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Device/Product name
Terrosa
Active Ingredient
Teriparatide
Date of decision
Published
Submission type
New biosimilar medicine
ATC codes
H05AA02
Decision
Approved
What was the decision based on
The decision was based on quality (chemistry and manufacturing), nonclinical (pharmacology and toxicology), clinical (pharmacology, safety and efficacy) and risk management plan information submitted by the sponsor. The benefit-risk profile of Terrosa was considered favourable for the therapeutic use approved.
What steps were involved in the decision process

Registration timeline

The following table summarises the key steps and dates for this application.

Description Date
Submission dossier accepted and first round evaluation commenced 3 January 2020
First round evaluation completed 10 July 2020
Sponsor provides responses on questions raised in first round evaluation 10 August 2020
Second round evaluation completed 28 August 2020
Delegate's overall benefit-risk assessment 12 November 2020
Sponsor's pre-Advisory Committee response Not applicable
Advisory Committee meeting Not applicable
Registration decision (Outcome) 24 November 2020
Completion of administrative activities and registration on ARTG 1 December 2020
Number of working days from submission dossier acceptance to registration decision* 195

*Statutory timeframe for standard applications is 255 working days

Date of entry onto ARTG
Original publication date
Black triangle scheme
No
Dose forms
Solution for injection
Strength
250 µg /mL
Other ingredients
Glacial acetic acid, mannitol, metacresol, sodium acetate trihydrate, hydrochloric acid (for pH adjustment), sodium hydroxide (for pH adjustment), water for injections
Containers
Cartridge
Pack sizes
1 cartridge and pen, 1 cartridge, and 3 cartridges
Routes of administration
Subcutaneous
Dosage

The recommended dose of Terrosa is 20 µg administered once daily by subcutaneous injection in the thigh or abdomen.

Terrosa should be prescribed to patients with a full explanation and their informed consent on the lifetime duration of 24 months treatment.

For further information refer to the Product Information.

Pregnancy category
Category B3Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.The use of any medicine during pregnancy requires careful consideration of both risks and benefits by the treating health professional. This must not be used as the sole basis of decision making in the use of medicines during pregnancy. The TGA does not provide advice on the use of medicines in pregnancy for specific cases. More information is available from obstetric drug information services in your State or Territory.
What was approved

Terrosa (teriparatide) was approved for the following therapeutic use:

Terrosa is indicated for the treatment of osteoporosis in postmenopausal women and the treatment of primary osteoporosis in men when other agents are considered unsuitable and when there is a high risk of fractures.

Terrosa is indicated for the treatment of osteoporosis associated with sustained systemic glucocorticoid therapy in women and men at high risk for fracture

What is this medicine and how does it work
Terrosa (teriparatide) solution for injection is a biosimilar medicine to Forteo solution for injection.Endogenous 84-amino-acid parathyroid hormone (PTH) is the primary regulator of calcium and phosphate metabolism in bone and kidney. Teriparatide is the active fragment (1 to 34) of endogenous human parathyroid hormone, manufactured using recombinant DNA technology.Physiological actions of PTH include regulation of bone metabolism, renal tubular reabsorption of calcium and phosphate, and intestinal calcium absorption. The biological actions of PTH and teriparatide are mediated through binding to specific PTH cell surface receptors. Teriparatide binds to these receptors with similar affinity as PTH and has the same actions in bone and kidney as PTH. Like endogenous PTH, teriparatide is not expected to accumulate in bone or other tissues.
What post-market commitments will the sponsor undertake
  • The Terrosa European Union (EU)-Risk Management Plan (RMP) (version 2.1, dated 18 June 2020; data lock point (DLP) 10 June 2020), with Australian Specific Annex (version 2.0, dated 24 June 2020), included with submission PM-2019-05333-1-5, and any subsequent revisions, as agreed with the Therapeutic Goods Administration (TGA) will be implemented in Australia.

    An obligatory component of risk management plans is routine pharmacovigilance. Routine pharmacovigilance includes the submission of periodic safety update reports (PSURs).

    Reports are to be provided in line with the current published list of EU reference dates and frequency of submission of PSURs until the period covered by such reports is not less than three years from the date of the approval letter.

    The reports are to at least meet the requirements for PSURs as described in the European Medicines Agency's Guideline on good pharmacovigilance practices (GVP) Module VII-periodic safety update report (Rev 1), Part VII.B Structures and processes. Note that submission of a PSUR does not constitute an application to vary the registration.

  • Laboratory testing and compliance with Certified Product Details (CPD)
    • All batches of Terrosa supplied in Australia must comply with the product details and specifications approved during evaluation and detailed in the CPD.
    • When requested by the TGA, the sponsor should be prepared to provide product samples, specified reference materials and documentary evidence to enable the TGA to conduct laboratory testing on the Product. Outcomes of laboratory testing are published biannually in the TGA Database of Laboratory Testing Results and periodically in testing reports on the TGA website.
    • Certified Product Details
      • The CPD, as described in Guidance 7: Certified Product Details of the Australian Regulatory Guidelines for Prescription Medicines (ARGPM), in PDF format, for the above products should be provided upon registration of these therapeutic goods. In addition, an updated CPD should be provided when changes to finished product specifications and test methods are approved in a Category 3 application or notified through a self-assessable change. The CPD should be emailed to Biochemistry.Testing@health.gov.au as a single PDF document.
  • For all injectable products the Product Information must be included with the product as package insert.

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