Treatment for Seizure Clusters
FDA Accepts New Drug Application (NDA) to Review Midazolam Nasal Spray, an Investigational Product for the Acute Treatment of Seizure Clusters
Brussels (Belgium) & Atlanta Georgia, August 13th 07:00 (CEST): UCB today announced that the U.S. Food and Drug Administration (FDA) has accepted the filing of a New Drug Application (NDA) for midazolam nasal spray*, an investigational product for the acute treatment of seizures in patients who require control of intermittent bouts of increased seizure activity (e.g. seizure clusters, acute repetitive seizures).
The application is supported by data from a Phase 3 clinical study (ARTEMIS 1 -Acute Rescue Therapy in Epilepsy with Midazolam Intranasal Spray), which evaluated the safety and efficacy of midazolam nasal spray in 292 patients.1
“Managing seizure clusters remains a challenge for thousands of patients and caregivers, in the US and beyond, who live their lives each day with this debilitating condition,” explained Jeff Wren, Head of Neurology and Executive Vice-President at UCB. “There is an unmet need for effective and convenient acute treatment of seizure clusters that can rapidly end ongoing seizures and potentially prevent or delay their reoccurrence.”
Seizure Clusters are unpredictable, even when a patient is compliant with their current anti-epileptic drugs. When it comes to managing seizure clusters, it is important that patients have an acute care plan that includes access to a treatment they can take anytime or anywhere.
“With midazolam nasal spray, UCB hopes to expand and diversify the treatment choices we are able to provide to the epilepsy community, complementing our already strong epilepsy portfolio and providing additional solutions to help patients.” said Jeff Wren.
UCB estimates that more than 150,000 people in the U.S. with refractory epilepsy also experience seizure clusters.2,3,4 These types of seizures pose multiple risks to patients, including repeated emergency room visits and related hospitalizations each year.
Midazolam nasal spray has been granted both orphan drug and fast track designations by the FDA, reflecting the significant unmet need which currently exists for acute care of seizure clusters.
The acceptance of this NDA could result in midazolam nasal spray being approved in the U.S. as an acute treatment for increased seizure activities in early 2019. If approved, midazolam nasal spray will be the first new medication approved to treat seizure clusters in more than 17 years.
UCB acquired midazolam nasal spray from Proximagen in June 2018. Both companies have collaborate to quickly progress the NDA filing. This reflects and reinforces the commitment of both companies to making their portfolios of development medicines available to as many patients who could benefit from them as quickly as possible.
About FDA Fast Track Designation
FDA Fast Track Designation is a process designed to facilitate the development and expedite the review of drugs to treat serious conditions and fill an unmet medical need, with the aim of getting important new medicines to patients more quickly. To be eligible for Fast Track designation, a drug must show some advantage over available therapy.
Fast Track designation provides many favorable elements which can help expedite a medicine’s review process. These can include more frequent meetings with FDA to discuss a drug’s development plan and ensure collection of appropriate data needed to support drug approval, more frequent written communication from FDA relating to the design of the proposed clinical trials and use of biomarkers, and Rolling Review – allowing a company to submit completed sections of its NDA for review by FDA, rather than waiting until every section of the NDA is completed before the entire application can be reviewed.
* Midazolam Nasal Spray has not been approved by the FDA. These statements solely reflect the opinions of the authors.
About UCB in Epilepsy
UCB has a rich heritage in epilepsy with over 20 years of experience in the research and development of antiepileptic drugs. As a company with a long-term commitment to epilepsy research, our goal is to address unmet medical needs. Our scientists are proud to contribute to advances in the understanding of epilepsy and its treatment. We partner and create super-networks with world-leading scientists and clinicians in academic institutions, pharmaceutical companies and other organizations who share our goals. At UCB, we are inspired by patients, and driven by science in our commitment to support patients with epilepsy.
UCB, Brussels, Belgium (www.ucb.com) is a global biopharmaceutical company focused on the discovery and development of innovative medicines and solutions to transform the lives of people living with severe diseases in immunology and neurology. With around 7,500 people operating in 40 countries, the company generated revenue of €4.5 billion in 2017. UCB is listed on Euronext Brussels (symbol: UCB). Follow us on Twitter: @UCB_news
Proximagen LLC, a member of the ACOVA family of companies located in Plymouth MN (USA), specializes in the development of novel small molecule therapeutics in the areas of CNS, pain and inflammation. Proximagen has a long history of drug development, as part of the Upsher-Smith Laboratories family of companies prior to the sale of its generics business in 2017.
Forward looking statements
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- Braun T.L et al. Safety and tolerability of nayzilam™ (usl261; midazolam nasal spray) in subjects with acute repetitive seizures: resultsfrom the randomized, phase 3 artemis-1 clinical trial 2017. 71st Annual Meeting of the American Epilepsy Society (AES), December 1-5, 2017; Washington, USA, abs. 3.271
- Jafarpour S et al. (in press). Seizure cluster: Definition, prevalence, consequences, and management. Seizure: Eur J Epilepsy (2018), https://doi.org/10.1016/j.seizure.2018.05.013.
- A Komaragiri et al. Seizure clusters: A common, understudied and undertreated phenomenon in refractory epilepsy. Epilepsy & Behavior 59 (2016) 83–86
- Acute Repetitive Seizures. Decision Base Report 2015. Data on file.
Posted: August 2018
Nayzilam (midazolam) FDA Approval History