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Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL

Device/Product name
Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL
Active Ingredient
Teriparatide acetate
Date of decision
Published
Submission type
New chemical entity
ATC codes
Not yet assigned
Decision
Approved
What was the decision based on
The decision was based on quality (chemistry and manufacturing), nonclinical (pharmacology and toxicology) and risk management plan information submitted by the sponsor. The benefit-risk profile of Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL was considered favourable for the therapeutic use approved.
What steps were involved in the decision process

The following table summarises the key steps and dates for this comparable overseas regulator approach B (COR-B) application.

Description

Date

Submission dossier accepted and first round evaluation commenced

2 May 2022

First round evaluation completed

26 July 2022

Sponsor provides responses on questions raised in first round evaluation

14 November 2022

Second round evaluation completed

16 December 2022

Delegate’s Overall benefit-risk assessment

10 February 2023

Sponsor’s pre-Advisory Committee response

Not applicable

Advisory Committee meeting

Not applicable

Registration decision (Outcome)

21 March 2023

Completion of administrative activities and registration on ARTG

6 April 2023

Number of working days from submission dossier acceptance to registration decision*

171

*Statutory timeframe for standard applications is 255 working days

Date of entry onto ARTG
Black triangle scheme
Yes.
This product will remain in the scheme for 5 years, starting on the date the product is first supplied in Australia.
Dose forms
Solution for injection
Strength
250 µg/mL
Other ingredients

Cresol, glacial acetic acid, hydrochloric acid, mannitol, sodium acetate, sodium hydroxide, water for injections

Containers
Pre-filled cartridge
Pack sizes
3 and 1
Routes of administration
Subcutaneous
Dosage

Each dose of 80 microlitres contains 20 micrograms of teriparatide.

The recommended dose of Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL is 20 micrograms administered once daily by subcutaneous injection in the thigh or abdomen.

For further information refer to the Product Information.

Pregnancy category
B3
Drugs 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

Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL (teriparatide acetate) was approved for the following therapeutic use: 

Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL (teriparatide acetate) 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.

Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL (teriparatide acetate) 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
Endogenous 84-amino-acid parathyroid hormone (PTH) is the primary regulator of calcium and phosphate metabolism in bone and kidney. 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 is the synthetic active fragment (1-34) of endogenous human PTH. The proposed teriparatide product is not manufactured using recombinant DNA technology. 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
  • Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL (teriparatide acetate) are to be included in the Black Triangle Scheme. The PI [Product Information] and CMI [Consumer Medicine Information] for Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL must include the black triangle symbol and mandatory accompanying text for five years, which starts from the date that the sponsor notifies the TGA of supply of the product.

  • The Teriparatide Lupin, Teriparatide GH and Teriparatide LAPL EU [European Union]-risk management plan (RMP) (version 3.0, dated 19 June 2020, data lock point 16 July 2018), with Australia specific annex (version 0.3, dated 14 November 2022), included with Submission PM-2021-03753-1-5, and any subsequent revisions, as agreed with the 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 (revision 1), Part VII.B Structures and processes. Note that submission of a PSUR does not constitute an application to vary the registration.

  • Any changes to which the sponsor has agreed should be included in a revised RMP and ASA. However, irrespective of whether or not they are included in the currently available version of the RMP document, the agreed changes become part of the risk management system.

  • For all injectable products the Product Information must be included with the product as a package insert.

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