`CENTER FOR DRUG EVALUATION AND RESEARCH
`
`Approval Package for:
`
`
`APPLICATION NUMBER:
`
`205395Orig1s000
`
`
`January 29, 2015
`
`PREZCOBIX
`
`darunavir and cobicistat
`
`JANSSEN PRODUCTS, LP
`
`Trade Name:
`
`Generic Name:
`
`Sponsor:
`
`Approval Date:
`
` PREZCOBIX is a two drug combination of darunavir,
`Indications:
`a human immunodeficiency virus (HIV-1) protease inhibitor and cobicistat,
`a CYP3A inhibitor and is indicated for the treatment of HIV-1 infection in
`adult patients.
`
`
`
`CENTER FOR DRUG EVALUATION AND
`RESEARCH
`
`205395Orig1s000
`
`CONTENTS
`
`Reviews / Information Included in this NDA Review.
`
`
`X
`
`X
`
`X
`X
`
`
`X
`X
`X
`X
`
`X
`X
`X
`
`X
`X
`
`
`
`
`Approval Letter
`Other Action Letters
`Labeling
`REMS
`Summary Review
`Officer/Employee List
`Office Director Memo
`Cross Discipline Team Leader Review
`Medical Review(s)
`Chemistry Review(s)
`Environmental Assessment
`Pharmacology Review(s)
`Statistical Review(s)
`Microbiology / Virology Review(s)
`Clinical Pharmacology/Biopharmaceutics Review(s)
`Other Reviews
`Risk Assessment and Risk Mitigation Review(s)
`Proprietary Name Review(s)
`Administrative/Correspondence Document(s)
`
`
`
`
`
`
`
`
`
`
`CENTER FOR DRUG EVALUATION AND
`RESEARCH
`
`
`
`APPLICATION NUMBER:
`205395Orig1s000
`
`APPROVAL LETTER
`
`
`
`DEPARTMENT OF HEALTH AND HUMAN SERVICES
`
`NDA 205395
`
`Janssen Products, LP
`Attention: Karen Gerry, BSc
`Manager, Global Regulatory Affairs
`1125 Trenton-Harbourton Road
`Titusville, NJ 08560
`
`Dear Ms. Gerry:
`
`Food and Drug Administration
`Silver Spring MD 20993
`
`NDA APPROVAL
`
`Please refer to your New Drug Application (NDA) dated March 31, 2014 and received
`March 31, 2014, submitted under section 505(b) of the Federal Food, Drug, and Cosmetic Act
`(FDCA), for Prezcobix™ (darunavir and cobicistat) tablet, 800 mg/150 mg for oral use.
`
`We also refer to our approval letter dated January 29, 2015 which contained the following errors:
`
`1. The Table numbers in the Prescribing Information were incorrect.
`
`This replacement approval letter incorporates the correction of the errors. The effective approval
`date will remain January 29, 2015 the date of the original approval letter.
`
`We acknowledge receipt of your amendments dated:
`
`April 11, 2014
`April 23, 2014
`May 6, 2014
`June 2, 2014
`June 24, 2014
`June 27, 2014
`June 30, 2014
`July 8, 2014
`July 14, 2014
`August 4, 2014
`
`August 4, 2014
`August 8, 2014
`August 11, 2014
`August 13, 2014
`September 12, 2014
`October 1, 2014
`October 15, 2014
`October 17, 2014
`November 24, 2014
`November 25, 2014
`
`November 26, 2014
`December 16, 2014
`December 18, 2014
`December 22, 2014
`January 7, 2015
`January 12, 2015
`January 14, 2015
`January 21, 2015
`January 26, 2015
`January 28, 2015
`
`This new drug application provides for the use of Prezcobix™ (darunavir and cobicistat) in
`combination with other antiretroviral agents for treatment of HIV-1 infection.
