Danicopan

作者：布布在全球新药审批格局中，美国长久以来被视为全球创新药物的“首发地”。然而，根据Pink Sheet对2024–2025年药品审批数据的深度分析揭示出一种值得关注的新趋势：在22款先获欧盟（EU）批准的新产品中，绝大多数为生物制剂，而非传统的小分子药物。这一现象或许并非偶然，而是源自美国在合同生产和质量审评上的系统性挑战。01FDA仍然领先，但欧盟“抢跑”增多Pink Sheet的最新分析指出，截至2025年5月20日，FDA已批准17款新药和生物制剂，欧盟和美国监管机构总计批准了37款产品。其中美国仍在整体数量上保持首批优势。然而，这一优势在生物制剂领域出现了“局部滑坡”。2024–2025年间，在欧盟率先获批的22款产品中，绝大多数为疫苗、抗体、细胞疗法和基因疗法等生物制品（表1）。表 1. 2024年至2025年5月20日欧盟领先美国上市新药一览表如果我们回顾2024年全年批准的新药构成，可以看出美国FDA在小分子药物领域仍保持强势地位。2024年FDA共批准了61款创新药物，而欧盟为37款，其中大部分欧盟获批产品最终也在美国获得上市许可。然而，在某些结构复杂、制造要求高的生物制剂领域，这一优势正在减弱。以典型案例来看，Novavax的COVID-19疫苗Nuvaxovid早在2021年底就已获得欧盟批准，美国直到2025年5月才完成正式批准，时间滞后超过40个月；medac/Medexus的Grafapex（treosulfan）在欧盟于2019年获批，美国则在2025年初才通过，滞后长达67个月。类似的还有Atara的Ebvallo（tabelecleucel），其在2022年即获欧盟上市许可，至2025年仍未获得FDA批准，反而收到CRL，主要因制造流程未满足FDA对一致性和GMP的高标准要求。在2025年欧盟先批的新药中，有3款用于新冠防治，包括Arcturus的Kostaive（首个自扩增 mRNA疫苗）、阿斯利康的Kavigale（长效抗体），以及InflaRx的Gohibic（ARDS治疗用抗体）。虽然这些产品在欧盟获得上市，但在美国则未能获得常规BLA批准，甚至部分尚未递交上市申请，反映出制药企业对美国监管节奏及市场预期的重新权衡。进一步观察数据还发现：除了极端的时间滞后案例，诸如PTC的Kebilidi（延迟28.9个月）、Orchard的Lenmeldy（延迟39个月）、Akebia的Vafseo（延迟11.1个月）等产品，也呈现出“欧先美后”的审批路径。这种时间差的背后，除了临床数据与适应症设定外，核心在于FDA对制造数据、生产体系一致性和第三方代工厂的深度审查，这些都大幅拉长了美国市场的准入周期。总体而言，美国FDA在新分子实体方面仍占据审批数量和速度的双重优势。但欧盟在生物制剂审批方面的“抢先”现象愈发频繁，且集中于制造复杂、CMC挑战高的产品类别。这种结构性变化表明，美国的全球首发地位虽未动摇，但已开始面临来自欧盟在特定技术领域上的有效挑战。02生物制剂审批的软肋：制造质量与第三方生产FDA对生物制剂的质量审评严苛，尤其在生产可比性（comparability）、验证数据完整性以及第三方合同生产（CDMO）设施的合规性方面，要求尤为苛刻。据统计，2024–2025年欧盟先批的22款药品中，有8款在FDA因制造相关问题收到完整回应信（CRL），其中5例直接关联第三方生产设施的质量问题。来自礼来（Lilly）的lebrikizumab（Ebglyss）便是典型案例：FDA要求其聘请第三方重新评估生产数据的可靠性，而欧洲则在早于FDA近一年时间内给予上市许可。又如Atara的复发或难治性EB病毒阳性移植后淋巴增殖性疾病细胞疗法Ebvallo（tabelecleucel）在欧洲通过“特殊情况”通道获批后迅速上市，而FDA因GMP问题和第三方厂商不合规发出CRL，并一度对临床试验实施临床暂停。此外，FDA对于海外生产数据的采信门槛亦显著提高。例如，PTC的基因疗法Kebilidi因临床研究样品与商业化产品工艺不一致被要求补充新的临床数据，导致美国上市时间晚于欧盟两年有余。03FDA对毒性与安全性数据关注严格除了生产环节，美国FDA在药物的安全性评估与数据完整性方面也保持着高度谨慎的态度，常常比其他监管机构设置更高的准入门槛。这种审慎策略虽然有助于保障患者利益，但在全球同步申报的背景下，也往往造成美方审批节奏的明显滞后。某些药物即便在日本或欧盟等海外市场已有多年上市经验和临床安全记录，仍可能因潜在的器官毒性问题而遭遇FDA的严格质疑。例如，Akebia Therapeutics 开发的口服HIF-PHI药物 Vafseo（vadadustat）早在2020年即在日本获批用于肾性贫血治疗，并在2023年获得欧盟上市许可。然而，FDA在审评过程中高度关注其早期临床试验中出现的肝脏不良反应，认为现有数据尚不足以排除肝毒性风险。在经历一次完整回应信（CRL）后，企业不得不收窄适应症范围，仅限于透析依赖型患者，并配套长期肝功能监测方案，最终才于2024年在美获批。这一过程反映出，即便拥有海外上市经验，美国监管方依旧对潜在毒性保留更高警惕性，特别是在作用机制新颖或靶点复杂的药物中更为常见。对于依赖复杂检测指标作为关键终点的产品，FDA尤其强调原始数据的可追溯性与逻辑一致性。以treosulfan（商品名为Grafapex）为例，该药在欧盟早于2019年便已获批用于造血干细胞移植前的预处理，但其美国新药申请于2020年提交后，连续两次遭遇FDA完整回应信（CRL）。FDA指出，该药关键终点为“无事件生存期（EFS）”，但企业最初提交的数据包中缺少全部患者的骨髓和血细胞检查原始记录，无法支撑终点判定。这一问题使得监管机构在2021年CRL中明确表示“无法确认EFS结果的可信度”，并在随后的补充回复中继续批评数据缺失与逻辑混乱。最终，企业在2024年提交了系统化的溯源审计材料，覆盖所有受试者的骨髓报告与原始数据后才获得FDA认可。这一审批过程充分说明，FDA在面对此类数据驱动型药物时，其标准不仅仅是“有效”或“安全”，而是“数据是否完整”、“分析是否透明”、“原始记录是否经得起溯源”。这些标准常常远超其他地区的监管机构，从而导致明显的审批周期延长。这也凸显出FDA在面对临床关键指标时，极度重视数据基础是否扎实、可重复。04制度因素也在“带节奏”FDA加速批准机制本意是为了让严重疾病领域的潜力药物更快上市，早期释放治疗价值。但自2022年《食品药品综合改革法案》（FDORA）生效后，该机制增加了一项关键性新要求：药品在获得加速批准时就开始进行验证性研究。这项变革虽有助于提升加速批准的可信度，却也在客观上延缓了部分创新疗法的上市节奏，尤其影响了那些尚未启动确证性试验或临床路径复杂的产品。再生元开发的CD20×CD3双特异性抗体odronextamab（商品名：Ordspono）便面临这一制度掣肘。该药在欧盟已于2024年8月获得批准，用于治疗两种B细胞非霍奇金淋巴瘤：复发或难治性的滤泡性淋巴瘤（FL）和弥漫性大B细胞淋巴瘤（DLBCL）。而在美国，尽管再生元也同步递交了BLA申请，但FDA于2024年3月向其发出完整回应信（CRL），指出公司所提交的III期OLYMPIA临床试验尚处于剂量探索阶段，未能满足FDORA法规下“确证性试验正在进行”的要求。因此，再生元不得不分拆提交，将BLA缩减为只覆盖FL适应症，而DLBCL部分则延后处理。这类制度性的门槛，不仅延迟了多发适应症同步推进的可能，也对企业的申报策略、临床节奏与商业部署带来更高的不确定性。05新药首发地的多极化趋势已成现实值得注意的是，在FDA持续应对制造质量、毒性控制、制度改革等多重挑战的同时，全球“首批上市地”的格局本身也在悄然发生变化。2024年FDA新批准药物中，越来越多的全球首次批准地已不在美国，而是来自亚洲、欧洲或加拿大（表2）。表 2. 非美国首次上市的FDA 2024年批准新药例如，2024年FDA批准的新药中，包括百济神州的Tevimbra、Akebia的Vafseo、阿斯利康的Voydeya、安斯泰来的Vyloy等多个产品，均早在中国、日本或欧盟市场获批。