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Pivotal trial characteristics and types of endpoints used to support Food and Drug Administration rare disease drug approvals between 2013 and 2022

Background/aims Rare disease drug development faces unique challenges, such as genotypic and phenotypic heterogeneity within small patient populations and a lack of established outcome measures for conditions without previously successful drug development programs. These challenges complicate the process of selecting the appropriate trial endpoints and conducting clinical trials in rare diseases. In this descriptive study, we examined novel drug approvals for non-oncologic rare diseases by the U.S. Food and Drug Administration’s Center for Drug Evaluation and Research over the past decade and characterized key regulatory and trial design elements with a focus on the primary efficacy endpoint utilized as the basis of approval. Methods Using the Food and Drug Administration’s Data Analysis Search Host database, we identified novel new drug applications and biologics license applications with orphan drug designation that were approved between 2013 and 2022 for non-oncologic indications. From Food and Drug Administration review documents and other external databases, we examined characteristics of pivotal trials for the included drugs, such as therapeutic area, trial design, and type of primary efficacy endpoints. Differences in trial design elements associated with primary efficacy endpoint type were assessed such as randomization and blinding. Then, we summarized the primary efficacy endpoint types utilized in pivotal trials by therapeutic area, approval pathway, and whether the disease etiology is well defined. Results One hundred and seven drugs that met our inclusion criteria were approved between 2013 and 2022. Assessment of the 107 drug development programs identified 150 pivotal trials that were subsequently analyzed. The pivotal trials were mostly randomized (80%) and blinded (69.3%). Biomarkers (41.1%) and clinical outcomes (42.1%) were commonly utilized as primary efficacy endpoints. Analysis of the use of clinical trial design elements across trials that utilized biomarkers, clinical outcomes, or composite endpoints did not reveal statistically significant differences. The choice of primary efficacy endpoint varied by the drug’s therapeutic area, approval pathway, and whether the indicated disease etiology was well defined. For example, biomarkers were commonly selected as primary efficacy endpoints in hematology drug approvals (70.6%), whereas clinical outcomes were commonly selected in neurology drug approvals (69.6%). Further, if the disease etiology was well defined, biomarkers were more commonly used as primary efficacy endpoints in pivotal trials (44.7%) than if the disease etiology was not well defined (27.3%). Discussion In the past 10 years, numerous novel drugs have been approved to treat non-oncologic rare diseases in various therapeutic areas. To demonstrate their efficacy for regulatory approval, biomarkers and clinical outcomes were commonly utilized as primary efficacy endpoints. Biomarkers were not only frequently used as surrogate efficacy endpoints in accelerated approvals, but also in traditionally approved rare disease drugs. The choice of primary efficacy endpoints varied by therapeutic area, approval pathway, and understanding of disease etiology.

Hong, Kyungwan [Rare Diseases Team, Office of New ↗

Search for light long-lived neutral particles produced in p p collisions at s = 13 TeV and decaying into collimated leptons or light hadrons with the ATLAS detector

CERN-LHC. Search for long-lived dark photons produced from the decay of a Higgs boson or a heavy scalar boson and decaying into displaced collimated Standard Model fermions. The search uses data corresponding to an integrated luminosity of 36.1/fb collected in proton-proton collisions at 13 TeV center-of-mass energy and recorded in 2015-2016 with the ATLAS detector at the Large Hadron Collider. The observed number of events is consistent with the expected background, and limits on the production cross section times branching fraction as a function of the proper decay length of the dark photon are reported. Detection efficiency as a function of the proper decay lenght are also reported.

72 PHYSICS OF ELEMENTARY PARTICLES AND FIELDS↗

Community Requirements Meta-Analysis: Characterizing Needs and Opportunities for HPDF

This High Performance Data Facility (HPDF) Project is creating a new scientific user facility to provide advanced infrastructure for data-intensive science, supporting the DOE’s Office of Science (SC) community. HPDF’s mission is to enable and accelerate scientific discovery by delivering state-of-the-art data management infrastructure, capabilities, and tools. This meta-analysis examines the needs of the breadth of the SC community, captured in publicly available community reports or mission documents. The meta-analysis identifies and provides initial characterization of fifteen core requirements for the HPDF Project team to consider during the conceptual design phase. The fifteen requirements illustrate how scientific work among SC communities requires modern, seamless user experiences across the ASCR Ecosystem to advance the use of large volumes of heterogeneous data. The scientific community requires support for the missing middle of compute between local and HPC to interactively and collaboratively use growing datasets. Data producers and end users will benefit from enhanced data catalogs and portals that improve data access through advanced search of well curated data. The fifteen requirements are examined here organized across five themes for discussion. Examples in each theme illustrate the array of scientific needs that convey the important role that the fully realized and operational High Performance Data Facility will be able to play as an integral part of the evolving ASCR Ecosystem. Our amalgamated data tables from ESnet reports demonstrate ranges to the volumes of data HPDF must be concerned with, but limitations are inherent to this meta-analysis (see Key Challenges & Limitations). Feedback and validation of these requirements along with additional details and emergent community requirements will be gathered through user research and design activities.