`
`APPROVAL & LABELING
`
`Reference ID: 3694997
`
`
`
`NDA 205395
`Page 2
`
`We have completed our review of this application, as amended. It is approved, effective on the
`date of this letter, for use as recommended in the enclosed agreed-upon labeling text.
`
`CONTENT OF LABELING
`
`As soon as possible, but no later than 14 days from the date of this letter, submit the content of
`labeling [21 CFR 314.50(l)] in structured product labeling (SPL) format using the FDA
`automated drug registration and listing system (eLIST), as described at
`http://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/default.htm. Content
`of labeling must be identical to the enclosed labeling (text for the package insert, text for the
`patient information). Information on submitting SPL files using eLIST may be found in the
`guidance for industry SPL Standard for Content of Labeling Technical Qs and As, available at
`http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/U
`CM072392.pdf.
`
`The SPL will be accessible via publicly available labeling repositories.
`
`IMMEDIATE CONTAINER LABEL
`
`Submit the final printed immediate container label that is identical to the enclosed immediate
`container label, as soon as it is available, but no more than 30 days after it is printed. Please
`submit the label electronically according to the guidance for industry Providing Regulatory
`Submissions in Electronic Format – Human Pharmaceutical Product Applications and Related
`Submissions Using the eCTD Specifications (June 2008). Alternatively, you may submit 12
`paper copies, with 6 of the copies individually mounted on heavy-weight paper or similar
`material. For administrative purposes, designate this submission “Final Printed Container
`Label for approved NDA 205395.” Approval of this submission by FDA is not required before
`the labeling is used.
`
`Marketing the product with FPL that is not identical to the approved labeling text may render the
`product misbranded and an unapproved new drug.
`
`MARKET PACKAGE
`
`Please submit one market package of the drug product when it is available to the following
`address:
`
`Nina Mani
`Food and Drug Administration
`Center for Drug Evaluation and Research
`White Oak Building 22, Room: 6317
`10903 New Hampshire Avenue
`Silver Spring, Maryland
`Use zip code 20903 if shipping via United States Postal Service (USPS).
`Use zip code 20993 if sending via any carrier other than USPS (e.g., UPS, DHL, FedEx).
`
`Reference ID: 3694997
`
`
`
`NDA 205395
`Page 3
`
`REQUIRED PEDIATRIC ASSESSMENTS
`
`Under the Pediatric Research Equity Act (PREA) (21 U.S.C. 355c), all applications for new
`active ingredients, new indications, new dosage forms, new dosing regimens, or new routes of
`administration are required to contain an assessment of the safety and effectiveness of the
`product for the claimed indication(s) in pediatric patients unless this requirement is waived,
`deferred, or inapplicable.
`
`We are waiving the pediatric study requirement for ages, birth to less than 3 years of age because
`there is evidence strongly suggesting that the drug product would be unsafe in this pediatric
`group. Use of darunavir, a component of the fixed dose combination (FDC) product, is not
`appropriate in pediatric patients < 3 years of age. This decision is based on the results of juvenile
`rat toxicology studies that provide evidence of potential safety risk as a result of accumulation of
`drug in the brain.
`
`We are also waiving the pediatric studies requirement for children ages 3 years to less than 18
`years weighing less than 15 kilograms (kg) because this product does not represent a meaningful
`therapeutic benefit over existing therapies for pediatric patients in this age and weight group. In
`addition, multiple FDC formulations would be required to be developed to accommodate the
`various weight bands in the small number of pediatric patients below 15 kg.
`
`We are deferring submission of your pediatric studies for children ages 3 years to less than 18
`years of age and who weigh 15 kg or more for this application because the product is ready for
`approval in adults and the pediatric studies have not been completed.
`
`Your deferred pediatric studies required by section 505B(a) of the FDCA are required
`postmarketing studies. The status of these postmarketing studies must be reported annually
`according to 21 CFR 314.81 and section 505B(a)(3)(C) of the FDCA. These required studies are
`listed below.
