Meeting highlights from the Committee for Medicinal Products for Human Use (CHMP) 12-15 September 2022
News
Human
COVID-19
Medicines
12 new medicines recommended for approval
EMA’s human medicines committee (CHMP) recommended 12 medicines for approval at its September 2022 meeting.
The CHMP recommended granting a marketing authorisation for Beyfortus (nirsevimab) intended for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in newborns and infants during their first RSV season (when there is a risk of RSV infection in the community). Beyfortus was supported through EMA's PRIority MEdicines (PRIME) scheme, which provides early and enhanced scientific and regulatory support to medicines that have a particular potential to address patients' unmet medical needs. See more information in the news announcement in the grid below.
The committee adopted a positive opinion for Enjaymo* (sutimlimab) for the treatment of haemolytic anaemia (breakdown of red blood cells) in adult patients with cold agglutinin disease, a rare autoimmune disorder characterised by the premature destruction of red blood cells.
Livtencity*3 (maribavir) received a positive opinion for the treatment of adults with cytomegalovirus infection and/or disease that is refractory to one or more prior therapies. Cytomegalovirus is a type of herpes virus that commonly causes infection after a stem cell or an organ transplant.
The committee adopted a positive opinion for Melatonin Neurim (melatonin) for the treatment of insomnia, a sleeping disorder affecting more than 10% of the European Union (EU) population.
The CHMP gave a positive opinion for Mycapssa* (octreotide) for the treatment of acromegaly, a rare hormonal disorder where the body produces too much growth hormone. This causes body tissues and bones to grow more quickly, leading e.g. to the enlargement of the hands, feet, forehead, jaw or nose.
The committee adopted a positive opinion for Pyrukynd*1 (mitapivat) for the treatment of an inherited condition called pyruvate kinase deficiency, a rare genetic disorder characterised by the premature destruction of red blood cells.
Zynlonta*2 (loncastuximab tesirine) received a conditional marketing authorisation from the CHMP. This medicine is intended for the treatment of adult patients with diffuse large B-cell lymphoma and high-grade B-cell lymphoma, two types of cancer that begin in the lymphatic system when abnormal white blood cells grow.
The committee adopted a positive opinion for the biosimilar medicine Ximluci (ranibizumab) for the treatment of neovascular age-related macular degeneration, a progressive retinal macular disease, causing gradual vision impairment, mainly in the elderly population.
The CHMP recommended granting a marketing authorisation for Teriparatide SUN (teriparatide) for the treatment of osteoporosis in adults. Osteoporosis affects around 22% of women over the age of 50 in the EU. The recommendation followed a hybrid application, which relies in part on the results of pre-clinical tests and clinical trials of an already authorised reference product and in part on new data.
The CHMP gave a positive opinion for the generic medicine Sorafenib Accord (sorafenib) for the treatment of hepatocellular carcinoma and renal cell carcinoma, two cancers that start in cells or tissues of the liver and kidney.
The committee adopted a positive opinion for the generic medicines Teriflunomide Accord and Teriflunomide Mylan (teriflunomide), indicated for the treatment of multiple sclerosis, a chronic disease affecting the central nervous system.
Recommendations on extensions of therapeutic indication for 11 medicines
The committee recommended 12 extensions of indication for medicines that are already authorised in the EU: Adtralza , Biktarvy, Brukinsa, Evusheld , Exparel liposomal, Revolade, Skyrizi, Vaxneuvance, Veklury (includes two extensions of indication for two paediatric populations, see the COVID-19 update below), Xalkori and Yescarta.
Withdrawals of initial applications
The application for marketing authorisation for Exkivity was withdrawn by the respective applicant. This medicine was indicated for the treatment of a certain type of lung cancer. A question-and-answer document on the withdrawal is available in the grid below.
The application for marketing authorisation for Sevsury was withdrawn by the respective applicant. This medicine was indicated for the treatment of progressive neuroendocrine tumours. A question-and-answer document on the withdrawal is available in the grid below.
Re-examination concluded
The CHMP confirmed its recommendation to suspend the marketing authorisations of several generic medicines tested by Synchron Research Services, a contract research organisation (CRO) located in Ahmedabad, India. This concludes the re-examination requested by the marketing authorisation holders for some of the medicines concerned. For more information, see the public health communication in the grid below.
COVID-19 update
Since the CHMP meeting in July, several recommendations related to COVID-19 vaccines and therapeutics were made.
