2nd UPDATE: FDA Warns Of PML Risk With Psoriasis Drug Raptiva
February 19 2009 - 3:29PM
Dow Jones News
The Food and Drug Administration Thursday warned patients on the
psoriasis drug Raptiva about the risk of developing a rare and
often fatal brain infection known as progressive multifocal
leukoencephalopathy.
In a public health advisory posted on the agency's Web site, the
FDA said it's received three confirmed and one possible report of
PML in patients taking Raptiva since the drug was approved in 2003.
Raptiva is marketed by Genentech (DNA) and is approved to treat a
condition characterized by inflamed, swollen and scaly patches of
skin. The agency said three of the patients died.
Separately, the European Medicines Agency recommended the drug
be withdrawn from the European market because of the risk of PML.
Merck Serono, a division of Germany's Merck KGaA (MRK.XE), sells
Raptiva in Europe while Genentech sells the drug in the U.S. The
European Commission must sign off on the recommendation to make it
official, which is expected.
Last October the U.S. product labeling for Raptiva was revised
to highlight in a boxed warning the risks of life-threatening
infections, including PML, after one case of PML was seen.
The FDA said it is reviewing the additional cases of PML "and
will take appropriate steps to ensure that the risks of Raptiva do
not outweigh its benefits."
"The FDA strongly recommends that health care professionals
carefully monitor patients on Raptiva, as well as those who have
discontinued the drug, for any signs or symptoms of neurologic
disease, and that they periodically reassess the benefits of
continued treatment," the agency said in a statement. The FDA noted
that there are several other approved products to treat
psoriasis.
A Genentech spokeswoman said the company takes "the risk of PML
very seriously and [is] working diligently with the FDA to put the
right plans in place that will help protect patient safety." Last
week Genentech sent out a letter to health care professionals
discussing the third case of PML.
The FDA said four patients were treated with the drug for more
than three years. None of the patients were receiving other
treatments that suppress the immune system.
PML is caused by a virus that affects the central nervous
system. PML usually occurs in people whose immune systems have been
severely weakened, and there's no treatment or known way to prevent
the condition. PML leads to an irreversible decline in neurologic
function and death.
Symptoms may include unusual weakness, loss of coordination,
changes in vision, difficulty speaking and personality changes, the
FDA said.
Raptiva was approved in 2003 to treat adults with moderate to
severe plaque psoriasis and there were no reports of PML seen in
clinical trials. The drug is a once-weekly injection and works by
suppressing T-cells in the immune system to keep the body from
producing excess skin cells which causes the scaly, build-up of
plaques in people with severe psoriasis. However, by suppressing
T-cells, Raptiva also decreases the function of the immune system
which increases a patient's susceptibility to infections.
-By Jennifer Corbett Dooren, Dow Jones Newswires; 202-862-9294;
jennifer.corbett@dowjones.com.