`
`2845-1
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed dose combination (FDC) age-appropriate
`formulation in HIV-infected pediatric subjects 3 years to less than 6 years of age
`and weighing at least 15 kg. The safety and antiviral activity (efficacy) of
`darunavir and cobicistat FDC age-appropriate formulation in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children ages 3
`years to less than 6 years may not be required if the dosing recommendation for
`the FDC age-appropriate formulation can be supported by pediatric trials already
`conducted with the individual drug products and if the age-appropriate FDC
`produces similar exposures as the individual components.
`
`Final Protocol Submission:
`Study Completion:
`Final Report Submission:
`
`03/31/2020
`12/31/2020
`12/31/2021
`
`Reference ID: 3694997
`
`
`
`NDA 205395
`Page 4
`
`2845-2
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed dose combination (FDC) age-appropriate
`formulation in HIV-infected pediatric subjects 6 years to less than 12 years of age
`and weighing at least 15 kg. The safety and antiviral activity (efficacy) of
`darunavir and cobicistat FDC age-appropriate formulation in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children ages 6
`years to less than 12 years may not be required if the dosing recommendation for
`the FDC age-appropriate formulation can be supported by pediatric trials already
`conducted with the individual drug products and if the age-appropriate FDC
`produces similar exposures as the individual components.
`
`Final Protocol Submission:
`Study Completion:
`Final Report Submission:
`
`03/31/2020
`12/31/2020
`12/31/2021
`
`2845-3
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed-dose combination (FDC) tablets in HIV-infected
`pediatric subjects 12 years to less than 18 years of age. The safety and antiviral
`activity (efficacy) of darunavir and cobicistat FDC tablets in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children 12
`years to less than 18 years of age may not be required if the dosing
`recommendation for the FDC tablets can be supported by pediatric trials already
`conducted with the individual drug products and if the FDC produces similar
`exposures as the individual components.
`
`Final Protocol Submission:
`Study Completion:
`Final Report Submission:
`
`03/31/2020
`12/31/2020
`12/31/2021
`
`Submit the protocols to your IND 113198, with a cross-reference letter to this NDA.
`
`Reports of these required pediatric postmarketing studies must be submitted as a new drug
`application (NDA) or as a supplement to your approved NDA with the proposed labeling
`changes you believe are warranted based on the data derived from these studies. When
`submitting the reports, please clearly mark your submission "SUBMISSION OF REQUIRED
`PEDIATRIC ASSESSMENTS" in large font, bolded type at the beginning of the cover letter of
`the submission.
`
`PROMOTIONAL MATERIALS
`
`You may request advisory comments on proposed introductory advertising and promotional
`labeling. To do so, submit, in triplicate, a cover letter requesting advisory comments, the
`proposed materials in draft or mock-up form with annotated references, and the package insert
`to:
`
`Reference ID: 3694997
`
`
`
`NDA 205395
`Page 5
`
`Food and Drug Administration
`Center for Drug Evaluation and Research
`Office of Prescription Drug Promotion
`5901-B Ammendale Road
`Beltsville, MD 20705-1266
`
`As required under 21 CFR 314.81(b)(3)(i), you must submit final promotional materials, and the
`package insert, at the time of initial dissemination or publication, accompanied by a Form FDA
`2253. Form FDA 2253 is available at
`http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM083570.pdf.
`Information and Instructions for completing the form can be found at
`http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM375154.pdf. For
`more information about submission of promotional materials to the Office of Prescription Drug
`Promotion (OPDP), see http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm090142.htm.
`
`REPORTING REQUIREMENTS
`
`We remind you that you must comply with reporting requirements for an approved NDA
`(21 CFR 314.80 and 314.81).
`
`If you have any questions, call Nina Mani, Regulatory Project Manager, at (240) 402-0333.