其中一些药品在FDA批准时，已在海外市场销售多年，甚至首次上市时间可追溯至十多年前。这不仅反映出这些国家监管机构能力的提升，也显示出全球药企对不同市场审批效率和路径确定性的重新评估与布局。对FDA而言，这种趋势可能进一步加剧其在生物制剂领域的“时间劣势”感知。从全球新药审批格局来看，“美国首批”已不再是唯一常态，首发地的多极化趋势正在成为行业新现实。06结语回顾2024–2025年欧盟“抢先”批准的生物制剂清单，人们看到的不只是个别产品命运的转折，更是一种全球监管格局的悄然重塑。在FDA仍牢牢掌握大多数全球首批审批主导权的同时，那些复杂度高、路径前沿、生产挑战大的创新疗法，越来越倾向于先在欧盟完成上市首发。这并非意味着FDA正在“放慢脚步”，而是反映出其对制造一致性、毒性控制、数据可追溯性和制度规范的多重叠加标准，正成为全球最严的准入门槛之一。随着FDORA等法规的强化实施，“快速上市”的定义在美国变得更为谨慎和多条件绑定。与此同时，EMA的策略则体现出更大程度的灵活性：在制造问题尚可控、数据充分支持疗效的基础上，以有条件批准、例外路径等方式为高需求治疗选项开通通道。这种对风险与应急之间的动态平衡，正成为欧盟在新药首发竞争中频频“超车”的关键变量。对全球药企而言，未来的新药首发路径不再只是技术成熟度与市场潜力的博弈，更是对不同监管体系中“可控性”与“可预测性”的评估。在这一新格局下，制造体系的稳健程度、注册策略的全球统筹能力，以及企业自身的临床开发节奏掌控，将共同决定创新药物能否在全球多个市场高效落地。首发之争的焦点，已从审批速度的简单比较，转向了对监管适应能力的全链条挑战。往期推荐1医健企业前沿动态2医健行业BD/出海/投融资洞察___*声明：本文仅为作者观点，不构成任何投资建议，且非治疗方案推荐Ref.Silverman, B. EU Authorization Before US? Biologics Manufacturing Is Likely To Blame. Pink Sheet. 26. 05. 2025.关于贝壳社贝壳社是国内领先的医健创新创业服务平台，构建了"产业空间+创业教育+投资孵化+资本运作"四位一体服务体系，为医健领域创业企业提供全周期赋能。通过深度挖掘高成长项目、精准匹配产业资源及全球化生态网络，覆盖企业从孵化培育到加速发展的全链路，重点提供包括空间落地、创业培训、资本运作及跨境资源链接服务。贝壳社以加速科学技术成果转化与产业升级为目标，致力于成为医健领域的孵化器、加速器、连接器。

--- Ruxoprubart (NM8074) met all clinical endpoints, offering a safe, differentiated treatment for Paroxysmal Nocturnal Hemoglobinuria (PNH). Paroxysmal Nocturnal Hemoglobinuria (PNH) is a rare hematological (Blood) disorder. Regulatory approval for the Phase II trial in PNH subjects was granted based on the safety profile of healthy subjects in the Phase I trial. Interim results from this 12-subject, three-month, multi-dose Phase II efficacy trial are compelling. The drug was safe and well-tolerated in all treated PNH subjects with expected safety & efficacy, meeting all clinical endpoints with no reported side effects. In this efficacy trial, Ruxoprubart: Protected PNH Red Blood cells against lysis and enabled complete transfusion avoidance, meeting the primary endpoint. Increased hemoglobin levels above baseline by 1.4 to 2.0 g/dL in most subjects, with some showing intra-subject hemoglobin increase of 1.5 to 4.3 g/dL, exceeding the threshold set for the primary endpoint. An average hemoglobin increase of >1.6 g/dL was observed across the cohort from baseline to the end of the treatment period. Reduced LDH levels to baseline, meeting the primary efficacy endpoint. Significantly increased PNH Type III clone size by protecting PNH Red Blood Cells from complement-mediated lysis. Allowed normal pathogenic clearance in all treated PNH subjects, as infection cleared as expected. The regulatory agency has recently approved a once-weekly subcutaneous protocol for Ruxoprubart — allowing for self-administration and offering a distinct advantage over Apellis, which requires twice-weekly dosing. Ruxoprubart effectively inhibited the Alternative Pathway (AP) without affecting the Classical Pathway (CP) in the trial. More importantly, the FDA has granted Orphan Drug Designation (ODD) to Ruxoprubart for treating PNH. A Breakthrough Therapy Designation (BTD) application for Ruxoprubart in PNH will soon be filed for FDA review. Ruxoprubart is set to be developed as a novel treatment for several complement-mediated disorders, including but not limited to renal, hematological, dermatological, and ocular diseases. May 19, 2025 -- NovelMed is pleased to announce positive 12-week interim results from the ongoing multi-dose Phase II trial of Ruxoprubart, a