97 MATHEMATICS AND COMPUTING↗

Chlamydomonas reinhardtii responses to Fe-excess, Fe-deficiency, and Fe-limitation in either photoautotrophic or mixotrophic growth

A systems level analysis of Chlamydomonas reinhardtii grown photoautotrophically or mixotrophically with a reduced carbon source, acetate, under four different defined Fe stages of Fe-replete, Fe-deficient, Fe-limited, or Fe-excess. Samples were digested with trypsin, labeled with TMT 10-Plex, then analyzed by LC-MS/MS. Data was searched with MS-GF+ using PNNL's DMS Processing pipeline. [doi:10.25345/C5707X12X] [dataset license: CC0 1.0 Universal (CC0 1.0)]

59 BASIC BIOLOGICAL SCIENCES↗

Iron-starvation induces photosystem I antenna remodeling in green algae

Dunaliella salina and Dunaliella tertiolecta are extremophile, marine algae that can survive in very low Fe conditions. In this study, we used TMT-proteomics to compare the Fe starvation responses to the Fe replete responses. Samples were digested with trypsin, labeled with TMT 10-Plex, then analyzed by LC-MS/MS. Data was searched with MS-GF+ using PNNL's DMS Processing pipeline.

59 BASIC BIOLOGICAL SCIENCES↗

Integrative SP3 Workflow for Multi-PTM Proteomics Profiling (TZ-DP0)

The goal of the experiment was to demonstrate that the optimized multiplexed multi-PTM profiling workflow can comprehensively and quantitatively capture dynamic changes in protein abundance, cysteine oxidation, phosphorylation, and acetylation in cytokine-induced inflammatory stress in mouse pancreatic ß-cells. Global proteomic, redox proteomic, phosphoproteomic, and acetylomic were data collected from mouse Beta-TC-6 pancreatic Beta-cells, untreated (mock) and cytokine-treated Beta-cells at 4, 8, and 24 hours with 4 biological replicates. Samples were digested with trypsin and Lys-C, then analyzed by LC-MS/MS. Data were searched with MS-GF+, MASIC, and MaxQuant using PNNL's DMS processing pipeline.

59 BASIC BIOLOGICAL SCIENCES↗

Untangling the Galaxy. II. Structure within 3 kpc

We present the results of the hierarchical clustering analysis of the Gaia DR2 data to search for clusters, comoving groups, and other stellar structures. The current paper builds on the sample from the previous work, extending it in distance from 1 to 3 kpc and increasing the number of identified structures up to 8292. To aid in the analysis of the population properties, we developed a neural network called Auriga to robustly estimate the age, extinction, and distance of a stellar group based on the input photometry and parallaxes of the individual members. We apply Auriga to derive the properties of not only the structures found in this paper, but also previously identified open clusters. Through this work, we examine the temporal structure of the spiral arms. Specifically, we find that the Sagittarius Arm has moved by >500 pc in the last 100 Myr and the Perseus Arm has been experiencing a relative lull in star formation activity over the last 25 Myr. We confirm the findings of the previous paper on the transient nature of the spiral arms, with the timescale of transition of a few 100 Myr. Finally, we find a peculiar ~1 Gyr old stream of stars that appears to be heliocentric. Its origin is unclear.

