FDA Withdraws Lone Premature Birth Drug Makena Over Lack of Proven Benefits

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  • Today, the FDA announced the final decision to withdraw approval of Privately held-Covis Pharma's Makena (hydroxyprogesterone caproate injection), a drug approved under the accelerated approval pathway to reduce the risk of preterm birth. 
  • The decision was issued jointly by the FDA Commissioner and Chief Scientist. 
  • Effective today, Makena and its generics are no longer approved and cannot lawfully be distributed.
  • The FDA approved Makena under the accelerated approval pathway in 2011 based on a determination that the sponsor had demonstrated a drug effect on an intermediate clinical endpoint that was reasonably likely to predict clinical benefit. 
  • The agency's approval required the sponsor to conduct a post-marketing confirmatory study. 
  • The confirmatory study did not verify clinical benefit, and the FDA's Center for Drug Evaluation and Research (CDER) proposed withdrawing the drug's approval in 2020. 
  • The sponsor requested a hearing, which was held in October 2022.
  • In October, the FDA's Obstetrics, Reproductive and Urologic Drugs Advisory Committee voted that Makena should not remain on the market after a large study failed to show that it was effective
  • Wall Street Journal writes that Makena has possible side effects, including blood clots, depression, and allergic reactions. 
  • Covis said previously that the drug has a strong safety record and that adverse events are rare, but the FDA has said some evidence suggests there may be long-term risks that aren't yet well understood.
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