The fourth quarter of 2025 presents a critical period for pharmaceutical approvals, with the FDA scheduled to make decisions on five therapies that could significantly impact treatment landscapes for both pediatric and adult populations. These upcoming approvals span rare genetic disorders, dermatological conditions, cardiovascular disease, and infectious diseases.
Breakthrough Potential for Achondroplasia Treatment
Ascendis Pharma's navepegritide (TransCon CNP) faces a November 30, 2025 PDUFA date for treating children with achondroplasia. The investigational prodrug of C-type natriuretic peptide (CNP) is administered once weekly and designed to provide continuous exposure of active CNP to receptor tissues across the body, including growth plates and skeletal muscle.
"[Navepegritide] is designed to provide sustained exposure to CNP, resulting in continuous inhibition of the FGFR3 pathway that is overactive in achondroplasia," said Janet Legare, MD, professor of Pediatrics at the University of Wisconsin School of Medicine and Public Health. The FDA accepted the NDA on June 2, 2025, and granted priority review designation.
Expanding Pediatric Dermatology Options
Arcutis Biotherapeutics' roflumilast cream 0.05% (Zoryve) has a PDUFA date of October 13, 2025, for treating atopic dermatitis in children aged 2 to 5 years. The once-daily, next-generation phosphodiesterase-4 (PDE4) inhibitor is being evaluated for patients with mild-to-moderate atopic dermatitis.
The NDA submission was based on data from multiple studies, including the INTEGUMENT-PED (NCT04845620) phase 3 trial involving 652 children with a mean atopic dermatitis Body Surface Area (BSA) of 22%. "The data highlight the efficacy of the cream, along with its favorable safety and tolerability profile, which are critical when prescribing a long-term treatment for children with AD," said Mercedes E. Gonzalez, MD, medical director of Pediatric Skin Research, LLC, and INTEGUMENT-PED clinical trial investigator.
Novel Approaches to Gonorrhea Treatment
Two investigational antibiotics are under FDA review for treating uncomplicated gonorrhea in patients 12 years and older. GSK's gepotidacin (Blujepa) has a December 11, 2025 PDUFA date, while Innoviva Specialty Therapeutics' zoliflodacin faces a December 15, 2025 decision date.
Gepotidacin's supplemental NDA is supported by findings from the phase 3 EAGLE-1 trial, published in The Lancet, which evaluated the drug as a non-inferior oral alternative to the current leading treatment combination of intramuscular ceftriaxone and oral azithromycin. The trial enrolled participants aged 12 years and older with suspected uncomplicated urogenital gonorrhea, randomly assigning them to receive either gepotidacin (2 oral doses of 3000 mg administered 10-12 hours apart) or the standard combination therapy.
Zoliflodacin represents a first-in-class antibacterial administered in a single oral dose. The FDA granted priority review on June 12, 2025. According to Innoviva, there are more than 82 million new gonorrhea infections globally each year, making it the second most common bacterial sexually transmitted infection.
Cardiovascular Disease Management
LIB Therapeutics' lerodalcibep faces a December 12, 2025 PDUFA date for reducing low-density lipoprotein cholesterol (LDL-C) in patients with atherosclerotic cardiovascular disease (ASCVD), or very high or high risk of ASCVD, and primary hyperlipidemia. The indication also includes patients 10 years or older with heterozygous and homozygous familial hypercholesterolemia (HeFH/HoFH).
Lerodalcibep is described as a novel, small protein-binding, third-generation PCSK9 inhibitor developed as a once-monthly, single small-volume subcutaneous injection that does not require refrigeration at home or during travel. The FDA accepted the Biologics License Application (BLA) on February 4, 2025.
