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FDA Grants Orphan Drug Status on Ciprofloxacin Dry Powder Inhaler for the Management of Pulmonary Infection in Cystic Fibrosis
"There continue to be significant unmet medical needs for people with cystic fibrosis," said Shannon Campbell, Vice President and General Manager, Oncology and General Medicine, Bayer HealthCare Pharmaceuticals. "We are pleased to receive the orphan drug designation from the FDA for ciprofloxacin DPI, which we are researching as a potential treatment option for management of pulmonary infections due to P. aeruginosa in CF patients."
Cystic fibrosis is a life-threatening inherited disease affecting the lungs, pancreas, liver, and intestines(1). Approximately 30,000 patients in the US are affected by CF. In 2008, the median age of survival for patients in the US was 37.4 years according to data compiled by the Cystic Fibrosis Foundation. The major consequences of the disease are pancreatic insufficiency and reduced lung function. Lung disease accounts for about 90 percent of the mortality associated with CF. Patients with cystic fibrosis have dehydrated, thickened respiratory secretions that are difficult to clear and provide an attractive environment for bacteria, thus increasing the risk of infection and inflammation.
Pulmonary infections in CF patients are a chronic problem and represent the leading cause of exacerbations and mortality. P. aeruginosa is the leading pathogen in CF patients(5). The thick mucus in the lungs is ideally suited to bacteria, and individuals with CF are colonized and infected by bacteria from an early age; about 20 percent of children under 1 year of age and 80 percent of adult patients with CF have P. aeruginosa present in their sputum(6). Chronic infection with P. aeruginosa is associated with an accelerated decline in pulmonary function, more frequent exacerbations, and increased mortality in patients with CF.
Clinical Trials with Ciprofloxacin DPI
In Phase I studies with ciprofloxacin DPI, including those in pediatric and adult CF patients, ciprofloxacin has been shown to reach high concentrations in the lung with very low systemic exposure following single and multiple dose administration. Adverse events reported in the Phase I studies included transient bitter taste after inhalation, a report of transient reduction of FEV1 that resolved without intervention, and one report of bronchospasm related to study drug. A multinational Phase II study evaluating safety and efficacy in CF patients is ongoing with the primary end point of improvement in lung function, measured by FEV1. An additional clinical study of ciprofloxacin DPI not related to the orphan drug designation for CF is ongoing. This study in patients with non-CF bronchiectasis is evaluating the safety and efficacy of ciprofloxacin DPI with respect to overall bacterial load and clinical outcomes.
About Orphan Drug Designation in the United States
Under legislation passed by the U.S. Congress in 1983, the Orphan Drugs Act provides incentives to sponsors to develop products for rare diseases. The first sponsor who obtains marketing approval for a designated orphan drug or biological product is granted US market exclusivity for a seven-year period. Exclusivity begins on the date that the marketing application is approved by the FDA for the designated orphan drug and applies only to the indication for which the drug has been designated and approved. The approval of an orphan designation request does not alter the standard regulatory requirements and process for obtaining marketing approval. Safety and efficacy of a compound must be established through adequate and well-controlled studies.
Source: Bayer HealthCare Pharmaceuticals