In October 2009, the FDA's Division of Reproductive and Urologic Products issued a Complete Response Letter for the Biologic License Application (BLA) for Prolia in the treatment and prevention of postmenopausal osteoporosis. The letter requested several items, including further information on the design of Amgen's previously submitted post-marketing surveillance program. The letter did not require additional pre-marketing clinical trials to complete the review of the treatment indication. The FDA also requested all updated safety data related to Prolia. Amgen submitted the requested information for the treatment indication in late January 2010.
Amgen continues to work with the FDA to determine appropriate next steps regarding its indications for Prolia in the prevention of postmenopausal osteoporosis, as well as in the treatment and prevention of bone loss due to hormone ablation in breast and prostate cancer patients.
Denosumab is the first and only therapy in late stage development that specifically targets RANK Ligand, an essential regulator of osteoclasts (the cells that break down bone). It is under study for administration every six months as a subcutaneous injection just under the skin and is being investigated for its potential to inhibit all stages of osteoclast development through a targeted mechanism. Denosumab is also being studied in a range of other bone loss conditions including rheumatoid arthritis, and for its potential to delay bone metastases and inhibit and treat bone destruction in patients with advanced cancer.
Often referred to as the "silent epidemic", osteoporosis is a global problem that is increasing in significance as the population of the world both increases and ages. In the U.S. today, nearly eight million women suffer from osteoporosis.(1) The World Health Organization (WHO) has recently identified osteoporosis as a priority health issue along with other major non-communicable diseases.
The economic burden of osteoporosis is comparable to that of other major chronic diseases; for example, in the U.S., the costs associated with osteoporosis-related fractures are equivalent to those of cardiovascular disease and asthma.(2,3,4) It has been reported that osteoporosis results in more hospital bed-days than stroke, myocardial infarction or breast cancer.(5)
Along with proper diet and weight-bearing exercise, medications can help slow bone loss and reduce the risk of fracture. Yet despite the availability of osteoporosis treatments for more than 10 years, the worldwide lifetime risk of fracture remains high at 30-50 percent for women and 15-30 percent for men.(6) It is estimated that fewer than 50 percent of patients adhere to their current therapy for more than one year(7,8,9), which may leave many patients insufficiently protected against bone loss.
Amgen discovers, develops, manufactures and delivers innovative human therapeutics. A biotechnology pioneer since 1980, Amgen was one of the first companies to realize the new science's promise by bringing safe and effective medicines from lab, to manufacturing plant, to patient. Amgen therapeutics have changed the practice of medicine, helping millions of people around the world in the fight against cancer, kidney disease, rheumatoid arthritis and other serious illnesses. With a deep and broad pipeline of potential new medicines, Amgen remains committed to advancing science to dramatically improve people's lives. To learn more about our pioneering science and our vital medicines, visit www.amgen.com.
1. http://www.nof.org/osteoporosis/diseasefacts.htm, accessed, 3/18/2009: Main bullet #5
2. Burge R, et al. J Bone Miner Res. 2007; 22:465-475
3. "Osteoporosis Fast Facts" Washington (DC): National Osteoporosis Foundation. Accessed on February 24, 2009 at http://www.nof.org/osteoporosis/stats.html.
4. "Economic Cost of Cardiovascular Diseases" Dallas (TX): American Heart Association. Accessed on February 24, 2009 at http://www.americanheart.org/statistics/10econom.html
5. Lippuner K, et al. "Incidence and direct medical costs of hospitalisations due to osteoporotic fractures in Switzerland" Osteoporosis International.1997;7:414
6. International Osteoporosis Foundation (2002). Osteoporosis in the Workplace: The social, economic and human costs of osteoporosis on employees, employers and governments
7. Rossini M et al. Osteoporosis Int. 2006;17:914-921
8. Payer J et al. Biomed Pharmacother 2007;61:191-193
9. McCombs JS et al. Maturitas 2004;48:271-287