Flexion Therapeutics gets USFDA nod to update product label for Zilretta to treat osteoarthritis knee pain

New Delhi: Flexion Therapeutics, Inc recently announced that the US Food and Drug Administration (FDA) has approved a supplemental New Drug Application (sNDA) to update the product label for Zilretta (triamcinolone acetonide extended-release injectable suspension) for the treatment of osteoarthritis (OA) knee pain.

Key elements of the label update include removal of language which stated that Zilretta was “not intended for repeat administration.” The updated label states that the “efficacy and safety of repeat administration of Zilretta have not been demonstrated.” Inclusion of a study description and safety data from the single-arm, open-label phase 3 repeat administration trial. Removal of a misleading statement describing a single secondary exploratory endpoint in the original phase 3 pivotal trial which compared Zilretta to immediate-release triamcinolone acetonide crystalline suspension. Inclusion of nonclinical toxicology data from previously submitted single and repeat administration studies in non-diseased animals.

“We are very pleased with the new product label as it achieves our primary goal of removing unclear language pertaining to repeat administration, which we believe was potentially confusing to patients, physicians and payers alike,” said Michael Clayman, MD, president and chief executive officer of Flexion. “In addition, we are gratified by the inclusion of safety data from our repeat administration trial and the removal of the inappropriate comparator statement. We believe the updated label supports our goal of seeing Zilretta become the leading intra-articular therapy for managing OA knee pain.”

Added John Richmond, MD, medical director for Network Development, New England Baptist Hospital, “As both a clinician and a Zilretta patient, I have firsthand experience with the significant magnitude and duration of pain relief it can provide to people confronting knee OA. Zilretta is an invaluable non-opioid option for managing chronic OA knee pain, and it is encouraging to see a new product label that better informs clinical decision making.”

On October 6, 2017, Zilretta was approved by the US FDA as the first and only extended-release intra-articular therapy for patients confronting osteoarthritis-related knee pain. Zilretta employs proprietary microsphere technology combining triamcinolone acetonide — a commonly administered, short-acting corticosteroid — with a poly lactic-co-glycolic acid (PLGA) matrix to provide extended pain relief. The pivotal phase 3 trial on which the approval of Zilretta was based showed that Zilretta significantly reduced knee pain for 12 weeks, with some people experiencing pain relief through week 16.

Osteoarthritis (OA), also known as degenerative joint disease, affects more than 30 million adults living in the US and accounts for more than US $185 billion in annual expenditures. In 2016, more than 15 million Americans were diagnosed with OA of the knee and the average age of physician-diagnosed knee OA has fallen by 16 years, from 72 in the 1990s to 56 in the 2010s. The prevalence of OA is expected to continue to increase as a result of aging, obesity and sports injuries. Each year, approximately five million OA patients receive either an immediate-release corticosteroid or hyaluronic acid intra-articular injection to manage their knee pain.

Flexion Therapeutics is a biopharmaceutical company focused on the development and commercialization of novel, local therapies for the treatment of patients with musculoskeletal conditions, beginning with osteoarthritis, the most common form of arthritis. The company's core values are focus, ingenuity, tenacity, transparency and fun.

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