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

fomivirsen · CMV IE2 mRNA (ASO)
Genotoxicity
Conducted: mutagenic potential evaluated in in vitro and in vivo assays
“The mutagenic potentials of fomivirsen were evaluated in both in vitro and in vivo systems and results were summarized in the following table.”
✓ VerifiedFDA review, p. 35Source ↗
Carcinogenicity
Not conducted; waiver requested citing lack of meaningful systemic exposure
“A waiver from performing carcinogenicity studies was requested by the sponsor. The sponsor stated that "lack of meaningful systemic exposure, additional systemic toxicity studies are neither relevant nor useful for assessing the safety profile of this compound".”
✓ VerifiedFDA review, p. 35Source ↗
Reproductive & developmental
Not conducted; no reproductive toxicology information provided
“No information was provided.”
✓ VerifiedFDA review, p. 35Source ↗
Safety pharmacology
ECG in repeat-dose intravitreal monkey study: no PR, QRS or QT changes, arrhythmia or conduction disturbances
“Neither significant changes in P-R, QRS, and Q-T intervals nor arrhythmia nor conduction disturbances were observed.”
✓ VerifiedFDA review, p. 20Source ↗
Genotox: Ames
Not mutagenic (Salmonella)
“Ames Salmonella syphimurium: T498, TAI00, 6.7 - 5000 up/plate Not mutagenic”
✓ VerifiedFDA review, p. 35Source ↗
Genotox: in vitro mammalian
Chromosome aberration in CHO-K1 cells: not clastogenic; mouse lymphoma assay result not legible
“Chromosome CHO-KI cells Aberration TReport N° ISIS 2922-1S01 : DETO 10, 800) , 800, or Not clastogenic”
✓ VerifiedFDA review, p. 35Source ↗
Genotox: in vivo
Mouse bone marrow micronucleus assay conducted; result not stated legibly
“Micronucleus ICR mice -Bone Marrow Cells”
✓ VerifiedFDA review, p. 35Source ↗
Carcinogenicity model
Not conducted: waiver citing lack of meaningful systemic exposure
“A waiver from performing carcinogenicity studies was requested by the sponsor. The sponsor stated that "lack of meaningful systemic exposure, additional systemic toxicity studies are neither relevant nor useful for assessing the safety profile of this compound".”
✓ VerifiedFDA review, p. 35Source ↗
Carcinogenicity timing
Not required: FDA accepted the carcinogenicity waiver
“the review division would accept the request from the sponsor for a waiver of carcinogenicity studies on fomivirsen.”
✓ VerifiedFDA review, p. 36Source ↗
hERG / QT
No hERG assay; no PR, QRS or QT changes, arrhythmia or conduction disturbances on ECG in repeat-dose monkey study
“Neither significant changes in P-R, QRS, and Q-T intervals nor arrhythmia nor conduction disturbances were observed.”
✓ VerifiedFDA review, p. 20Source ↗

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

Cyfendus

anthrax vaccine adsorbed, adjuvanted · TLR9 (CpG 7909 adjuvant)
Not conducted

Dawnzera

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

Defitelio

defibrotide · Fragmented DNA oligonucleotides
Negative: Ames assay and in vivo rat bone marrow micronucleus assay

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

Heplisav-B

hepatitis B vaccine (recombinant), adjuvanted · TLR9 (CpG 1018 adjuvant)
CpG adjuvant negative in Ames, in vitro chromosome aberration and in vivo mouse micronucleus tests

Izervay

avacincaptad pegol · C5 (aptamer)
Conducted: Ames, chromosomal aberration in mammalian cells, mouse 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 28 oligonucleotides →