FDA Approves Sirion Therap's Zirgan

The US Food and Drug Administration (FDA) has approved its New Drug Application for Zirgan (ganciclovir ophthalmic gel) 0.15% as a treatment for acute herpetic keratitis (dendritic ulcers).

The FDA approval was based on the results of clinical trials conducted by Laboratoires Théa of France in Europe, Asia, and Africa that compared the efficacy and tolerability of Zirgan to acyclovir ophthalmic ointment 3% in patients with herpetic keratitis. Both ganciclovir gel and acyclovir ointment are standard-of-care therapies outside of the US, and selectively target the replication of HSV DNA, unlike older antivirals which affect both healthy and infected cells.

In one open-label, randomized, controlled, multicenter clinical trial which enrolled 164 patients with herpetic keratitis, Zirgan was non-inferior to acyclovir in patients with dendritic ulcers. Clinical resolution (defined as percentage of healed ulcers) at Day 7 was achieved in 77% (55/71) for Zirgan versus 72% (48/67) for acyclovir.

In three randomized, single-masked, controlled, multicenter clinical trials which enrolled 213 patients, Zirgan was non-inferior to acyclovir in patients with dendritic ulcers. Clinical resolution at Day 7 was achieved in 72% (41/57) for Zirgan versus 69% (34/49) for acyclovir.

Sirion Therapeutics, Inc., a privately held ophthalmic-focused biopharmaceutical company, announced today that the US Food and Drug Administration (FDA) has approved its New Drug Application for Zirgan(TM) (ganciclovir ophthalmic gel) 0.15% as a treatment for acute herpetic keratitis (dendritic ulcers). The FDA granted orphan drug designation to Zirgan for this indication in April 2007.

Herpetic keratitis, an ocular disease caused by the herpes simplex virus (HSV), is a significant cause of corneal blindness and a leading indication for corneal transplantation in the US, with approximately 50,000 new and recurrent cases each year. After the initial outbreak, HSV becomes a latent infection in the trigeminal ganglion or cornea, with repeated recurrences that frequently lead to corneal scarring and ocular inflammation, increasing the risk of blindness.

Zirgan is a topical gel formulation of ganciclovir. Ganciclovir is a guanosine derivative that, upon phosphorylation, inhibits DNA replication by herpes simplex viruses (HSV).

Zirgan is specifically indicated for the treatment of herpetic keratitis (dendritic ulcers).

Zirgan is supplied as a 0.15% gel designed for topical ophthalmic administration. The recommended initial dose is 1 drop in the affected eye 5 times per day (approximately every 3 hours while awake) until the corneal ulcer heals, and then 1 drop 3 times per day for 7 days.

Zirgan is a topical ophthalmic antiviral that is indicated for the treatment of acute herpetic keratitis (dendritic ulcers).

Zirgan ophthalamic gel dosage: The recommended dosing regimen for Zirgan is 1 drop in the affected eye 5 times per day until the ulcer heals, and then 1 drop 3 times per day for 7 days. You should not allow the dropper tip to touch any surface, as this may contaminate the gel. If pain develops, or if redness, itching, or inflammation becomes aggravated, you should consult a physician.

Zirgan gel Side Effects: The most common adverse reactions reported in patients were blurred vision (60%), eye irritation (20%), punctate keratitis (5%), and conjunctival hyperemia (5%).