Additional Relevant Details
The CRL stated that, based on the available data, the agency cannot approve the terlipressin NDA in its current form and requires more information to support a positive risk-benefit profile for terlipressin for patients with HRS-1. HRS-1 is an acute and life-threatening syndrome involving acute kidney failure in people with cirrhosis1 for which there is currently no FDA-approved treatment.2 HRS-1 is estimated to affect between 30,000 and 40,000 Americans annually,3,4 and often is a challenge to effectively diagnose in a timely manner due to its diagnosis of exclusion.5 If left untreated, HRS-1 has a median survival time of approximately two weeks and greater than 80 percent mortality within three months.5,6 U.S. discharge data in a recently published study indicated an in-hospital mortality rate of 34.2% (n=1,133), while an additional 14.4% (n=475) of patients were discharged to hospice.