novel complement-targeting immunotherapy, in adult patients with Paroxysmal Nocturnal Hemoglobinuria (PNH). These interim data demonstrate that Ruxoprubart, administered as monotherapy, was safe, well-tolerated, and met all primary efficacy endpoints. Ruxoprubart achieved transfusion avoidance, increased hemoglobin levels, reduced LDH, and increased PNH clone size — key outcomes that contributed to improved disease control and enhanced quality of life for PNH patients. “The promising interim results from our Phase II PNH study solidify Ruxoprubart as a novel treatment for patients with advanced hematological conditions, offering hope where existing therapies fall short. This achievement not only underscores our commitment to advancing Ruxoprubart, an immunotherapy for PNH, but also marks a significant step toward addressing critical unmet needs within this patient population," said Dr. Rekha Bansal, CEO. "I extend my sincere gratitude to the PNH subjects and investigators whose dedication has been instrumental in this success. We are eager to present our findings to regulatory authorities and proceed with the Phase III trial." Ruxoprubart works by binding to Bb and selectively inhibiting the protease activity of the Alternative Pathway C3 convertase, while preserving the Classical Pathway. By acting proximally in the Alternative Pathway, Ruxoprubart provides complete control over both intravascular and extravascular hemolysis, resulting in marked increases in hemoglobin levels observed in this trial. These findings support the drug’s advancement as a novel, next-generation immunotherapy for the treatment of PNH and a broad range of hematological, renal, inflammatory, and ocular diseases. “We are excited to announce that our Alternative Pathway strategy for treating PNH is delivering exceptional results,” said Mr. Alex Kumar, Chief Strategy Advisor at NovelMed. “These data reinforce our confidence as we look forward to working with the regulatory agency to bring Ruxoprubart to PNH patients without delay. Our mission is to transform the lives of chronically ill patients for whom an ideal treatment has yet to be discovered.” This Phase II trial was initiated following the successful completion of a Phase I study involving 40 (forty) healthy volunteers. Ruxoprubart was well tolerated across all dose levels, ranging from 0.3 to 20 mg/kg, with no safety concerns. The drug demonstrated selective inhibition of the Alternative Pathway through Bb binding, without affecting the Classical Pathway. These promising safety findings paved the way for regulatory approval to initiate a Phase II study in patients with PNH. This ongoing 12-week clinical trial of Ruxoprubart is an open-label, multi-dose study in treatment-naïve adult subjects with PNH. The primary objectives are to evaluate the safety, tolerability, and efficacy of Ruxoprubart as a monotherapy in the Alternative Pathway-mediated lysis of Red Blood Cells. To date, 10 out of 12 PNH subjects have completed the study. Subjects 11 & 12 have been enrolled to complete the two-cohort trial. Interim results confirm that Ruxoprubart achieved all primary efficacy endpoints, delivering sustained clinical benefit in PNH. The primary efficacy endpoints include: Transfusion Avoidance: PNH patients typically require multiple blood transfusions to maintain normal hemoglobin levels. Ruxoprubart effectively