`
`Sincerely,
`
`{See appended electronic signature page}
`
`Jeffrey S. Murray, MD, MPH
`Deputy Director
`Division of Antiviral Products
`Office of Antimicrobial Products
`Center for Drug Evaluation and Research
`
`Enclosure(s):
`Content of Labeling
`Container Labeling
`
`Reference ID: 3694997
`
`
`
`---------------------------------------------------------------------------------------------------------
`This is a representation of an electronic record that was signed
`electronically and this page is the manifestation of the electronic
`signature.
`---------------------------------------------------------------------------------------------------------
`/s/
`----------------------------------------------------
`JEFFREY S MURRAY
`01/29/2015
`
`Reference ID: 3694997
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`
`January 30, 2015
`
`The below approval letter contained the incorrect Table numbers in the Prescribing Information.
`
`A courtesy copy of this letter was e-mailed to the applicant but the official copy was not mailed.
`The communication function of this letter has been changed to Advice.
`
`The corrected approval letter was entered on January 30, 2015, and backdated to January 29,
`2015, to maintain the original action date.
`
`Reference ID: 3694190
`
`
`
`DEPARTMENT OF HEALTH AND HUMAN SERVICES
`
`NDA 205395
`
`Janssen Products, LP
`Attention: Karen Gerry, BSc
`Manager, Global Regulatory Affairs
`1125 Trenton-Harbourton Road
`Titusville, NJ 08560
`
`Dear Ms. Gerry:
`
`Food and Drug Administration
`Silver Spring MD 20993
`
`NDA APPROVAL
`
`Please refer to your New Drug Application (NDA) dated March 31, 2014 and received
`March 31, 2014, submitted under section 505(b) of the Federal Food, Drug, and Cosmetic Act
`(FDCA), for Prezcobix™ (darunavir and cobicistat) tablet, 800 mg/150 mg for oral use.
`
`We acknowledge receipt of your amendments dated:
`
`April 11, 2014
`April 23, 2014
`May 6, 2014
`June 2, 2014
`June 24, 2014
`June 27, 2014
`June 30, 2014
`July 8, 2014
`July 14, 2014
`August 4, 2014
`
`August 4, 2014
`August 8, 2014
`August 11, 2014
`August 13, 2014
`September 12, 2014
`October 1, 2014
`October 15, 2014
`October 17, 2014
`November 24, 2014
`November 25, 2014
`
`November 26, 2014
`December 16, 2014
`December 18, 2014
`December 22, 2014
`January 7, 2015
`January 12, 2015
`January 14, 2015
`January 21, 2015
`January 26, 2015
`January 28, 2015
`
`This new drug application provides for the use of Prezcobix™ (darunavir and cobicistat) in
`combination with other antiretroviral agents for treatment of HIV-1 infection.
`
`APPROVAL & LABELING
`
`We have completed our review of this application, as amended. It is approved, effective on the
`date of this letter, for use as recommended in the enclosed agreed-upon labeling text.
`
`Reference ID: 3694190
`
`
`
`NDA 205395
`Page 2
`
`CONTENT OF LABELING
`
`As soon as possible, but no later than 14 days from the date of this letter, submit the content of
`labeling [21 CFR 314.50(l)] in structured product labeling (SPL) format using the FDA
`automated drug registration and listing system (eLIST), as described at
`http://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/default.htm. Content
`of labeling must be identical to the enclosed labeling (text for the package insert, text for the
`patient information). Information on submitting SPL files using eLIST may be found in the
`guidance for industry SPL Standard for Content of Labeling Technical Qs and As, available at
`http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/U
`CM072392.pdf.
`
`The SPL will be accessible via publicly available labeling repositories.
`
`IMMEDIATE CONTAINER LABEL
`
`Submit the final printed immediate container label that is identical to the enclosed immediate
`container label, as soon as it is available, but no more than 30 days after it is printed. Please
`submit the label electronically according to the guidance for industry Providing Regulatory
`Submissions in Electronic Format – Human Pharmaceutical Product Applications and Related
`Submissions Using the eCTD Specifications (June 2008). Alternatively, you may submit 12
`paper copies, with 6 of the copies individually mounted on heavy-weight paper or similar
`material. For administrative purposes, designate this submission “Final Printed Container
`Label for approved NDA 205395.” Approval of this submission by FDA is not required before
`the labeling is used.
