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Izervay: genotox, carcinogenicity and repro: done or skipped?

avacincaptad pegol · C5 (aptamer)
Genotoxicity
Conducted: Ames, chromosomal aberration in mammalian cells, mouse micronucleus; all negative
“Avacincaptad pegol was negative for genotoxicity based on a standard battery of studies including the bacterial reverse mutation assay, chromosomal aberration in mammalian cells and in vivo mouse bone marrow micronucleus assays.”
✓ VerifiedFDA pharmacology/toxicology review, p. 8Source ↗
Carcinogenicity
Not conducted (waiver accepted; low systemic exposure, C5-inhibitor class experience)
“Carcinogenicity No studies were conducted. The Applicant submitted a justification to support a waiver request not to conduct the carcinogenicity studies”
✓ VerifiedFDA pharmacology/toxicology review, p. 69Source ↗
Reproductive & developmental
EFD studies in rat and rabbit (IV, NOAEL 1.2 mg/kg/day); FEED and PPND waived
“In the embryofetal development (EFD) toxicity studies in rats and rabbits, there was no avacincaptad pegol-related adverse effects on any measured maternal or fetal parameter at doses up to 1.2 mg/kg/day (NOAEL).”
✓ VerifiedFDA pharmacology/toxicology review, p. 8Source ↗
Safety pharmacology
Dedicated: hERG assay, rat CNS study, monkey telemetry CV/respiratory (NOAEL 100 mg/kg IV); transient APTT prolongation
“The NOAEL for cardiovascular and respiratory findings in this study was the high dose, 100 mg/kg.”
✓ VerifiedFDA pharmacology/toxicology review, p. 35Source ↗

Same question, other oligonucleotides

Amondys 45

casimersen · DMD exon 45 (PMO)
Conducted; negative (Ames, CHO chromosomal aberration, mouse micronucleus)

Amvuttra

vutrisiran · TTR (siRNA)
Conducted: Ames, human lymphocyte chromosome aberration, rat micronucleus; all negative

Dawnzera

donidalorsen · Prekallikrein / KLKB1 (ASO)
Conducted: in vitro Ames, CHL chromosomal aberration and in vivo mouse bone marrow micronucleus; no genotoxicity

Exondys 51

eteplirsen · DMD exon 51 (PMO)
Conducted; negative (Ames, CHO chromosomal aberration, mouse micronucleus)

Givlaari

givosiran · ALAS1 (siRNA)
Conducted: Ames, human lymphocyte chromosome aberration, rat micronucleus; all negative

Kynamro

mipomersen · APOB (ASO)
Conducted; negative (Ames, mouse lymphoma, mouse micronucleus)

Leqvio

inclisiran · PCSK9 (siRNA)
Conducted: standard panel, negative

Macugen

pegaptanib · VEGF-165 (aptamer)
Conducted (GLP); pegaptanib and 2'-FU/2'-FC nucleosides negative overall

Onpattro

patisiran · TTR (siRNA)
Conducted: Ames, human lymphocyte chromosome aberration, mouse micronucleus; all negative

Oxlumo

lumasiran · HAO1 (siRNA)
Conducted: Ames, human lymphocyte chromosome aberration, rat micronucleus; all negative

Qalsody

tofersen · SOD1 (ASO)
Conducted; negative (Ames, CHL chromosomal aberration, mouse micronucleus)

Qfitlia

fitusiran · Antithrombin / SERPINC1 (siRNA)
Conducted: bacterial reverse mutation, in vitro chromosomal aberration (human lymphocytes), rat bone-marrow micronucleus; all negative

Redemplo

plozasiran · APOC3 (siRNA)
Conducted: Ames, in vitro chromosomal aberration (TK6), in vivo mouse micronucleus; not genotoxic

Rivfloza

nedosiran · LDHA (siRNA)
Conducted; negative (Ames, in vitro micronucleus, in vivo mouse micronucleus)

Rytelo

imetelstat · Telomerase (oligo)
Conducted; negative (Ames, in vitro micronucleus, in vivo mouse micronucleus)

Spinraza

nusinersen · SMN2 (ASO)
Conducted; negative (Ames, CHO chromosomal aberration, mouse micronucleus)

Tegsedi

inotersen · TTR (ASO)
Conducted; negative (Ames, CHL chromosomal aberration, mouse micronucleus)

Tryngolza

olezarsen · APOC3 (ASO)
Conducted; negative (Ames, chromosomal aberration, mouse micronucleus)

Viltepso

viltolarsen · DMD exon 53 (PMO)
Conducted; negative (Ames, CHL chromosomal aberration, mouse micronucleus)

Vyondys 53

golodirsen · DMD exon 53 (PMO)
Conducted; negative (Ames, CHO chromosomal aberration, mouse micronucleus)

Wainua

eplontersen · TTR (ASO)
Conducted; negative (Ames, chromosomal aberration, mouse micronucleus)

Waylivra

volanesorsen · APOC3 (ASO)
Conducted: bacterial reverse mutation, mouse lymphoma TK, mouse bone-marrow micronucleus; all negative

Zanvastro

zilganersen · GFAP (ASO)
Conducted: Ames, in vitro chromosomal aberration, mouse micronucleus; all negative

Summary across all 24 oligonucleotides →