The Japanese healthcare authorities have granted approval to Evenity (romosozumab), Amgen and UCB's innovative bone-forming medication for osteoporosis treatment, marking a significant milestone as the first regulatory approval worldwide for this therapeutic agent.
The approval holds particular significance in Japan, where approximately 12 million people suffer from osteoporosis, with hip fracture rates showing dramatic increases among both men and women over 75 years of age. Japan's aging population and world-leading life expectancy rates make this approval especially relevant for addressing a growing public health concern.
Clinical Evidence and Mechanism of Action
Evenity's approval is supported by robust clinical evidence from two pivotal Phase 3 trials. The FRAME study, which enrolled 7,180 postmenopausal women with osteoporosis, and the BRIDGE trial, involving 245 men with osteoporosis, demonstrated the drug's efficacy. The medication works through a dual mechanism of action, simultaneously promoting bone formation while reducing bone resorption to enhance bone mineral density and decrease fracture risk.
Regulatory Journey and Safety Considerations
The path to approval has not been without challenges. In 2017, the U.S. Food and Drug Administration initially rejected Evenity after identifying an unexpected increase in cardiovascular events in one of the Phase 3 trials. Amgen and UCB subsequently resubmitted their application in summer 2018 with additional data from two clinical trials, aiming to address these safety concerns.
The Japanese Pharmaceuticals and Medical Devices Agency conducted a comprehensive review of Evenity's safety profile, including careful examination of the cardiovascular safety findings from the ARCH trial that had prompted the FDA's initial rejection.
Strategic Importance and Market Impact
For Amgen, Evenity represents a strategic asset as the company prepares for the eventual patent expiration of its current osteoporosis treatment, Prolia (denosumab). The development and commercialization in Japan has been led by a joint venture between Amgen and Astellas Pharma, headquartered in Tokyo.
The drug is currently under regulatory review in Europe, while a crucial FDA Bone, Reproductive and Urologic Drugs Advisory Committee meeting is scheduled for later this month. While advisory committee recommendations are not binding, they typically provide strong indicators of the FDA's likely decision on approval.
Japanese Market Context
Japan's approval of Evenity addresses a significant medical need in a country with one of the world's most rapidly aging populations. The high prevalence of osteoporosis, affecting approximately 12 million individuals, underscores the potential impact of this new therapeutic option in the Japanese healthcare landscape.