79 ASTRONOMY AND ASTROPHYSICS↗

A Near-infrared Chemical Inventory of the Atmosphere of 55 Cancri e

We present high-resolution near-infrared spectra taken during eight transits of 55 Cancri e, a nearby low-density super-Earth with a short orbital period (<18 hr). While this exoplanet’s bulk density indicates a possible atmosphere, one has not been detected definitively. Our analysis relies on the Doppler cross-correlation technique, which takes advantage of the high spectral resolution and broad wavelength coverage of our data, to search for the thousands of absorption features from hydrogen-, carbon-, and nitrogen-rich molecular species in the planetary atmosphere. Although we are unable to detect an atmosphere around 55 Cancri e, we do place strong constraints on the levels of HCN, NH{sub 3}, and C{sub 2}H{sub 2} that may be present. In particular, at a mean molecular weight of 5 amu, we can rule out the presence of HCN in the atmosphere down to a volume mixing ratio (VMR) of 0.02%, NH{sub 3} down to a VMR of 0.08%, and C{sub 2}H{sub 2} down to a VMR of 1.0%. If the mean molecular weight is relaxed to 2 amu, we can rule out the presence of HCN, NH{sub 3}, and C{sub 2}H{sub 2} down to VMRs of 0.001%, 0.0025%, and 0.08%, respectively. Our results reduce the parameter space of possible atmospheres consistent with the analysis of Hubble Space Telescope/WFC3 observations by Tsiaras et al. and indicate that if 55 Cancri e harbors an atmosphere, it must have a high mean molecular weight or clouds.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

X-Rays in Cepheids: XMM-Newton Observations of η Aql

X-ray bursts have recently been discovered in the Cepheids δ Cep and β Dor modulated by the pulsation cycle. We have obtained an observation of the Cepheid η Aql with the XMM-Newton satellite at the phase of maximum radius; the phase at which there is a burst of X-rays in δ Cep. No X-rays were seen from the Cepheid η Aql at this phase, and the implications for Cepheid upper atmospheres are discussed. We have also used the combination of X-ray sources, as well as Gaia and 2MASS data, to search for a possible grouping around the young intermediate mass Cepheid. No indication of such a group was found.

79 ASTRONOMY AND ASTROPHYSICS↗

The Fermi-LAT Lightcurve Repository

The Fermi Large Area Telescope (LAT) lightcurve repository (LCR) is a publicly available, continually updated library of gamma-ray lightcurves of variable Fermi-LAT sources generated over multiple timescales. The Fermi-LAT LCR aims to provide publication-quality lightcurves binned on timescales of 3, 7, and 30 days for 1525 sources deemed variable in the source catalog of the first 10 yr of Fermi-LAT observations. The repository consists of lightcurves generated through full likelihood analyses that model the sources and the surrounding region, providing fluxes and photon indices for each time bin. The LCR is intended as a resource for the time-domain and multimessenger communities by allowing users to search LAT data quickly to identify correlated variability and flaring emission episodes from gamma-ray sources. We describe the sample selection and analysis employed by the LCR and provide an overview of the associated data access portal.

79 ASTRONOMY AND ASTROPHYSICS↗

Enabling Early Transient Discovery in LSST via Difference Imaging with DECam

We present SLIDE, a pipeline that enables transient discovery in data from the Vera C. Rubin Observatory’s Legacy Survey of Space and Time (LSST), using archival images from the Dark Energy Camera as templates for difference imaging. We apply this pipeline to the recently released Data Preview 1 (DP1; the first public release of Rubin commissioning data) and search for transients in the resulting difference images. The image subtraction, photometry extraction, and transient detection are all performed on the Rubin Science Platform. We demonstrate that SLIDE effectively extracts clean photometry by circumventing poor or missing LSST templates. We identified 29 previously unreported transients, 12 of which would not have been detected based on the DP1 DiaObject catalog. SLIDE will be especially useful for transient analysis in the early years of LSST, when template coverage will be largely incomplete or when templates may be contaminated by transients present at the time of acquisition. We present multiband light curves for a sample of known transients, along with new transient candidates identified through our search. Finally, we discuss the prospects of applying this pipeline during the main LSST survey. Our pipeline is broadly applicable and will support studies of all transients with slowly evolving phases.

