Ocaliva

obeticholic acid

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An overview of Ocaliva and why it is authorised in the EU

Ocaliva is used to treat adults with a liver disease known as primary biliary cholangitis.

Primary biliary cholangitis is an autoimmune condition in which there is gradual destruction of the small bile ducts in the liver. These ducts transport fluid called bile from the liver to the intestines, where it is used to help digest fats. As a result of the damage to the ducts, bile builds up in the liver causing damage to the liver tissue. This may lead to scarring and liver failure, and may increase the risk of liver cancer.

Ocaliva contains the active substance obeticholic acid. It is used together with another medicine, ursodeoxycholic acid (UDCA), in patients who do not respond sufficiently to UDCA alone, and on its own in patients who cannot take UDCA.

Primary biliary cholangitis is rare, and Ocaliva was designated an ‘orphan medicine’ (a medicine used in rare diseases) on 27 July 2010.

How is Ocaliva used?

Ocaliva is available as tablets (5 and 10 mg) and can only be obtained with a prescription. The recommended starting dose is 5 mg once a day or 5 mg once a week, depending on the patient’s degree of liver impairment (which should be determined before starting treatment with Ocaliva). After a few months, if Ocaliva is well tolerated the dose can be increased. Doses can be reduced or treatment may need to be stopped in patients who experience intolerable itching (a possible side effect with Ocaliva).

For more information about using Ocaliva, see the package leaflet or contact your doctor or pharmacist.

How does Ocaliva work?

The active substance in Ocaliva, obeticholic acid, is a modified form of a bile acid (the main components of bile). It works mainly by attaching to receptors in the liver and gut (farnesoid X receptors) which control the production of bile. By attaching to these receptors, Ocaliva reduces the production of bile in the liver, preventing it from building up and damaging the liver tissue.

What benefits of Ocaliva have been shown in studies?

Ocaliva was compared with placebo (a dummy treatment) in a main study involving 217 adults with primary biliary cholangitis who either had been taking UDCA for at least 1 year, or who could not take UDCA. The measure of effectiveness was based on the number of patients whose blood levels of the substances bilirubin and ALP (markers of liver damage) decreased by at least 15% (for ALP) and below a certain value considered normal (for bilirubin) after 1 year of treatment.

The study showed that Ocaliva was more effective than placebo at reducing the blood levels of bilirubin and ALP: levels decreased by the required amount in 47% (34 out of 73) of patients treated with Ocaliva 10 mg and in 46% (32 out of 70) of patients treated with increasing doses of Ocaliva (from 5 mg up to 10 mg), compared with 10% (7 out of 73) of patients on placebo.

What are the risks associated with Ocaliva?

The most common side effects with Ocaliva are itching (which may affect more than 6 in 10 people) and tiredness (which may affect more than 2 in 10 people). Itching is also the most common side effect that can lead to discontinuation of treatment. In the majority of cases seen, itching occurred within the first month of treatment and tended to resolve over time while continuing treatment. For the list of all side effects with Ocaliva, see the package leaflet.

Ocaliva must not be used in patients whose bile ducts are completely blocked. For the full list of restrictions, see the package leaflet.

Why is Ocaliva authorised in the EU?

Patients with primary biliary cholangitis have limited treatment options. Ocaliva has been shown to reduce the blood levels of bilirubin and ALP in patients with primary biliary cholangitis, including those who could not be treated with UDCA. Reductions in bilirubin and ALP were to an extent which is indicative of an improvement in the condition of the liver. However, the clinical benefits of Ocaliva need to be demonstrated in further studies. The safety profile of the medicine was considered to be favourable, with side effects that were tolerable and manageable with supportive treatment (e.g. for itching) and dose adjustments. The European Medicines Agency therefore decided that Ocaliva’s benefits are greater than its risks and it can be authorised for use in the EU.

Ocaliva has been given ‘conditional authorisation’. This means that there is more evidence to come about the medicine, which the company is required to provide. Every year, the Agency will review any new information that becomes available and this overview will be updated as necessary.

What information is still awaited for Ocaliva?

Since Ocaliva has been granted a conditional authorisation, the company that markets Ocaliva will provide additional data from two studies to confirm the effectiveness and safety of the medicine. The first study is designed to demonstrate the clinical benefit of Ocaliva, while the second study will investigate the benefits of Ocaliva in patients with moderate to severe liver disease.

What measures are being taken to ensure the safe and effective use of Ocaliva?

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Ocaliva have been included in the summary of product characteristics and the package leaflet.