- Authorising use of Nuvaxovid as a booster dose for adults who have had Nuvaxovid, an mRNA vaccine or an adenoviral vector vaccine as their primary vaccination. (The recommendation was made on 1 September 2022)
- Authorising two vaccines adapted to provide broader protection against COVID-19. Comirnaty Original/Omicron BA.1 and Spikevax bivalent Original/Omicron BA.1 are for use in people aged 12 years and above who have received at least primary vaccination against COVID-19. For more information, see the news announcement. (The recommendation was made on 1 September 2022)
COVID-19 recommendations adopted during the present meeting of the CHMP:
- Authorising the adapted bivalent vaccine Comirnaty Original/Omicron BA.4-5 for use in people aged 12 years and above who have received at least a primary course of vaccination against COVID-19. This vaccine is an adapted version of the mRNA COVID-19 vaccine Comirnaty and targets the Omicron subvariants BA.4 and BA.5 in addition to the original strain of SARS-CoV-2. For more information, see the news announcement .
- Converting the conditional marketing authorisations of the COVID-19 vaccines Comirnaty and Spikevax into standard marketing authorisations. CHMP considered that the additional studies conducted by the companies as part of their post-authorisation obligations have provided ample information on the vaccines’ protection against COVID-19, as well as their quality and safety. For more information, see the news announcement.
- Approving a new manufacturing site in Dessau-Rosslau, Germany, for COVID-19 Vaccine Valneva.
- Authorising booster doses of Comirnaty for children from 5 to 11 years of age .
- Extending the use of COVID-19 therapeutic Evusheld for the treatment of adults and adolescents with COVID-19 who do not require supplemental oxygen.
- Extending the use of COVID-19 therapeutic Veklury in two paediatric populations:
- Paediatric patients (of at least 4 weeks of age and weighing at least 3 kg) with pneumonia requiring supplemental oxygen or other non-invasive ventilation at the start of treatment.
- Paediatric patients (weighing at least 40 kg) who do not require supplemental oxygen and who are at increased risk of progressing to severe COVID-19.
Safety update
At its extraordinary meeting, on 2 September 2022, the CHMP endorsed the recommendation of the Pharmacovigilance Risk Assessment Committee (PRAC) and recommended that medicines containing high-dose nomegestrol (3.75 – 5 mg) or high-dose chlormadinone (5 – 10 mg) should be used at the lowest effective dose and for the shortest duration possible, and only when other interventions are not appropriate. In addition, low- and high-dose nomegestrol- or chlormadinone-containing medicines must not be used by patients who have, or have had, meningioma. For more information, see the news announcement .
Agenda and minutes
The agenda of the September 2022 CHMP meeting is published on EMA's website. Minutes of the September 2022 CHMP meeting will be published in the coming weeks.
CHMP statistics
Key figures from the September 2022 CHMP meeting are represented in the graphic below.
1 The information for Pyrukind was corrected on 19 September 2022 to reflect that the product has received a positive opinion for a full marketing authorisation (and not a conditional marketing authorisation as stated on 16 September 2022).
2 The information for Zynlonta was corrected on 19 September 2022 to reflect that the product has received a positive opinion for a conditional marketing authorisation (and not a full marketing authorisation as stated on 16 September 2022).
3 The information for Livtencity was corrected on 22 September 2022 to reflect that the product is intended for adults only (and not for paediatric patients as stated on 16 September 2022).
*This product was designated as an orphan medicine during its development. Orphan designations are reviewed by EMA's Committee for Orphan Medicinal Products (COMP) at the time of approval to determine whether the information available to date allows maintaining the medicine’s orphan status and granting the medicine ten years of market exclusivity.
Positive recommendations on new medicines
| Name of medicine | Beyfortus |
| International non-proprietary name (INN) | nirsevimab |
| Marketing-authorisation applicant | AstraZeneca AB |
| Therapeutic indication | Prevention of respiratory syncytial virus lower respiratory tract disease in newborns and infants |
| More information |
Beyfortus: Pending EC decision News announcement: New medicine to protect babies and infants from respiratory syncytial virus (RSV) infection |
| Name of medicine | Enjaymo |
| INN | sutimlimab |
| Marketing-authorisation applicant | Genzyme Europe BV |
| Therapeutic indication | Treatment of haemolytic anaemia in adult patients with cold agglutinin disease |
| More information | Enjaymo: Pending EC decision |
| Name of medicine | Livtencity |
| INN | maribavir |
| Marketing-authorisation applicant | Takeda Pharmaceuticals International AG Ireland Branch |
