Journey Medical Corporation's Emrosi (DFD-29), a minocycline hydrochloride extended-release capsule (40 mg), has received FDA approval for the treatment of inflammatory lesions caused by rosacea in adults. The approval marks a new option for the millions affected by this chronic skin condition and is supported by robust data from Phase 3 clinical trials.
The approval is based on data from two Phase 3 clinical trials, MVOR-1 (NCT05296629) and MVOR-2 (NCT05343455), which were 16-week, multicenter, randomized, double-blind, controlled studies. These trials enrolled approximately 320 participants aged 18 and older with severe papulopustular rosacea. Participants were randomized to receive either 40-mg extended-release capsules of DFD-29, 40-mg capsules of doxycycline (Oracea), or a placebo.
Efficacy and Safety Data
Both trials met their co-primary endpoints, demonstrating statistically significant superiority of DFD-29 over both placebo and doxycycline in terms of Investigator's Global Assessment (IGA) treatment success and reduction in total inflammatory lesion count from baseline to week 16. Specifically, an analysis from June 2023 showed that IGA success rates in the DFD-29 groups were approximately 65.0% and 60.1% in the MVOR-1 and MVOR-2 studies, respectively, compared to lower rates in the doxycycline (46.1% and 31.4%) and placebo (31.2% and 26.8%) groups. Furthermore, the DFD-29 groups exhibited a greater mean reduction in lesions (MVOR-1: 21.3; MVOR-2: 18.4) compared to the doxycycline (MVOR-1: 15.9; MVOR-2: 12.2) and placebo (MVOR-1: 14.9; MVOR-2: 11.1) groups.
All participants completed the 16-week treatment duration, and no significant safety issues were reported. The most common adverse event reported in patients receiving DFD-29 was dyspepsia.
Pharmacokinetic Profile
Data presented at the 44th Fall Clinical Dermatology Conference highlighted the dermal and systemic pharmacokinetics of DFD-29 compared to doxycycline. The randomized, open-label study in healthy adult volunteers showed that DFD-29 (40 mg) provided higher dermal concentrations of minocycline than a similar dose of doxycycline from Day 1 onward. Plasma pharmacokinetic parameters (Cmax & AUC) were similar on Day 1 and Day 21 for minocycline (DFD-29), while doxycycline showed accumulation in plasma with a significant increase in PK parameters from Day 1 to Day 21. This suggests that the modified-release formulation of DFD-29 allows for sustained and higher drug concentrations in the skin, potentially leading to improved clinical outcomes.
Clinical Significance
Rosacea is a chronic inflammatory skin condition affecting an estimated 16 million Americans and 415 million people worldwide. Symptoms include facial redness, inflammatory lesions (papules and pustules), and spider veins (telangiectasia). According to the National Rosacea Society, the condition can significantly impact patients' self-confidence, social interactions, and professional lives.
"Rosacea is a difficult to treat skin condition and based on the favorable results from our phase 3 clinical trials, [DFD-29] has potential to become the best-in-class oral medication to treat the condition," said Claude Maraoui, co-founder, president, and CEO of Journey Medical. Srinivas Sidgiddi, MD, vice president of research and development at Journey Medical, added that DFD-29 showed great efficacy and tolerability in the pivotal clinical trials.
With this FDA approval, DFD-29 (Emrosi) offers a new, effective treatment option for adults suffering from rosacea-related inflammatory lesions, potentially improving their quality of life and addressing a significant unmet medical need.
