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EMA says Bayer's Xofigo must not be used with Janssen's Zytiga and prednisone because of raised death risk

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LONDON, Mar 9 (APM) - Bayer's Xofigo must not be used with Janssen's Zytiga and prednisone because of an increased risk of death and fractures with this combination, the European Medicines Agency said on Friday.
The EMA's safety committee PRAC is recommending contraindicating the use of prostate cancer medicine Xofigo (radium-223 dichloride) with Zytiga (abiraterone acetate) and prednisone/prednisolone because of the increased risk.
The EMA said the committee has reviewed the preliminary data from an ongoing clinical study in metastatic prostate cancer patients. In this study, 34.7% of patients treated with Xofigo, Zytiga and prednisone/prednisolone have died so far, compared with 28.2% of patients given placebo, Zytiga and prednisone/prednisolone, it said.
Fractures have also occurred more frequently with the Xofigo combination than with the placebo combination (26% versus 8.1%).
"In view of the seriousness of the events reported, the PRAC has taken action by introducing a contraindication as a temporary measure to protect patients’ safety while an in-depth review of the benefits and risks of Xofigo is ongoing," it said.
Xofigo is currently authorised for use in men whose prostate cancer has spread to the bones and is causing symptoms. The ongoing clinical study includes metastatic prostate cancer patients who have not previously received chemotherapy and who have no symptoms or only mild symptoms, such as pain.
Patients have completed the Xofigo part of the study and the combination is no longer being used; all the patients involved are being monitored closely, the PRAC added.
Healthcare professionals in the EU must not use a combination of Xofigo with the anti-androgen Zytiga and prednisone/prednisolone, and should stop this combination in men currently treated with it and review the treatment for these patients, it said.
Healthcare professionals are also being warned that the safety and efficacy of Xofigo in combination with a class of medicines called second-generation androgen receptor antagonists, such as Pfizer/Astellas's Xtandi (enzalutamide), have not been established.
"These are temporary measures until the ongoing in-depth review of the benefits and risks of Xofigo is complete. EMA will communicate further at the conclusion of the review."
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