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FDA approved Sohonos (palovarotene) for Heterotopic Ossification in Fibrodysplasia Ossificans ProgressivaFDA approved Sohonos for Rare Bone Growth Disorder

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Key Takeaway
Consider Sohonos for reducing new heterotopic ossification in FOP; monitor pregnancy status.

The FDA has approved Sohonos (palovarotene) for the reduction in volume of new heterotopic ossification in adults and pediatric patients with fibrodysplasia ossificans progressiva (FOP). The indication specifies females aged 8 years and older and males aged 10 years and older. FOP is a rare genetic disorder characterized by progressive heterotopic ossification, leading to cumulative disability. This approval provides a pharmacologic option aimed at reducing the volume of new heterotopic ossification.

The recommended dosing includes a chronic daily dose that can be increased during flare-ups. For adults and patients 14 years and older, the daily dose is 5 mg, with flare-up dosing of 20 mg daily for 4 weeks followed by 10 mg daily for 8 weeks. For younger pediatric patients, weight-based dosing is used. A negative pregnancy test is required before initiation in females of reproductive potential. The label does not report clinical trial data.

Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Mechanism of Action

Not reported in label.

Indication & Patient Population

SOHONOS is indicated for the reduction in volume of new heterotopic ossification in adults and pediatric patients aged 8 years and older for females and 10 years and older for males with fibrodysplasia ossificans progressiva (FOP).

Dosing & Administration

Obtain a negative pregnancy test in females of reproductive potential before initiation. Take with food, preferably at the same time each day. For adults and pediatric patients 14 years and older: recommended daily dose is 5 mg once daily. At flare-up, increase to 20 mg once daily for 4 weeks, followed by 10 mg once daily for 8 weeks (total 12 weeks), then return to 5 mg daily. For pediatric patients under 14 years: weight-adjusted dosing. Daily dosage ranges from 2.5 to 5 mg based on weight. Flare-up dosing is also weight-based: for 10 to 19.9 kg, 10 mg for weeks 1-4 then 5 mg for weeks 5-12; for 20 to 39.9 kg, 12.5 mg then 6 mg; for 40 to 59.9 kg, 15 mg then 7.5 mg; for 60 kg and above, 20 mg then 10 mg. Stop daily dosing when flare-up dosing begins. If a dose is missed, take as soon as possible unless more than 6 hours have passed, then skip and resume next scheduled dose. Do not double dose. Capsules may be swallowed whole or opened and contents mixed with soft food.

Key Clinical Trial Data

Trial data not available in label.

Warnings & Contraindications

Not reported in label.

Place in Therapy

Not reported in label.

The FDA has approved a new medicine called Sohonos (palovarotene). It is meant to help people with a rare genetic condition called fibrodysplasia ossificans progressiva, or FOP. In FOP, the body slowly forms extra bone in places where bone should not be, such as muscles and soft tissues. This can lead to lasting disability over time.

Sohonos is approved to reduce the amount of new extra bone that forms. It is for females aged 8 years and older and males aged 10 years and older. The medicine is taken daily, and the dose can be raised for a short time during flare-ups, which are periods when the condition worsens. Younger children receive doses based on their weight. Females who could become pregnant must have a negative pregnancy test before starting.

This approval gives patients and families a new treatment option for a condition that has had very few. However, the label does not include data from clinical trials, so the full picture of benefits and risks is not yet clear from the label alone. Patients should talk with their doctor to understand if Sohonos is right for them and to discuss possible side effects.

What this means for you:
Sohonos is a new FDA-approved option for a rare bone-growth disorder, but ask your doctor if it is right for you.

Study Details

Study typeFda approval
PublishedAug 2023
View Original Abstract ↓
1 INDICATIONS AND USAGE SOHONOS is indicated for the reduction in volume of new heterotopic ossification in adults and pediatric patients aged 8 years and older for females and 10 years and older for males with fibrodysplasia ossificans progressiva (FOP). SOHONOS is a retinoid indicated for reduction in the volume of new heterotopic ossification in adults and children aged 8 years and older for females and 10 years and older for males with fibrodysplasia ossificans progressiva (FOP) ( 1 ).
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