February 11, 2009 4:43 PM
- Text
Feds Reject French Weight-Loss Drug
(AP)
Federal health advisers unanimously rejected a weight-loss drug Wednesday after hearing testimony that it increases the risk of suicidal thoughts, even in patients without a history of depression.
The manufacturer, Sanofi-Aventis SA, further failed to show the drug rimonabant is safe, the panel said.
The back-to-back, 14-0 votes by the expert panel made it unlikely the Food and Drug Administration will approve the drug. The agency usually follows its panel's advice, but it isn't required to do so.
"There is a reasonable suspicion we better learn some more and watch this affair more closely before we launch into massive use of this drug," said panelist Dr. Jules Hirsch, a senior physician at New York's Rockefeller University.
In studies, patients given the once-daily tablet reported twice as many psychiatric side effects, including depression, anxiety and sleep problems, than those who received sham treatment, Dr. Amy Egan, an FDA medical officer, told the advisers.
"The numbers of events are small, but in aggregate they are worrisome," Egan said.
Officials from Sanofi-Aventis suggested that patients be screened for depression before they are prescribed the drug. They also advised that patients visit their doctors five times during the first year of treatment to be reassessed to further curtail any potential problems.
"Who is the right patient to receive rimonabant? Not everybody," Sanofi-Aventis' Richard Gural told the panel of advisers earlier Wednesday. The drug is not appropriate for anyone with a history of depression or suicidal thoughts, or who has been diagnosed with depression or is taking antidepressant medication, he added.
The FDA is to make a final decision on the drug by July 27.
The company proposes selling the drug under the brand name Zimulti. Rimonabant already is sold in Europe as Acomplia.
The litany of mental problems associated with the drug clearly gave the panelists pause.
"I think this is a drug that needs further understanding with respect to what it does to people's psyche," said panelist Dr. Sid Gilman, a University of Michigan neurologist.
Even if the FDA does approve the first-in-its-class drug, the findings make it highly likely it would bear stern warnings. Company officials embraced the idea of such warnings, which could exclude FDA-approved use in some patients.
The company, FDA and panelists all agreed that Zimulti, along with diet and exercise, works to help shed weight. In yearlong studies, patients on the drug lost roughly 14 pounds. Those given dummy pills lost only about 4 pounds. However, patients regained weight when treatment was stopped after a year.
But the FDA and its outside advisers shared deep concerns that the drug's effect on the body could lead to an array of psychiatric symptoms, including anxiety, phobias, post-traumatic stress disorders and depression. No panelist felt the company had sufficiently characterized the drug's safety.
The manufacturer, Sanofi-Aventis SA, further failed to show the drug rimonabant is safe, the panel said.
The back-to-back, 14-0 votes by the expert panel made it unlikely the Food and Drug Administration will approve the drug. The agency usually follows its panel's advice, but it isn't required to do so.
"There is a reasonable suspicion we better learn some more and watch this affair more closely before we launch into massive use of this drug," said panelist Dr. Jules Hirsch, a senior physician at New York's Rockefeller University.
In studies, patients given the once-daily tablet reported twice as many psychiatric side effects, including depression, anxiety and sleep problems, than those who received sham treatment, Dr. Amy Egan, an FDA medical officer, told the advisers.
"The numbers of events are small, but in aggregate they are worrisome," Egan said.
Officials from Sanofi-Aventis suggested that patients be screened for depression before they are prescribed the drug. They also advised that patients visit their doctors five times during the first year of treatment to be reassessed to further curtail any potential problems.
"Who is the right patient to receive rimonabant? Not everybody," Sanofi-Aventis' Richard Gural told the panel of advisers earlier Wednesday. The drug is not appropriate for anyone with a history of depression or suicidal thoughts, or who has been diagnosed with depression or is taking antidepressant medication, he added.
The FDA is to make a final decision on the drug by July 27.
The company proposes selling the drug under the brand name Zimulti. Rimonabant already is sold in Europe as Acomplia.
The litany of mental problems associated with the drug clearly gave the panelists pause.
"I think this is a drug that needs further understanding with respect to what it does to people's psyche," said panelist Dr. Sid Gilman, a University of Michigan neurologist.
Even if the FDA does approve the first-in-its-class drug, the findings make it highly likely it would bear stern warnings. Company officials embraced the idea of such warnings, which could exclude FDA-approved use in some patients.
The company, FDA and panelists all agreed that Zimulti, along with diet and exercise, works to help shed weight. In yearlong studies, patients on the drug lost roughly 14 pounds. Those given dummy pills lost only about 4 pounds. However, patients regained weight when treatment was stopped after a year.
But the FDA and its outside advisers shared deep concerns that the drug's effect on the body could lead to an array of psychiatric symptoms, including anxiety, phobias, post-traumatic stress disorders and depression. No panelist felt the company had sufficiently characterized the drug's safety.
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Scott Conroy Scott Conroy is a National Political Reporter for RealClearPolitics and a contributor for CBS News.
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