Dong, Yize 一泽董 [Harvard-Smithsonian Center for Ast↗

Chandra Discovery of a Candidate Hyperluminous X-Ray Source in MCG+11-11-032

We present a multiwavelength analysis of MCG+11-11-032, a nearby active galactic nucleus (AGN), with a unique classification as being both a binary and a dual AGN candidate. With new Chandra observations, we aim to resolve any dual AGN system via imaging data and search for signs of a binary AGN via analysis of the X-ray spectrum. Analyzing the Chandra spectrum, we find no evidence of the previously suggested double-peaked Fe Kα lines; the spectrum is instead best fit by an absorbed power law with a single Fe Kα line, as well as an additional line centered at ≈7.5 keV. The Chandra observation reveals faint, soft, and extended X-ray emission, possibly linked to low-level nuclear outflows. Further analysis shows evidence for a compact hard source—MCG+11-11-032 X2—located 3.″3 from the primary AGN. Modeling MCG+11-11-032 X2 as a compact source, we find that it is relatively luminous (L2–10 keV=1.5−0.5+0.9×1041erg s$^{−1}$), and the location is coincident with a compact and off-nuclear source resolved in Hubble Space Telescope infrared (F105W) and optical (F621M, F547M) bands. Pairing our X-ray results with a 144 MHz radio detection at the host galaxy location, we observe X-ray and radio properties similar to those of ESO 243-49 HLX-1, suggesting that MCG+11-11-032 X2 may be a hyperluminous X-ray source. This detection with Chandra highlights the importance of a high-resolution X-ray imager as well as how previous binary AGN candidates detected with large-aperture instruments can benefit from high-resolution follow-up. Future spatially resolved optical spectra, and deeper X-ray observations, can better constrain the origin of MCG+11-11-032 X2.

79 ASTRONOMY AND ASTROPHYSICS↗

High-Frequency Gravitational Wave Search with ABRACADABRA-10 cm

ABRACADABRA-10 cm has had great success as a pathfinder lumped-element axion dark matter experiment, setting limits on axion dark matter at the GUT scale. Now, using the interaction of gravitational waves with electrodynamics and a change in readout strategy, we use the ABRA-10 cm detector for the first search for high-frequency gravitational waves using a modified axion detector. Potential sources at these high frequencies (10 kHz to 5 MHz) include merging primordial black hole binaries or superradiance, among other beyond the standard model phenomena. This paper presents the design, results, and challenges from the ABRA-10 cm high-frequency gravitational wave search, showing it is possible to simultaneously look for axions and high-frequency gravitational waves with both searches matching theoretical expectations for sensitivity. Additionally, we conducted the first time series transient search with data from an axion experiment, achieving sensitivity to $10^{-4}$ in strain. Scaled directly to the next generation axion experiment, DMRadio-GUT, this sensitivity would imply a reach to 0.01 $M_{\odot}$ primordial black hole mergers at distances around 3 pc, with prospects to go significantly further with modifications to the readout.

Pappas, Kaliroë M.W. [MIT, LNS] (ORCID:00000003425↗

Sediment concentration mapping in tidal estuaries

An analytical procedure has been developed that considers the ERTS-1 multispectral scanner as a reflectance spectrophotometer. ADP techniques requiring only very limited computer capability are utilized to search the data defining the spectral reflectance characteristics of a scene on a pixel-by-pixel basis, identify each pixel whose spectral reflectance matches a reference spectrum, and generate maps that identify pixel locations where spectrum matches occur and identify the spectrum that was matched. If the reference spectra are known to represent a specific condition on the ground, a map of the distribution of that condition can be output as a dimensionally accurate overlay to maps of any selected scale. Two applications are described: (1) mapping the distribution of water masses exhibiting specific suspended sediment concentrations; and (2) determining the location and delineation of surface water bodies in the southeastern U. S. The techniques described are being successfully used to map the land area inundated by the 1973 spring flood in the Lower Mississippi River Valley, map sediment distributions in Lake Pontchartrain (in Louisiana) as a result of opening the Bonnet Carre Floodway during the spring flood, and inventory lakes and reservoirs.

Williamson, A. N.↗

Millimeter-wave studies of the surfaces of Mercury and Mars and the atmosphere of Venus

Disk average brightness temperatures of Mercury were obtained using a 4.6 m radio telescopes. The data was searched for periodicities which correlate with phase angle, hermocentric longitude and beat frequencies produced by modulations of various celestial mechanical parameters. Spectral line observations were made of Venus with the NRAO 11 m radio telescope. The total CO content and the CO vertical profile, and their variability were observed. Large scale thermophysical properties of the surface of Mars were studied.

Epstein, E. E.↗

HEAO-1 observations of gamma ray bursts

A search of data from the High Energy X-Ray and Low Energy Gamma Ray Experiment on HEAO-1 uncovered 14 gamma ray bursts. Nine of these events are reported for the first tiome. Except for the faintest events, all of the bursts detected by this experiment have been measured above an MeV, thereby confirming the hard spectral character of gamma ray burst spectra reported by SMM. Results give a burst rate of at least 105 per year above 6 times 10 to the minus 7th power ergs, which is consistent with previous measurements of burst frequency.

Hueter, G. J.↗