August 2015 Australian Public Assessment Report for Insulin glargine



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therapeutic goods administration


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August 2015

Australian Public Assessment Report for Insulin glargine

Proprietary Product Name: Abasria / Abasria KwikPen

Sponsor: Eli Lilly Australia Pty Ltd







About the Therapeutic Goods Administration (TGA)

The Therapeutic Goods Administration (TGA) is part of the Australian Government Department of Health and is responsible for regulating medicines and medical devices.

The TGA administers the Therapeutic Goods Act 1989 (the Act), applying a risk management approach designed to ensure therapeutic goods supplied in Australia meet acceptable standards of quality, safety and efficacy (performance), when necessary.

The work of the TGA is based on applying scientific and clinical expertise to decision-making, to ensure that the benefits to consumers outweigh any risks associated with the use of medicines and medical devices.

The TGA relies on the public, healthcare professionals and industry to report problems with medicines or medical devices. TGA investigates reports received by it to determine any necessary regulatory action.

To report a problem with a medicine or medical device, please see the information on the TGA website .



About AusPARs

An Australian Public Assessment Record (AusPAR) provides information about the evaluation of a prescription medicine and the considerations that led the TGA to approve or not approve a prescription medicine submission.

AusPARs are prepared and published by the TGA.

An AusPAR is prepared for submissions that relate to new chemical entities, generic medicines, major variations, and extensions of indications.

An AusPAR is a static document, in that it will provide information that relates to a submission at a particular point in time.

A new AusPAR will be developed to reflect changes to indications and/or major variations to a prescription medicine subject to evaluation by the TGA.



Copyright

© Commonwealth of Australia 2015


This work is copyright. You may reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the TGA Copyright Officer, Therapeutic Goods Administration, PO Box 100, Woden ACT 2606 or emailed to .

Contents



List of the most common abbreviations used in this AusPAR 4

I. Introduction to product submission 5

Submission details 5

Product background 5

Regulatory status 7

Product information 7

II. Quality findings 7

Drug substance (active ingredient) 7

Drug product 8

Biopharmaceutics 8

Quality summary and conclusions 9

III. Nonclinical findings 9

Introduction 9

Pharmacology 9

Pharmacokinetics 10

Toxicology 10

Nonclinical summary and conclusions 11



IV. Clinical findings 11

Introduction 11

Clinical rationale 11

Guidance 12

Contents of the clinical dossier 13

Pharmacokinetics 13

Pharmacodynamics 16

Dosage selection for the pivotal studies 17

Efficacy 17

Safety 18

First round benefit-risk assessment 22

First round recommendation regarding authorisation 22

Clinical questions 22

Second round evaluation of clinical data submitted in response to questions 22



V. Pharmacovigilance findings 23

Risk management plan 23



VI. Overall conclusion and risk/benefit assessment 28

Quality 28

Nonclinical 28

Clinical 29

Risk management plan 34

Risk-benefit analysis 34



Outcome 38

Attachment 1. Product Information 39

Attachment 2. Extract from the Clinical Evaluation Report 39


List of the most common abbreviations used in this AusPAR


Abbreviation

Meaning

ACE

angiotensin converting enzyme

ALAT

alanine aminotransferase

ASR

annual safety report

CCDS

company core data sheet

CHMP

Committee for Medicinal Products for Human Use

DCCT

Diabetes Control and Complications Trial

DSUR

development safety update report

EEA

European Economic Area

EMA

European Medicines Agency

EU

European Union

FDA

Food and Drug Administration

GLP-1

glucagon-like peptide-1

GPRD

General Practice Research Database

GW

gestational week

HMEC

human mammary epithelial cells

HIV

human immunodeficiency virus

IBD

international birth date

ICH

International Conference on Harmonisation

L6-hIR

L6 myoblasts from ATTC transfected with human insulin receptors

MAH

market authorisation holder

MAOI

monoamine oxidase inhibitors

MedDRA

Medical Dictionary for Regulatory Activities

NPH

neutral protamine Hagedorn

NYHA

New York Heart Association

PD

pharmacodynamics

PK

pharmacokinetics

PSUR

periodic safety update report

PT

preferred term

PYE

patient years of exposure

RR

reporting rate

RMP

risk management plan

RSI

request for supplementary information

SmPC

summary of product characteristics

SMQ

standardised MedDRA query

TZD

thiazolidinedione

WHO

World Health Organization



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