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Device/Product name
Active Ingredient
Date of decision
Submission type
New biosimilar medicine
ATC codes
What was the decision based on
The decision was based on quality (chemistry and manufacturing), nonclinical (pharmacology and toxicology) and clinical (pharmacology, safety and efficacy) information submitted by the sponsor. The benefit-risk profile of Ziextenzo was considered favourable for the therapeutic use approved.
What steps were involved in the decision process

Registration timeline

The following table summarises the key steps and dates for this application.

Description Date
Submission dossier accepted and first round evaluation commenced 28 September 2018
First round evaluation completed 29 April 2019
Sponsor provides responses on questions raised in first round evaluation 3 May 2019
Second round evaluation completed 31 May 2019
Delegate's overall benefit-risk assessment and request for Advisory Committee advice 1 July 2019
Sponsor's pre-Advisory Committee response N/A
Advisory Committee meeting N/A
Registration decision (Outcome) 9 July 2019
Completion of administrative activities and registration on ARTG 6 September 2019
Number of working days from submission dossier acceptance to registration decision* 153

*Statutory timeframe for standard applications is 255 working days

Date of entry onto ARTG
Original publication date
Black triangle scheme
Dose forms
Solution for injection
6 mg/0.6 mL
Other ingredients
The product is formulated at pH 4.0 with 0.36 mg acetic acid, 30 mg sorbitol, 0.02 mg polysorbate 20, sodium hydroxide (if necessary for pH adjustment) in Water for Injection to 0.6 mL.
Prefilled syringe with automatic needle guard
Pack sizes
Routes of administration

The recommended dosage of Ziextenzo is a single subcutaneous injection of 6 mg administered once per chemotherapy cycle, approximately 24 hours after the administration of cytotoxic chemotherapy.

For further information refer to the Product Information.

Pregnancy category
Category B3Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed.The use of any medicine during pregnancy requires careful consideration of both risks and benefits by the treating health professional. This must not be used as the sole basis of decision making in the use of medicines during pregnancy. The TGA does not provide advice on the use of medicines in pregnancy for specific cases. More information is available from obstetric drug information services in your State or Territory.
What was approved

Ziextenzo (pegfilgrastim) was approved for the following therapeutic use:

Ziextenzo is indicated for the treatment of cancer patients following chemotherapy, to decrease the duration of severe neutropenia and so reduce the incidence of infection, as manifested by febrile neutropenia.
What is this medicine and how does it work
Ziextenzo (pegfilgrastim) is a long-acting form of recombinant human granulocyte colony-stimulating factor (G-CSF). Ziextenzo is composed of recombinant human G-CSF (filgrastim) bound to a polyethylene glycol (PEG) molecule.Ziextenzo is a biosimilar medicine to Neulasta.Human G-CSF is a glycoprotein which regulates the production and release of neutrophils from the bone marrow. Pegfilgrastim has reduced renal clearance and prolonged persistence in vivo compared to filgrastim. Pegfilgrastim and filgrastim have been shown to have identical modes of action. They cause a marked increase in peripheral blood neutrophil counts within 24 hours in subjects with healthy bone marrow, with minor increases in monocytes and/or lymphocytes. Similarly to filgrastim, neutrophils produced in response to pegfilgrastim show normal or enhanced function as demonstrated by tests of chemotactic and phagocytic function.
What post-market commitments will the sponsor undertake

For all injectable products the Product Information must be included with the product.

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