`
`Marketing the product with FPL that is not identical to the approved labeling text may render the
`product misbranded and an unapproved new drug.
`
`MARKET PACKAGE
`
`Please submit one market package of the drug product when it is available to the following
`address:
`
`Nina Mani
`Food and Drug Administration
`Center for Drug Evaluation and Research
`White Oak Building 22, Room: 6317
`10903 New Hampshire Avenue
`Silver Spring, Maryland
`Use zip code 20903 if shipping via United States Postal Service (USPS).
`Use zip code 20993 if sending via any carrier other than USPS (e.g., UPS, DHL, FedEx).
`
`Reference ID: 3694190
`
`
`
`NDA 205395
`Page 3
`
`REQUIRED PEDIATRIC ASSESSMENTS
`
`Under the Pediatric Research Equity Act (PREA) (21 U.S.C. 355c), all applications for new
`active ingredients, new indications, new dosage forms, new dosing regimens, or new routes of
`administration are required to contain an assessment of the safety and effectiveness of the
`product for the claimed indication(s) in pediatric patients unless this requirement is waived,
`deferred, or inapplicable.
`
`We are waiving the pediatric study requirement for ages, birth to less than 3 years of age because
`there is evidence strongly suggesting that the drug product would be unsafe in this pediatric
`group. Use of darunavir, a component of the fixed dose combination (FDC) product, is not
`appropriate in pediatric patients < 3 years of age. This decision is based on the results of juvenile
`rat toxicology studies that provide evidence of potential safety risk as a result of accumulation of
`drug in the brain.
`
`We are also waiving the pediatric studies requirement for children ages 3 years to less than 18
`years weighing less than 15 kilograms (kg) because this product does not represent a meaningful
`therapeutic benefit over existing therapies for pediatric patients in this age and weight group. In
`addition, multiple FDC formulations would be required to be developed to accommodate the
`various weight bands in the small number of pediatric patients below 15 kg.
`
`We are deferring submission of your pediatric studies for children ages 3 years to less than 18
`years of age and who weigh 15 kg or more for this application because the product is ready for
`approval in adults and the pediatric studies have not been completed.
`
`Your deferred pediatric studies required by section 505B(a) of the FDCA are required
`postmarketing studies. The status of these postmarketing studies must be reported annually
`according to 21 CFR 314.81 and section 505B(a)(3)(C) of the FDCA. These required studies are
`listed below.
`
`2845-1
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed dose combination (FDC) age-appropriate
`formulation in HIV-infected pediatric subjects 3 years to less than 6 years of age
`and weighing at least 15 kg. The safety and antiviral activity (efficacy) of
`darunavir and cobicistat FDC age-appropriate formulation in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children ages 3
`years to less than 6 years may not be required if the dosing recommendation for
`the FDC age-appropriate formulation can be supported by pediatric trials already
`conducted with the individual drug products and if the age-appropriate FDC
`produces similar exposures as the individual components.
`
`Final Protocol Submission:
`Study Completion:
`Final Report Submission:
`
`03/31/2020
`12/31/2020
`12/31/2021
`
`Reference ID: 3694190
`
`
`
`NDA 205395
`Page 4
`
`2845-2
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed dose combination (FDC) age-appropriate
`formulation in HIV-infected pediatric subjects 6 years to less than 12 years of age
`and weighing at least 15 kg. The safety and antiviral activity (efficacy) of
`darunavir and cobicistat FDC age-appropriate formulation in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children ages 6
`years to less than 12 years may not be required if the dosing recommendation for
`the FDC age-appropriate formulation can be supported by pediatric trials already
`conducted with the individual drug products and if the age-appropriate FDC
`produces similar exposures as the individual components.
