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Tenofovir: FDA Hearing October 3, Public Comment Deadlines September 26

By John S. James

August 24, 2001

On October 3 the FDA's Antiviral Drugs Advisory Committee will hold a public hearing on tenofovir (full chemical name tenofovir disoproxil fumarate, or tenofovir DF; new brand name Viread™, an antiretroviral developed by Gilead Sciences and currently in pre-approval expanded access. Public comments are scheduled for the October 3 hearing, and written statements can also be submitted. Both written comments, and sign-up to make an oral presentation, are due at the FDA by September 26. Details are included in the official announcement below.

[Name and drug class: The full chemical name of tenofovir is tenofovir disoproxil fumarate, or tenofovir DF; the new brand name is Viread. Tenofovir is a nucleotide analog -- differing from the nucleoside analogs (AZT, d4T, etc.) in that it requires less processing within cells, and therefore is active in certain cells where the nucleoside analogs generally are not. Both nucleotide analogs and nucleoside analogs are reverse transcriptase inhibitors.]

On the following day, October 4, the same Advisory Committee will discuss another drug, voriconazole, for severe fungal infections.


Tenofovir is an important new HIV treatment because of its resistance profile, potency, apparently low side effects, and ease of use. The Committee is expected to recommend it for approval. (The FDA does not have to follow the recommendation of an Advisory Committee, but it almost always does.)

A likely issue before the Committee will be whether to recommend a broad indication (such as "indicated in combination with other antiretroviral agents for the treatment of HIV infection"), or a narrow one that would limit the drug to advanced patients, where more data is available. In either case physicians would legally be permitted to prescribe the drug for any patient, but insurance reimbursement will often be a problem if the drug is labeled only for treatment-failure cases and physicians want to use it earlier. We believe that approval with a broad indication is important for several reasons:

One can never be sure what will come out of an advisory committee -- especially when the FDA has been under increasing pressure in recent years to be more conservative in its drug approvals. We hope HIV physicians will write or speak to the Committee about their need for new treatment options -- and tell the Committee and the FDA what labeling for tenofovir would be best.

FDA Meeting Announcement, Distributed August 21

The Food and Drug Administration (FDA) will hold a public meeting of the Antiviral Drugs Advisory Committee on October 3 and 4, 2001, 8:30 a.m. to 5 p.m. at the Town Center Hotel, Maryland Ballroom, 8727 Colesville Road, Silver Spring, MD. For directions, or information about lodging, please call the hotel directly at (301) 589-5200.

On October 3, 2001, the committee will discuss new drug application (NDA) 21-356, for Viread™ (tenofovir disoproxil fumarate) Tablets, proposed for the treatment of Human Immunodeficiency Virus (HIV) infection. The sponsor is Gilead Sciences, Inc.

Additionally, on October 4, 2001, the committee will discuss new drug application (NDA) 21-266, for Vfend™ (voriconazole) Tablets, and (NDA) 21-267, Vfend™ I.V. (voriconazole) for Infusion, Pfizer Global Research and Development, proposed for the treatment of invasive aspergillosis, serious Candida infections, infections caused by Scedosporium spp. and Fusarium spp., rare and refractory infections and empirical treatment.

This meeting is free and open to the public. No prior registration is required to attend.

Interested persons are encouraged to present data, information, or views, orally or in writing, on issues pending before the committee.

If you would like to make an oral presentation, please send the following information to: Tara Turner, Pharm.D., Center for Drug Evaluation and Research (HFD-21), 5600 Fishers Lane, Lane (for express delivery: 5630 Fishers Lane, rm. 1093) Rockville, MD 20857, by FAX at 301-827-6776, or by e-mail to by September 26, 2001.

Oral presentations from the public are scheduled on both days between approximately 1 p.m. and 2 p.m. Time allotted for each presentation may be limited, depending on the number of speakers.

Written submissions may also be sent to Dr. Turner by September 26, 2001.

Please call the FDA Advisory Committee Information Line, 1-800-741-8138 (301-443-0572 in the Washington, DC area), code 12531, for up-to-date information on this meeting.

ISSN # 1052-4207

Copyright 2001 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.

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