protected PNH Type III cells from Alternative Pathway-mediated destruction, resulting in complete transfusion avoidance and successfully meeting the primary efficacy endpoint. Hemoglobin Increase: PNH patients experience reduced hemoglobin levels, leading to severe anemia. Ruxoprubart increased hemoglobin levels above baseline by 1.4 to 2.0 g/dL in most subjects, with some showing intra-subject increases ranging from 1.5 to 4.3 g/dL, surpassing the efficacy threshold defined for the primary endpoint. An average increase of >1.6 g/dL in hemoglobin was observed across the cohort from the beginning to the end of the treatment period. LDH Reduction: PNH patients experience severe lysis of Red Blood Cells (RBCs), leading to elevated lactate dehydrogenase (LDH) levels. By controlling complement-mediated hemolysis, Ruxoprubart reduced LDH levels to baseline, achieving the primary efficacy endpoint. Preservation of PNH Cells: Continuous lysis of Red Blood Cells in PNH leads to a dramatic reduction in total RBC count, often exceeding 80 to 90%. By effectively preventing this lysis, Ruxoprubart significantly preserved PNH cells, resulting in a substantial increase in the total PNH clone size and hemoglobin, successfully meeting the primary efficacy endpoint. Pathogenic Clearance: As expected, Ruxoprubart facilitated effective pathogenic clearance across all treated PNH subjects. In summary, the observed changes in efficacy parameters support the drug's mechanism of action and validate Ruxoprubart’s potential as a highly effective monotherapy for PNH. “We are thrilled to share these data, which demonstrate the potential of Ruxoprubart in advanced PNH, and look forward to working with regulatory authorities to bring this new immunotherapy to this patient community,” said Mr. Robert Bard, Vice President of Regulatory Affairs at NovelMed. “It’s very clear that we are on a promising path with exciting Phase II data in this serious hematological disorder.” PNH is a rare, acquired hematologic disorder in which Red Blood Cells lack protective surface proteins due to a mutation in the phosphatidylinositol glycan class A (PIGA) gene, leaving them vulnerable to complement-mediated destruction. In healthy individuals, Type I RBCs express complement regulatory proteins and are fully protected from complement-mediated destruction. In contrast, PNH patients have a significant percentage of Type III RBCs, which completely lack these protective proteins and are therefore highly susceptible to Alternative Pathway-mediated lysis. PNH is primarily an Alternative Pathway-mediated disease, with no involvement of the Classical or Lectin pathways in its pathology. Key laboratory markers indicative of disease progression include reduced Type III Red Blood Cells, low hemoglobin, elevated lactate dehydrogenase (LDH), and an increased need for blood transfusions. These markers reflect the underlying hemolytic anemia, which in turn leads to debilitating symptoms such as chronic fatigue, pain, jaundice, and organ damage. As the disease progresses, it significantly affects the patient’s quality of life and can ultimately result in life-threatening complications and death if not properly managed. While Soliris® (eculizumab) is the current FDA-approved standard of care for PNH – administered via intravenous infusion to provide C5 blockade – clinical limitations persist. Up to 88% of