`
`Final Protocol Submission:
`Study Completion:
`Final Report Submission:
`
`03/31/2020
`12/31/2020
`12/31/2021
`
`2845-3
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed-dose combination (FDC) tablets in HIV-infected
`pediatric subjects 12 years to less than 18 years of age. The safety and antiviral
`activity (efficacy) of darunavir and cobicistat FDC tablets in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children 12
`years to less than 18 years of age may not be required if the dosing
`recommendation for the FDC tablets can be supported by pediatric trials already
`conducted with the individual drug products and if the FDC produces similar
`exposures as the individual components.
`
`Final Protocol Submission:
`Study Completion:
`Final Report Submission:
`
`03/31/2020
`12/31/2020
`12/31/2021
`
`Submit the protocols to your IND 113198, with a cross-reference letter to this NDA.
`
`Reports of these required pediatric postmarketing studies must be submitted as a new drug
`application (NDA) or as a supplement to your approved NDA with the proposed labeling
`changes you believe are warranted based on the data derived from these studies. When
`submitting the reports, please clearly mark your submission "SUBMISSION OF REQUIRED
`PEDIATRIC ASSESSMENTS" in large font, bolded type at the beginning of the cover letter of
`the submission.
`
`PROMOTIONAL MATERIALS
`
`You may request advisory comments on proposed introductory advertising and promotional
`labeling. To do so, submit, in triplicate, a cover letter requesting advisory comments, the
`proposed materials in draft or mock-up form with annotated references, and the package insert
`to:
`
`Reference ID: 3694190
`
`
`
`NDA 205395
`Page 5
`
`Food and Drug Administration
`Center for Drug Evaluation and Research
`Office of Prescription Drug Promotion
`5901-B Ammendale Road
`Beltsville, MD 20705-1266
`
`As required under 21 CFR 314.81(b)(3)(i), you must submit final promotional materials, and the
`package insert, at the time of initial dissemination or publication, accompanied by a Form FDA
`2253. Form FDA 2253 is available at
`http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM083570.pdf.
`Information and Instructions for completing the form can be found at
`http://www.fda.gov/downloads/AboutFDA/ReportsManualsForms/Forms/UCM375154.pdf. For
`more information about submission of promotional materials to the Office of Prescription Drug
`Promotion (OPDP), see http://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm090142.htm.
`
`REPORTING REQUIREMENTS
`
`We remind you that you must comply with reporting requirements for an approved NDA
`(21 CFR 314.80 and 314.81).
`
`If you have any questions, call Nina Mani, Regulatory Project Manager, at (240) 402-0333.
`
`Sincerely,
`
`{See appended electronic signature page}
`
`Jeffrey S. Murray, MD, MPH
`Deputy Director
`Division of Antiviral Products
`Office of Antimicrobial Products
`Center for Drug Evaluation and Research
`
`Enclosure(s):
`Content of Labeling
`Container Labeling
`
`Reference ID: 3694190
`
`
`
`---------------------------------------------------------------------------------------------------------
`This is a representation of an electronic record that was signed
`electronically and this page is the manifestation of the electronic
`signature.
`---------------------------------------------------------------------------------------------------------
`/s/
`----------------------------------------------------
`JEFFREY S MURRAY
`01/29/2015
`
`Reference ID: 3694190
`
`
`
`at}
`0"“
`
`
`
`'
`
`Food and Drug Administration
`Silver Spring MD 20993
`
`NDA 2053 95
`
`Janssen Products, LP
`Attention: Karen Gerry, BSc
`Manager, Global Regulatory Affairs
`1125 Trenton-Harbourton Road
`
`Titusville, NJ 08560
`
`Dear Ms. Gerry:
`
`NDA APPROVAL
`
`Please refer to your New Drug Application (NDA) dated March 31, 2014 and received
`March 31, 2014, submitted under section 505(b) of the Federal Food, Drug, and Cosmetic Act
`(FDCA), for PrezcobixTM (darunavir and cobicistat) tablet, 800 mg/ 150 mg for oral use.
