FDA targets treatment of rare diseases

Oct. 17, 2022

The U.S. Food and Drug Administration announced it has awarded 19 new grants and two new contracts totaling more than $38 million in funding over the next four years to support clinical trials, natural history studies and regulatory science tools related to rare diseases. These grants and contracts, which were funded by the FDA’s Orphan Products Grants Program, aim to advance the development of medical products to treat rare diseases. Several awards support the Accelerating Access to Critical Therapies for Amyotrophic Lateral Sclerosis Act (ACT for ALS) which recently established the FDA Rare Neurodegenerative Disease Grant Program to promote medical product development for rare neurodegenerative diseases such as ALS.

“One of the greatest obstacles facing individuals who suffer from rare diseases is the limited treatment options currently available,” said FDA Commissioner Robert M. Califf, M.D. “Since the beginning of the Orphan Products Grants Program in 1983, it has facilitated the approval of more than 80 rare disease products. Through this and other efforts focused on rare diseases, the FDA continues to advance the development and evaluation of safe and effective medical products that help address patients’ unmet needs.”

The FDA received 33 clinical trial grant applications and awarded more than $25 million spread over the next four years to 11 clinical trials that support product development for rare disease treatments. Seven of the awards fund studies of rare cancers, mostly targeting cancers of the brain and peripheral nerves. Visit Orphan Products Grants (clinical trials) for more information.

Natural history studies look closely at how specific diseases progress over time. The FDA received 43 natural history grant applications and funded eight new grants totaling more than $11 million spread over the next four years for natural history studies that support innovative research to inform medical product development. Several studies seek to characterize certain subgroups within a disease, identify novel clinical outcome measures and biomarkers, which have the potential to improve the current standard of care and inform future drug development, including gene therapies. Visit Orphan Products Grants (natural history studies) for more information.

The Rare Neurodegenerative Disease Grant Program was established specifically for ALS and neurodegenerative conditions upon enactment of the ACT for ALS in December 2021. The ACT requires that the FDA award grants and contracts to public and private entities to cover costs of research on, and development of interventions intended to prevent, diagnose, mitigate, treat, or cure ALS and other rare neurodegenerative diseases in adults and children. Three of the natural history studies awarded by the FDA are related to rare neurodegenerative diseases including for ALS, Myotonic Dystrophy Type 1, and Ataxia-Telangiectasia. The study for ALS, partially funded by the National Institutes of Health (NIH) has the potential to advance existing knowledge of the natural history of ALS, inform drug development and possibly support future regulatory decisions.

Additionally, the FDA funded two contracts related to rare neurodegenerative diseases. One contract, co-funded by NIH and the FDA, will study whether a physical assessment of ALS patients, typically done in a health care professional’s office, can be done remotely at home to minimize the burden on patients. This can ultimately lead to lower clinical trial costs and enable decentralized trials, where appropriate, improving access to trials for patients in rural areas and lower-resource healthcare settings.

The second contract is a landscape analysis of patient preference information (PPI) studies focused on brain-computer interface (BCI) devices. The FDA is specifically interested in BCI devices that communicate with the brain and provide patients, who are no longer able to speak or move, with the ability to interact with their families and health care professionals. The contract will review the literature to determine what is already known about BCI devices and PPI studies in ALS. In total, through collaborative efforts, the FDA and its partners were able to support nearly $6 million in research and science to advance the mission of the ACT for ALS Act. Visit Rare Neurodegenerative Disease Grant Program for more information about the contracts.

“These grants provide important funding to researchers who are working to develop better treatments for rare disease patients,” said Sandra Retzky, D.O., J.D., MPH, director of the FDA’s Office of Orphan Products Development (OOPD). “The contracts aim to advance treatment options for patients, help inform regulatory decision making, and promote diversity, equity and inclusion in clinical research. OOPD will continue to make investments in progressive studies to advance medical product development.”

Earlier this year, the FDA announced the agency’s Action Plan for Rare Neurodegenerative Diseases, including ALS – a five-year plan to further the development of safe and effective medical products and facilitate patient access to novel treatments. The plan was developed in accordance with the ACT for ALS Act. The FDA recently announced a call for comments on current funding needs in the rare neurodegenerative disease space that could be supported by grants from the Office of Orphan Products Development. 

The FDA remains committed to supporting rare disease research by providing existing grantees with critical funding and encouraging innovative trial designs, collaborations among stakeholders, early and ongoing patient engagement, use of innovative methods, and use of established infrastructure.

FDA release