• February 1, 2023: FDA revised the Letters of Authorization for two EUAs, Paxlovid and Lagevrio, to remove the requirement for positive test results to prescribe these products. The agency continues to recommend that providers use direct SARS-CoV-2 viral testing to help diagnose COVID-19. However, we recognize that, in rare instances, individuals with a recent known exposure (e.g., a household contact) who develop signs and symptoms consistent with COVID-19 may be diagnosed by their health care provider as having COVID-19 even if they have a negative direct SARS-CoV-2 viral test result. In such instances, their health care provider may determine that treatment with authorized therapeutics may be appropriate if the patient reports mild-to-moderate symptoms of COVID-19 and is at high risk for progression to severe COVID-19, including hospitalization or death, and the terms and conditions of the product’s authorization are met. Additional information is available on the EUA page.

• February 1, 2023: FDA issued a draft guidance for industry, Considerations for the Design and Conduct of Externally Controlled Trials for Drug and Biological Products. This guidance makes recommendations to sponsors and investigators considering the use of externally controlled clinical trials to show evidence of the safety and effectiveness of a drug. The guidance provides stakeholders with considerations for designing and conducting externally controlled trials that use patient-level data (i.e., information on individual people, such as medical and treatment history) to study the effectiveness and safety of drugs, including threats to the validity of trial results from sources of potential bias. The external data can include data from other clinical trials or from real-world data sources such as registries, electronic health records, or medical claims. This guidance also describes considerations for communicating with FDA and ensuring the agency has access to data from an externally controlled trial. This draft guidance is part of a series of guidances FDA has already published, or plans to publish, as part of the agency’s Real-World Evidence Program and in support of the 21st Century Cures Act and the Prescription Drug User Fee Act. Submit comments by May 2, 2023. 

• February 1, 2023: MCMi email - COVID-19 therapeutics update: Evusheld not currently authorized in U.S. | Watch out for illegally sold mpox products

• January 31, 2023: FAQs: What happens to EUAs when a public health emergency ends? (updated)

• January 31, 2023: FDA published a new web page, Illegally Sold Monkeypox (Mpox) Products, and issued warning letters to five companies illegally selling products that claim to cure, treat, mitigate, or prevent human monkeypox (mpox) infection. Images of these products are available on Flickr. 

• January 26, 2023: FDA announces Evusheld is not currently authorized for emergency use in the U.S. - FDA revised the EUA (PDF) for Evusheld (tixagevimab co-packaged with cilgavimab) to limit its use to when the combined frequency of non-susceptible SARS-CoV-2 variants nationally is less than or equal to 90%. Based on this revision, Evusheld is not currently authorized for use in the U.S. until further notice by the Agency. 
  
  Should a patient become infected with SARS-CoV-2 and develop symptoms of COVID-19, they should seek medical attention, including starting treatment for COVID-19 as appropriate. There are several treatments – Paxlovid, Veklury (remdesivir) and Lagevrio (molnupiravir) – that are expected to work against currently circulating variants, and that are authorized or approved to treat certain patients with mild-to-moderate COVID-19 who are at high risk for progression to severe disease, including hospitalization or death. Health care providers should assess whether treatments are right for their patients. Also see: Important prescribing information for health care providers (PDF, 135 KB)
  
  The U.S. Government recommends that facilities and providers with Evusheld retain all product in the event that SARS-CoV-2 variants which are neutralized by Evusheld become more prevalent in the U.S. in the future. Retained product must be appropriately held in accordance with storage conditions detailed in the authorized Fact Sheet for Health Care Providers (PDF, 769 KB) and the Letter of Authorization (PDF, 286 KB). Also see: Expiration Dating Extension - COVID-19 Therapeutics

• January 26, 2023: Emergent Recalls Certain RSDL Kits Due to Leak Potential - Emergent is recalling RSDL (Reactive Skin Decontamination Lotion) kits from a specific batch after customers noted that some packets were leaking. The leak in the package could cause the lotion-bearing sponge to be less effective when used to remove or neutralize chemical warfare agents. Users also may be unnecessarily exposed to the lotion from leaked packages. The RSDL kit is an easy-to-open packet containing a sponge soaked with lotion. The RSDL kit is carried by members of the military and is intended to remove and/or neutralize chemical warfare agents and T-2 Toxin from the skin. FDA has identified this as a Class I recall, the most serious type of recall. Use of these devices may cause serious injuries and/or serious health consequences.

• January 25, 2023: MCMi email - Developers of drug and biological products for mpox: new draft guidance | Jan. 26 VRBPAC viewing info

• January 20, 2023: FDA issued an immediately-in-effect guidance on compounding certain ibuprofen products in an effort to bolster supply of pediatric ibuprofen amid record high demand. The guidance clarifies FDA’s regulatory and enforcement priorities regarding the compounding of certain ibuprofen oral suspension products in outsourcing facilities for administration in hospitals and health systems.

• January 19, 2023: FDA announced availability of a draft guidance for industry: Mpox: Development of Drugs and Biological Products. FDA is issuing this guidance to support sponsors in their development of drugs and biological products for mpox. This guidance provides nonclinical, virology, and clinical considerations for mpox drug and biological product development programs, with a focus on recommendations to support initiation of clinical trials. Preventive vaccines are not addressed in this guidance. Submit comments by March 21, 2023. 

• January 18, 2023: MCMi email - Regulatory science funding deadline reminder | COVID-19 and mpox updates from FDA

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