431 words
13 April 2006
Pharma Marketletter
English
Copyright 2006. Marketletter Publications
The US consumer group Public Citizen has petitioned the Food and Drug Administration to immediately remove from the market the prescription version of Xenical (orlistat, made by Roche ) because, it says, the obesity treatment has been known to cause a significant increase in aberrant crypt foci (ACF), which are widely believed to be a precursor to colon cancer.
Earlier this month, the FDA sent an "approvable" letter concerning the over-the-counter version of orlistat to GlaxoSmithKline, which has applied to market this version. Despite safety concerns, if GSK meets the conditions set by the FDA - conditions that have not been made public - this would make the drug eligible for final approval for OTC sales, says Public Citizen.
According to the consumer body, its petition is based on findings from the pharmacology review of Roche's own data and a recent independent confirmation that orlistat causes ACF in the colon of rats. There is a large amount of scientific literature that acknowledges the importance of ACF as the earliest identifiable neoplastic colonic lesion and a putative precursor of colon cancer. The FDA's own 1997 review of orlistat indicated a concern with colonic cell proliferation, and the drug was not initially approved by the agency because of clinical trials that found a four to seven-fold increased risk of getting breast cancer while taking orlistat, it states.
Also questions efficacy
In addition to cancer concerns, adverse events for patients taking orlistat include a cluster of gastrointestinal symptoms and a loss of fat-soluble vitamins, including beta-carotene and vitamins A, D, E and K, says Public Citizen, adding that orlistat's efficacy has also been called into question because of two recently-published clinical trials that demonstrated only a 2.8% difference in weight loss after four years versus placebo.
"The failure to ban the prescription version of this drug or, worse, to make it much more widely available by allowing OTC sales, is a decision that is likely to increase cancer incidence," said Sidney Wolfe, director of Public Citizen's Health Research Group. Public Citizen is joined in the petition by two professors of pathology at Case Western Reserve School of Medicine, Theresa Pretlow and Thomas Pretlow, who are both experts on ACF's link to colorectal cancer.
"The FDA should not allow a drug...to remain on the market for the long-term treatment of a non-lethal condition when it combines so little efficacy coupled with a still unresolved potential to cause breast and colon caner," says the 12-page petition.