Acadia is "committed to working constructively with EU regulators" following a recent European rejection for Rett syndrome drug Daybue, CEO Catherine Adam Owens said.
Acadia Pharmaceuticals isn’t taking its recent rejection from the European Medicines Agency lying down, vowing to seek a re-examination of the decision from the regulator's Committee for Medicinal Products for Human Use (CHMP) that limits the reach of its Rett syndrome drug Daybue.The CHMP’s negative decision, issued Feb. 26, poked holes in Acadia's pivotal Lavender trial, which tested Daybue (trofinetide) against placebo in 187 female patients with Rett syndrome, a rare neurodevelopmental disorder. Now, after reviewing the CHMP’s rejection, Acadia has pledged to request a re-examination of the opinion, maintaining in a March 2 release that it now has a better understanding of the European regulator's concerns. “While we are disappointed by the CHMP’s recommendation to refuse approval, we continue to be encouraged by the meaningful benefits trofinetide has demonstrated for people living with Rett syndrome,” CEO Catherine Owen Adams said in a statement. “We remain committed to working constructively with EU regulators to explore next steps and to bring this therapy to patients.” In Acadia's study, patients were randomized to receive Daybue or placebo over 12 weeks and primarily evaluated through a caregiver assessment, the Rett Syndrome Behaviour Questionnaire (RSBQ), and a physician Clinical Global Impression–Improvement (CGI-I) scale. The FDA signed off on Daybue in 2023 based on this study, as did Canada’s health regulators in 2024 and Israel’s health ministry more recently. The CHMP, however, took the opinion that based on the trial, “the benefits of Daybu in the treatment of Rett syndrome have not been demonstrated,” the agency explained in its rejection, using the drug's would-be commercial moniker in the EU. The EMA found that the size of the drug’s effects after 12 weeks was “too small” and not expected to be clinically meaningful for patients, pointing out that the trial did not assess “several key symptoms of Rett syndrome.” Acadia’s long-term effectiveness data, meanwhile, were “complicated” by the “large” number of patients who withdrew from the study, the agency said.Ultimately, 154 out of the 187 patients in Lavender chose to roll over to the company’s open-label extension study, while the company's long-term study, Lilac-2, consisted of 77 patients who had previously completed both trials. European regulators also determined that the proposed Daybue use was “not representative of the patients included in the main study, as the latter did not involve patients across the different disease stages.”Acadia had been planning for a re-examination since Feb. 2, when the CHMP informed the company of a “negative trend vote” during a closed-door meeting on its application. “While the negative trend vote is disappointing and not what we hoped for, we believe the strong data that supported the approval of trofinetide for the treatment of Rett syndrome in the United States, Canada, and Israel speak to the meaningful benefits that trofinetide can deliver,” Owen Adams said at the time, pointing to more than 1,000 patients globally across a broad age range who are currently on treatment. She also cited a U.S.-based real-world experience study that shows outcomes that “closely mirror” the impact observed in Acadia's clinical trials. EU legislation allows a drug applicant to request a re-examination within 15 calendar days of the official opinion, Acadia further explained at the time. The company must then submit its grounds for the request within 60 days, after which the CHMP has up to 60 days to examine its opinion again. Acadia’s Daybue is the world's first drug specifically approved to treat Rett syndrome, a complex genetic disorder that occurs in one of every 10,000 to 15,000 female births worldwide. In the U.S., Acadia estimates the disease affects around 6,000 to 9,000 patients. In Europe, where the company first filed Daybue for approval in January 2025, the drug could help about 9,000 to 12,000 patients with the disease, the company has said. In 2025, the company achieved Owen Adams’ goal of locking down over $1 billion in annual sales for the first time, based on $391 million in Daybue sales and $692 million from older Parkinson’s disease psychosis med Nuplazid. The company is expecting between $460 million and $490 million from Daybue this year as it grows its oral solution version of the drug, a powder called Daybue Stix, following the new product's December FDA approval.