As for all medicines, data on the use of Ocaliva is continuously monitored. Side effects reported with Ocaliva are carefully evaluated and any necessary action taken to protect patients.

Other information about Ocaliva

Ocaliva received a marketing authorisation valid throughout the EU on 12 December 2016.

Name Language First published Last updated
Ocaliva : EPAR - Summary for the public BG = bălgarski 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public ES = español 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public CS = čeština 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public DA = dansk 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public DE = Deutsch 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public ET = eesti keel 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public EL = elliniká 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public EN = English 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public FR = français 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public IT = italiano 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public LV = latviešu valoda 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public LT = lietuvių kalba 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public HU = magyar 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public MT = Malti 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public NL = Nederlands 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public PL = polski 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public PT = português 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public RO = română 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public SK = slovenčina 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public SL = slovenščina 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public FI = suomi 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public SV = svenska 2016-12-19 2018-05-14
Ocaliva : EPAR - Summary for the public HR = Hrvatski 2016-12-19 2018-05-14

This EPAR was last updated on 14/05/2018 .

Authorisation details

Product details

Product details for Ocaliva
NameOcaliva
Agency product numberEMEA/H/C/004093
Active substance

obeticholic acid

International non-proprietary name (INN) or common name

obeticholic acid

Therapeutic area Liver Cirrhosis, Biliary
Anatomical therapeutic chemical (ATC) code A05AA04
Additional monitoring

This medicine is under additional monitoring. This means that it is being monitored even more intensively than other medicines. For more information, see medicines under additional monitoring.

Treatment of rare diseases

This medicine has an "orphan designation" which means that it is used to treat life-threatening or chronically debilitating conditions that affect no more than five in 10,000 people in the European Union, or are medicines which, for economic reasons, would be unlikely to be developed without incentives.

Conditional Approval

Sometimes, the CHMP recommends that a medicine be given ‘conditional approval’. This happens when the Committee has based its positive opinion on data which, while not yet comprehensive, indicate that the medicine’s benefits outweigh its risks.

The company is given obligations to fulfil, such as the performance of further studies. The approval is renewed on a yearly basis until all obligations have been fulfilled, and is then converted from a conditional approval into a normal approval. Conditional approvals can only be granted for medicines that satisfy an ‘unmet medical need’, meaning the medicine is intended to be used for a disease or condition for which no treatment is readily available, and it is therefore important that patients have early access to the medicine concerned.

Publication details

Publication details for Ocaliva
Marketing-authorisation holder

Intercept Pharma Ltd

Revision2
Date of issue of marketing authorisation valid throughout the European Union12/12/2016

Contact address:

Intercept Pharma Ltd
2 Pancras Square
London N1C 4AG
United Kingdom

Product information

Product information

21/03/2018  Ocaliva -EMEA/H/C/004093 -PSUSA/00010555/201706

Name Language First published Last updated
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14
Ocaliva : EPAR - Product Information HR = Hrvatski 2016-12-19 2018-05-14

Contents

  • Annex I - Summary of product characteristics
  • Annex IIA - Manufacturing-authorisation holder responsible for batch release
  • Annex IIB - Conditions of the marketing authorisation
  • Annex IIIA - Labelling
  • Annex IIIB - Package leaflet

Please note that the size of the above document can exceed 50 pages.

You are therefore advised to be selective about which sections or pages you wish to print.


Name Language First published Last updated
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13
Ocaliva : EPAR - All Authorised presentations HR = Hrvatski 2016-12-19 2017-06-13

Pharmacotherapeutic group

Bile and liver therapy

Therapeutic indication

Ocaliva is indicated for the treatment of primary biliary cholangitis (also known as primary biliary cirrhosis) in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA or as monotherapy in adults unable to tolerate UDCA.

Assessment History

Changes since initial authorisation of medicine

Name Language First published Last updated
Ocaliva : EPAR - Procedural steps taken and scientific information after authorisation HR = Hrvatski 2017-06-13 2018-05-14
Ocaliva-H-C-PSUSA-00010555-201706 : EPAR - Scientific conclusions and grounds for the variation to the terms of the marketing authorisation HR = Hrvatski 2018-05-14  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  
Ocaliva : EPAR - Conclusions on the granting of the conditional marketing authorisation HR = Hrvatski 2016-12-19  

Initial marketing-authorisation documents

Name Language First published Last updated
Ocaliva : EPAR - Public assessment report HR = Hrvatski 2016-12-19  
CHMP summary of positive opinion for Ocaliva HR = Hrvatski 2016-10-14