UPDATE:FDA Updates Singulair Label For Neuropsychiatric Events
12 Juin 2009 - 10:35PM
Dow Jones News
The U.S. Food and Drug Administration said Friday it was
updating the label of Merck & Co.'s (MRK) Singulair and similar
asthma medications to discuss reports of neuropsychiatric events
such as agitation, depression, insomnia and suicidal thinking.
The new labeling will apply to Accolate, by AstraZeneca PLC
(AZN), and Zyflo, by Cornerstone Therapeutics Inc. (CRTX). All
three products fall into a drug class known as leukotriene
modifiers. Leukotrienes are chemicals the body releases in response
to an inflammatory stimulus such as breathing in an allergen.
The FDA said in a posting on its Web site that "patients and
healthcare professionals should be aware of the potential for
neuropsychiatric events with these medications."
Singulair, first approved in the U.S. in 1998, is Merck's
top-selling product and had $4.3 billion in sales in 2008 and is
the dominant drug in its class. The product is approved for use in
children and adults as an asthma and allergy treatment. Accolate
and Zyflo are approved as asthma treatments.
In a statement, Merck said it was "confident in the efficacy and
safety of Singulair" and that it would work with the FDA to revise
the label.
Merck noted it previously updated the post-marketing section of
Singulair's label to discuss post-marketing reports of
neuropsychiatric events.
The FDA said it requested manufacturers to include a precaution
in the drug-prescribing information discussing such events, which
is considered a strengthening of Singulair's current label and new
information on the other two drug labels.
The FDA announced a safety review of Singulair last year after
receiving reports of mood and behavior changes in patients who used
Singulair. The agency asked Merck and the other two drug makers to
submit all available clinical trial information, which the agency
reviewed along with post-marketing reports.
The agency said some of the post-marketing reports involving
neuropsychiatric events "included clinical details consistent with
a drug-induced effect."
The FDA said reported neuropsychiatric events include agitation,
aggression, anxiousness, dream abnormalities and hallucinations,
depression, insomnia, irritability, restlessness, suicidal thinking
and behavior, suicides and tremor. The agency said neuropsychiatric
events "were not commonly observed" in the clinical trial data
submitted by the manufacturers, but said the studies weren't
designed to look for such events. The agency said sleep disorders
such as insomnia were reported more frequently in clinical studies
of all three drugs compared to patients taking placebos.
-By Jennifer Corbett Dooren, Dow Jones Newswires; 202-862-9294;
jennifer.corbett@dowjones.com