`
`We acknowledge receipt of your amendments dated:
`
`April 11, 2014
`April 23, 2014
`May 6, 2014
`June 2, 2014
`June 24, 2014
`June 27, 2014
`June 30, 2014
`July 8, 2014
`July 14, 2014
`August 4, 2014
`
`August 4, 2014
`August 8, 2014
`August 11, 2014
`August 13, 2014
`September 12, 2014
`October 1, 2014
`October 15, 2014
`October 17, 2014
`November 24, 2014
`November 25, 2014
`
`November 26, 2014
`December 16, 2014
`December 18, 2014
`December 22, 2014
`January 7, 2015
`January 12, 2015
`January 14, 2015
`January 21, 2015
`January 26, 2015
`January 28, 2015
`
`This new drug application provides for the use of PrezcobixTM (darunavir and cobicistat) in
`combination with other antiretroviral agents for treatment of HIV—1 infection.
`
`APPROVAL & LABELING
`
`It is approved, effective on the
`We have completed our review of this application, as amended.
`date of this letter, for use as recommended in the enclosed agreed-upon labeling text.
`
`Reference ID: 3694190
`Reference ID: 3699643
`Reference ID: 3699643
`
`
`
`NDA 205395
`
`Page 2
`
`CONTENT OF LABELING
`
`As soon as possible, but no later than 14 days from the date of this letter, submit the content of
`labeling [21 CFR 3 1450(1)] in structured product labeling (SPL) format using the FDA
`automated drug registration and listing system (eLIST), as described at
`http://wwwfda. gov/Forlndustry/DataStandards/StructuredProductLabeling/defaulthtm. Content
`of labeling must be identical to the enclosed labeling (text for the package insert, text for the
`patient information). Information on submitting SPL files using eLIST may be found in the
`guidance for industry SPL Standardfor Content ofLabeling Technical Qs and As, available at
`ht_tp://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryIn-formation/Guidances/U
`CM0723 92.pdf.
`
`The SPL will be accessible via publicly available labeling repositories.
`
`IMMEDIATE CONTAINER LABEL
`
`Submit the final printed immediate container label that is identical to the enclosed immediate
`container label, as soon as it is available, but no more than 30 days after it is printed. Please
`submit the label electronically according to the guidance for industry Providing Regulatory
`Submissions in Electronic Format — Human Pharmaceutical Product Applications and Related
`Submissions Using the eCTD Specifications (June 2008). Alternatively, you may submit 12
`paper copies, with 6 of the copies individually mounted on heavy-weight paper or similar
`material. For administrative purposes, designate this submission “Final Printed Container
`Label for approved NDA 205395.” Approval of this submission by FDA is not required before
`the labeling is used.
`
`Marketing the product with FPL that is not identical to the approved labeling text may render the
`product misbranded and an unapproved new drug.
`
`MARKET PACKAGE
`
`Please submit one market package of the drug product when it is available to the following
`address:
`
`Nina Mani
`
`Food and Drug Administration
`Center for Drug Evaluation and Research
`White Oak Building 22, Room: 6317
`10903 New Hampshire Avenue
`Silver Spring, Maryland
`Use zip code 20903 ifshipping via United States Postal Service (USPS).
`Use Zip code 20993 ifsending via any carrier other than USPS (e.g., UPS, DHL, FedEx).
`
`Reference ID: 3694190
`
`Reference ID: 3699643
`Reference ID: 3699643
`
`
`
`NDA 205395
`
`Page 3
`
`REQUIRED PEDIATRIC ASSESSMENTS
`
`Under the Pediatric Research Equity Act (PREA) (21 U.S.C. 35 50), all applications for new
`active ingredients, new indications, new dosage forms, new dosing regimens, or new routes of
`administration are required to contain an assessment of the safety and effectiveness of the
`product for the claimed indication(s) in pediatric patients unless this requirement is waived,
`deferred, or inapplicable.
