment, even in regions with low unintended pregnancy rates, that empowers women and girls across countries to choose under what circumstances they want to have children,” says Jonathan Bearak, a senior research scientist at Guttmacher Institute and lead author of the article.

The proportion of unintended pregnancies ending in abortion—as great as 68%, even among countries that completely prohibited abortion—illustrates the strength of the desire of millions of women and adolescents to avoid unplanned childbearing.”

While the estimates go a long way in increasing the quality of evidence available, there remains a pressing need for more and better data.

The availability of reliable abortion data varied substantially by region, ranging from 12 percent of countries in Western Asia and Northern Africa to 73 percent of countries in Europe and Northern America.

With additional investments in country data collection, it would be possible to make estimates with greater certainty, monitor trends and possibly assess the impact of large-scale programmes in the future.

Sexual and reproductive health and rights are an essential part of universal health coverage and are required to end discrimination against women and girls.

These country-level estimates highlight the importance of equitable investment in comprehensive sexual and reproductive health care, and will further inform countries working to implement WHO’s new guidelines for quality abortion services.

For good health, people in countries around the world need access to a comprehensive package of sexuality education, accurate family planning information and services, as well as quality abortion care,” said Dr Bela Ganatra, who leads WHO’s Prevention of Unsafe Abortion unit.

This research aims to support countries as they work to strengthen the lifesaving services they provide for sexual and reproductive health and improve health outcomes – especially for women and girls.”

https://www.who.int/news/item/24-03-2022-first-ever-country-level-estimates-of-unintended-pregnancy-and-abortion

Effect of COVID-19 on Tuberculosis in the U.S.

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March 24, 2022: “In the United States, reported tuberculosis (TB) disease diagnoses fell 20% in 2020 and remained 13% lower in 2021 than TB disease diagnoses made prior to the COVID-19 pandemic, according to preliminary CDC data published today.

The new data suggest that the pandemic has had a substantial effect on TB trends in the United States. Before COVID-19, TB disease diagnoses typically declined between 1% and 2% each year.

The 2020 and 2021 declines may be related to factors associated with the COVID-19 pandemic, including a true reduction in incidence as well as delayed or missed TB diagnoses. For example:

  • Efforts to prevent COVID-19, such as wearing masks and staying six feet away from others, may also reduce the spread of TB.
  • Widespread disruptions to healthcare during the COVID-19 pandemic may have delayed TB diagnoses. The COVID-19 pandemic has strained public health services, including TB prevention and control services.
  • Similarities in symptoms between COVID-19 and TB disease may have led to missed TB diagnoses.
    Case reports have revealed some people with TB disease were evaluated for COVID-19 — but not tested for TB — during multiple encounters with healthcare systems.
    Initial misassumptions might have contributed to missed diagnoses, or delayed diagnoses until more advanced stages of disease.

TB prevention and control activities are essential public health functions for communities throughout the United States.

To assist in these efforts, CDC launched the Think. Test. Treat TB campaign to help raise awareness of TB and recognize the importance of TB prevention.

Starting a conversation with your doctor is the first step to protecting your family, friends, and community from TB disease.

Please attribute the following quote to Philip LoBue, MD, FACP, FCCP, Director of CDC’s Division of Tuberculosis Elimination

“Delayed or missed tuberculosis disease diagnoses are threatening the health of people with TB disease and the communities where they live.

A delayed or missed TB diagnosis leads to TB disease progression and can result in hospitalization or death – and the risk of transmitting TB to others.

The nation must ensure that healthcare providers understand how to diagnose and distinguish TB disease from potential cases of COVID-19.”

https://www.cdc.gov/media/releases/2022/s0324-tuberculosis-covid-19.html