CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 211617Orig1s000 INTEGRATED REVIEW Executive Summary Interdisciplinary Assessment Appendices NDA211617 Nexlizet I bempedoic acid and ezetimibe Integrated Review Table 1. Administrative Application Information Category Application Information Application type NDA Application number 211617 Priority or standard Standard Submit date 2/26/2019 Received date 2/26/2019 PDUFA goal date 2/26/2020 Division/office Division of Metabolism and Endoc1inology Products (DMEP) Review completion date 2/25/2020 Established name Bempedoic acid and ezetimibe (Proposed) trade name Nexlizet Phannacologic class an adenosine triphosphate-citrate lyase (ACL) inhibitor and a cholesterol abso1ption inhibitor Code name ETC-I 002/ezetimibe Applicant Esperion Therapeutics, Inc. Dose form/formulation Tablets, 180 mg/10 mg One tablet dail Applicant proposed Adjunct to diet indication(s)/population(s) Proposed SNOMED 55822004 (hyperlipidemia) indication Regulatory action Approval Approved adjunct to diet and maximally tolerated stat.in therapy for the indication(s)/population(s) treatment of adults with heterozygous familial (if applicable) hypercholesterolemia or established atherosclerotic cardiovascular disease who require additional lowering of LDL-C Approved SNOMED 55822004 (hyperlipidemia) indication Integrated Review Template, version date 2019/06/14 Reference ID 4566970 1'$ 1H[OL]HW EHPSHGRLF DFLG DQG H]HWLPLEH 7DEOH RI &RQWHQWV 7DEOH RI 7DEOHV Y 7DEOH RI )LJXUHV YLLL *ORVVDU\ , ([HFXWLYH 6XPPDU\ 6XPPDU\ RI 5HJXODWRU\ $FWLRQ %HQHILW5LVN $VVHVVPHQW ,, ,QWHUGLVFLSOLQDU\ $VVHVVPHQW ,QWURGXFWLRQ $SSURDFK WR WKH 5HYLHZ 3DWLHQW ([SHULHQFH 'DWD 3KDUPDFRORJLF $FWLYLW\ 3KDUPDFRNLQHWLFV DQG &OLQLFDO 3KDUPDFRORJ\ 1RQFOLQLFDO $VVHVVPHQW RI 3RWHQWLDO (IIHFWLYHQHVV (YLGHQFH RI %HQHILW $VVHVVPHQW RI (IILFDF\ $VVHVVPHQW RI 'RVH DQG 3RWHQWLDO (IIHFWLYHQHVV 'HVLJQ RI &OLQLFDO 7ULDOV ,QWHQGHG WR 'HPRQVWUDWH %HQHILW WR 3DWLHQWV 7ULDO 'HVLJQ (OLJLELOLW\ &ULWHULD 6WDWLVWLFDO $QDO\VLV 3ODQ 5HVXOWV RI $QDO\VHV RI &OLQLFDO 7ULDOV6WXGLHV ,QWHQGHG WR 'HPRQVWUDWH %HQHILW WR 3DWLHQWV 3DWLHQW 'LVSRVLWLRQ 'HPRJUDSKLFV DQG %DVHOLQH &KDUDFWHULVWLFV (IILFDF\ 5HVXOWV 5HYLHZ ,VVXHV 5HOHYDQW WR (YDOXDWLRQ RI %HQHILW 'HPRQVWUDWLRQ RI (IILFDF\ 'DWD ,QWHJULW\ ,VVXH 6HOHFWLRQ RI /'/ $QDO\VLV :LQGRZV 5LVN DQG 5LVN 0DQDJHPHQW 3RWHQWLDO 5LVNV RU 6DIHW\ &RQFHUQV %DVHG RQ 1RQFOLQLFDO 'DWD 3RWHQWLDO 5LVNV RU 6DIHW\ &RQFHUQV %DVHG RQ 'UXJ &ODVV RU 2WKHU 'UXJ 6SHFLILF )DFWRUV 3RWHQWLDO 6DIHW\ &RQFHUQV ,GHQWLILHG 7KURXJK 3RVWPDUNHW ([SHULHQFH )'$ $SSURDFK WR WKH 6DIHW\ 5HYLHZ $GHTXDF\ RI WKH &OLQLFDO 6DIHW\ 'DWDEDVH 6DIHW\ )LQGLQJV DQG 6DIHW\ &RQFHUQV %DVHG RQ 5HYLHZ RI WKH &OLQLFDO 6DIHW\ 'DWDEDVH 2YHUDOO $GYHUVH (YHQW 6XPPDU\ 'HDWKV LL ,QWHJUDWHG 5HYLHZ 7HPSODWH YHUVLRQ GDWH Reference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eference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eference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eference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eference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
Details
-
File Typepdf
-
Upload Time-
-
Content LanguagesEnglish
-
Upload UserAnonymous/Not logged-in
-
File Pages133 Page
-
File Size-