RE: RNS5 May 2019 17:27
Scott, just listened at they said “the fda were willing to do the meeting”, so be mindful, not picking on words but it’s very different to FDA “requesting” the meeting”
I can see FDA issues around toxicity and have a feeling that they will want a further trial, given some within revive 2 had Hep A also. Whilst circa 3% on numbers seems a small trial. That said review questions were addressed with use of outside experts, so they seem well prepared.
Interesting to see after NDA review no questions in CRL re efficacy, but seems surrounding around elevated liver levels. I don’t believe the FDA will just “change their mind”, both politically and clinically after putting this in the CRL. Currently no demand for additional trials according to webcast however.
My feeling is the FDA is using a lower level of acceptance than motif potentially, and that’s the stumbling block. 3X upper limit is the marker, but none of the results from Iclaprim exceeded that.....which begs an interesting question....why deny the approval? CRL says liver toxins yet it appears within the 3X guidance. Motif also looked at 5X, which was again within FDA guidance levels
I do think it very odd that they would not go into any detail on the CRL contents however.
Interesting times.