`
`We are waiving the pediatric study requirement for ages, birth to less than 3 years of age because
`there is evidence strongly suggesting that the drug product would be unsafe in this pediatric
`group. Use of darunavir, a component of the fixed dose combination (FDC) product, is not
`appropriate in pediatric patients < 3 years of age. This decision is based on the results ofjuvenile
`rat toxicology studies that provide evidence of potential safety risk as a result of accumulation of
`drug in the brain.
`
`We are also waiving the pediatric studies requirement for children ages 3 years to less than 18
`years weighing less than 15 kilograms (kg) because this product does not represent a meaningful
`therapeutic benefit over existing therapies for pediatric patients in this age and weight group. In
`addition, multiple FDC formulations would be required to be developed to accommodate the
`various weight bands in the small number of pediatric patients below 15 kg.
`
`We are deferring submission of your pediatric studies for children ages 3 years to less than 18
`years of age and who weigh 15 kg or more for this application because the product is ready for
`approval in adults and the pediatric studies have not been completed.
`
`Your deferred pediatric studies required by section 505B(a) of the FDCA are required
`postmarketing studies. The status of these postmarketing studies must be reported annually
`according to 21 CFR 314.81 and section 505B(a)(3)(C) of the FDCA. These required studies are
`listed below.
`
`2845—1
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed dose combination (FDC) age—appropriate
`formulation in HIV-infected pediatric subjects 3 years to less than 6 years of age
`and weighing at least 15 kg. The safety and antiviral activity (efficacy) of
`darunavir and cobicistat FDC age-appropriate formulation in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children ages 3
`years to less than 6 years may not be required if the dosing recommendation for
`the FDC age-appropriate formulation can be supported by pediatric trials already
`conducted with the individual drug products and if the age-appropriate FDC
`produces similar exposures as the individual components.
`
`Final Protocol Submission:
`
`03/31/2020
`
`Study Completion:
`Final Report Submission:
`
`12/31/2020
`12/31/2021
`
`Reference ID: 3694190
`Reference ID: 3699643
`Reference ID: 3699643
`
`
`
`NDA 205395
`
`Page 4
`
`2845-2
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed dose combination (FDC) age-appropriate
`formulation in HIV-infected pediatric subjects 6 years to less than 12 years of age
`and weighing at least 15 kg. The safety and antiviral activity (efficacy) of
`darunavir and cobicistat FDC age-appropriate formulation in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children ages 6
`years to less than 12 years may not be required if the dosing recommendation for
`the FDC age-appropriate formulation can be supported by pediatric trials already
`conducted with the individual drug products and if the age—appropriate FDC
`produces similar exposures as the individual components.
`
`Final Protocol Submission:
`
`03/31/2020
`
`Study Completion:
`Final Report Submission:
`
`12/31/2020
`12/3 1/2021
`
`2845 -3
`
`Evaluate the pharmacokinetics, safety, and antiviral activity (efficacy) of
`darunavir and cobicistat fixed-dose combination (FDC) tablets in HIV—infected
`pediatric subjects 12 years to less than 18 years of age. The safety and antiviral
`activity (efficacy) of darunavir and cobicistat FDC tablets in pediatric subjects
`should be evaluated for a minimum of 24 weeks. A clinical trial in children 12
`
`years to less than 18 years of age may not be required if the dosing
`recommendation for the FDC tablets can be supported by pediatric trials already
`conducted with the individual drug products and if the FDC produces similar
`exposures as the individual components.
`
`Final Protocol Submission:
`
`03/31/2020
`
`Study Completion:
`Final Report Submission:
`
`12/31/2020
`12/31/2021
`
`Submit the protocols to your lND 113198, with a cross-reference letter to this NDA.
`
`Reports of these required pediatric postmarketing studies must be submitted as a new drug
`application (NDA) or as a supplement to your approved NDA with the proposed labeling
`changes you believe are warr