| Therapeutic indication | Treatment of cytomegalovirus infection and/or disease that is refractory to one or more prior therapies |
| More information | Livtencity: Pending EC decision |
| Name of medicine | Melatonin Neurim |
| INN | melatonin |
| Marketing-authorisation applicant | RAD Neurim Pharmaceuticals EEC SARL |
| Therapeutic indication | Treatment of insomnia |
| More information | Melatonin Neurim: Pending EC decision |
| Name of medicine | Mycapssa |
| INN | octreotide |
| Marketing-authorisation applicant | Amryt Pharmaceuticals DAC |
| Therapeutic indication | Treatment of acromegaly |
| More information | Mycapssa: Pending EC decision |
| Name of medicine | Pyrukynd |
| INN | mitapivat |
| Marketing-authorisation applicant | Agios Netherlands B.V. |
| Therapeutic indication | Treatment of pyruvate kinase deficiency |
| More information | Pyrukynd: Pending EC decision |
| Name of medicine | Zynlonta |
| INN | loncastuximab tesirine |
| Marketing-authorisation holder | ADC Therapeutics (NL) B.V. |
| Therapeutic indication | Treatment of adult patients with diffuse large B-cell lymphoma and high-grade B-cell lymphoma |
| More information | Zynlonta: Pending EC decision |
Positive recommendation on new biosimilar medicine
| Name of medicine | Ximluci |
| INN | ranibizumab |
| Marketing-authorisation applicant | STADA Arzneimittel AG |
| Therapeutic indication | Treatment of neovascular age-related macular degeneration |
| More information | Ximluci: Pending EC decision |
Positive recommendation on new hybrid medicine
| Name of medicine | Teriparatide SUN |
| INN | teriparatide |
| Marketing-authorisation applicant | Sun Pharmaceutical Industries Europe B.V. |
| Therapeutic indication | Treatment of osteoporosis in adults |
| More information | Teriparatide SUN: Pending EC decision |
Positive recommendations on new generic medicines
| Name of medicine | Sorafenib Accord |
| INN | sorafenib |
| Marketing-authorisation applicant | Accord Healthcare S.L.U. |
| Therapeutic indication | Treatment of hepatocellular carcinoma and renal cell carcinoma |
| More information | Sorafenib Accord: Pending EC decision |
| Name of medicine | Teriflunomide Accord |
| INN | teriflunomide |
| Marketing-authorisation applicant | Accord Healthcare S.L.U. |
| Therapeutic indication | Treatment of multiple sclerosis |
| More information | Teriflunomide Accord: Pending EC decision |
| Name of medicine | Teriflunomide Mylan |
| INN | teriflunomide |
| Marketing-authorisation applicant | Mylan Pharmaceuticals Limited |
| Therapeutic indication | Treatment of multiple sclerosis |
| More information | Teriflunomide Mylan: Pending EC decision |
Positive recommendations on extensions of indications
| Name of medicine | Adtralza |
| INN | tralokinumab |
| Marketing-authorisation holder | LEO Pharma A/S |
| More information | Adtralza: Pending EC decision |
| Name of medicine | Biktarvy |
| INN | bictegravir / emtricitabine / tenofovir alafenamide |
| Marketing-authorisation holder | Gilead Sciences Ireland UC |
| More information | Biktarvy: Pending EC decision |
| Name of medicine | Brukinsa |
| INN | zanubrutinib |
| Marketing-authorisation holder | BeiGene Ireland Ltd |
| More information | Brukinsa: Pending EC decision |
| Name of medicine | Evusheld |
| INN | tixagevimab / cilgavimab |
| Marketing-authorisation holder | AstraZeneca AB |
| More information | Evusheld: Pending EC decision |
| Name of medicine | Exparel liposomal |
| INN | bupivacaine |
| Marketing-authorisation holder | Pacira Ireland Limited |
| More information | Exparel liposomal: Pending EC decision |
| Name of medicine | Revolade |
| INN | eltrombopag |
| Marketing-authorisation holder | Novartis Europharm Limited |
| More information | Revolade: Pending EC decision |
| Name of medicine | Skyrizi |
| INN | risankizumab |
| Marketing-authorisation holder | AbbVie Deutschland GmbH & Co. KG |
| More information | Skyrizi: Pending EC decision |
| Name of medicine | Vaxneuvance |
| Common name | pneumococcal polysaccharide conjugate vaccine (adsorbed) |
| Marketing-authorisation holder | Merck Sharp & Dohme B.V. |
| More information | Vaxneuvance: Pending EC decision |
| Name of medicine | Veklury |
| INN | remdesivir |
| Marketing-authorisation holder | Gilead Sciences Ireland UC |
| More information | Veklury: Pending EC decision |
| Name of medicine | Xalkori |
| INN | crizotinib |
| Marketing-authorisation holder | Pfizer Europe MA EEIG |
| More information | Xalkori: Pending EC decision |
| Name of medicine | Yescarta |
| INN | axicabtagene ciloleucel |
| Marketing-authorisation holder | Kite Pharma EU B.V. |
| More information | Yescarta: Pending EC decision |
| Name of medicine | Exkivity |
| INN | mobocertinib |
| Marketing-authorisation applicant | Takeda Pharma A/S |
| More information | Exkivity: Withdrawn application |
| Name of medicine | Sevsury |
| INN | surufatinib |
| Marketing-authorisation applicant | Hutchmed Europe B.V. |
| More information | Sevsury: Withdrawn application |
Outcome of referral re-examination
| Name of medicine | Synchron Research Services |
| More information | Synchron |