Soliris-treated patients continue to experience persistent anemia, with more than one-third of them requiring blood transfusions at least once every year. Despite its effectiveness in some patients, Soliris does not fully address the needs of many patients, as a significant proportion remain anemic, fatigued, and require blood transfusions, highlighting the need for specific, effective, and comprehensive therapies. Nearly all FDA-approved therapies for PNH and other complement-mediated disorders, oral or intravenous, suffer from the well-documented Black Box warning label because of the broad immunosuppression of the Classical Pathway, elevating the risk of life-threatening infections. Ruxoprubart offers a selective, upstream, and targeted approach to Alternative Pathway inhibition, without compromising the Classical Pathway, offering the best-in-class novel therapy. These attributes position Ruxoprubart as a safer and more effective treatment for patients with PNH. Ruxoprubart, an engineered human immunoglobulin, exhibits dual specificity: 1) it blocks only the Alternative Pathway, dysregulated by the disease, and 2) it binds Bb which has no binding to Factor B. Ruxoprubart met all primary endpoints in the interim evaluation of the ongoing Phase II clinical trial in PNH, positioning it as the first immunotherapy in this indication with the potential for approval without a Black Box warning. This immunotherapy has demonstrated a safe and well-tolerated profile across all five cohorts in the Phase I trial, including the highest dose of 20 mg/kg. Our findings confirm that the drug selectively blocks the Alternative Pathway. This differentiated, novel mechanism sets Ruxoprubart apart from other complement blockers (Soliris®, Ultomiris®, Empaveli®, Voydeya®, and Fabhalta®) currently approved or in development worldwide. Voydeya®, which received FDA approval in 2024 as a combination therapy, was developed by Achillion and acquired by AstraZeneca for $930 million. Despite its limited clinical efficacy, Voydeya®'s reliance on co-administration with a C5 inhibitor restricts its potential as a standalone therapy. Unlike Fabhalta®, which targets Factor B, Ruxoprubart (NM8074) binds to Bb, which is generated only upon activation of the Alternative Pathway, offering a unique mechanism of action as monotherapy. As a novel monotherapy with a unique, upstream, and pathway-specific mechanism, Ruxoprubart is emerging as a best-in-class candidate for the treatment of PNH and numerous complement-mediated diseases. NovelMed is a clinical-stage biopharmaceutical company dedicated to developing innovative novel biologics (immunotherapies) to treat a wide range of complement-mediated diseases. NovelMed proudly leads the development of Alternative Pathway-specific antibodies (NM8074, NM5072, and NM8070) to address a wide range of chronic complement-mediated disorders. The company is actively conducting a Phase II clinical trial in treatment-naïve PNH subjects to expedite the availability of this promising treatment. Additionally, the FDA has approved Phase II studies for several rare diseases, including but not limited to Atypical Hemolytic Uremic Syndrome (aHUS), C3 Glomerulopathy (C3G), IgA Nephropathy (IgAN), ANCA-Associated Vasculitis (AAV), and Dermatomyositis (DM). The content above comes from the network. if any infringement, please contact us to modify.