Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities (2024)

Chapter: Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022

Previous Chapter: Appendix F: Non-Exhaustive List of Patient Focused Drug Development Meetings and Patient Listening Sessions for Rare Diseases Between 2013 and 2023
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Brand nameGeneric NameApproved by EMAEMA Approved as OrphanEMA Approval YearApproved by FDAFDA Approved as OrphanFDA Approval YearDivergent DecisionTherapeutic AreaReason for non-approval in EMAReason for non-approval in FDA
Abecmaidecabtagene vicleucelYY2021YY2021NL01
AdakveocrizanlizumabYY2020YY2019NB06
AlofiseldarvadstrocelYY2018NN#N/AYL04Not submitted
Amondys 45casimersenNN#N/AYY2021YM09Not submitted
Amvuttravutrisiran sodiumYY2022YY2022NN07
Andexxacoagulation factor Xa [recombinant], inactivated-zhzoYN2019YY2018NB02
ANTHIMobiltoxaximabYY2020YYa2016NJ01
Artesunate AmivasArtesunateYY2021YY2020NP01
Asparlascalaspargase pegol-mknlNN#N/AYY2018YL01Not submitted
AyvakitAvapritinibYY2020YY2020NL01
Besremiropeginterferon alfa-2bYN2019YY2021NL03
Blenrepbelantamab mafodotinYY2020YY2020NL01
BraftoviencorafenibYN2018YY2018NL01
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Breyanzilisocabtagene maraleucelYN2022YY2021NL01
BrukinsazanubrutinibYN2021YY2019NL01
BylvayodevixibatYY2021YY2021NA05
CablivicaplacizumabYY2018YY2019NB01
CamzyosmavacamtenYN2023YY2022NC01
Carvykticiltacabtagene autoleucelYY2022YY2022NL01
CopiktraduvelisibYN2021YY2018NL01
CrysvitaburosumabYY2018YY2018NM05
Cytaluxpafolacianine sodiumNN#N/AYY2021YV04Not submitted
Danyelzanaxitamab-gqgkNN#N/AYY2020YL01Not submitted
DaurismoglasdegibYY2020YY2018NL01
Detectnetcopper Cu 64 dotatate injectionNN#N/AYY2020YV09Not submitted
DiacomitstiripentolYYa2007YY2018NN03
DojolvitriheptanoinNN#N/AYY2020YA16Not submitted
Ebangaansuvimab-zyklNN#N/AYY2020YJ05Not submitted
EbvalloTabelecleucelYY2022NN#N/AYL01Not submitted
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Brand nameGeneric NameApproved by EMAEMA Approved as OrphanEMA Approval YearApproved by FDAFDA Approved as OrphanFDA Approval YearDivergent DecisionTherapeutic AreaReason for non-approval in EMAReason for non-approval in FDA
EGATENtriclabendazoleNN#N/AYY2019YP02Not submitted
Elaheremirvetuximab soravtansine-gynxNN#N/AYY2022YL01Still in review
ElzonristagraxofuspYY2021YY2018NL01
EmpavelipegcetacoplanYY2021YY2021NL04
EnjaymosutimlimabYY2022YY2022NL04
EnspryngsatralizumabYY2021YY2020NL04
EpidiolexcannabidiolYYa2019YY2018NN03
EvkeezaevinacumabYN2021YY2021NC10
EvrysdirisdiplamYY2021YY2020NM09
Exkivitymobocertinib succinateNN#N/AYY2021YL01Withdrawn by the sponsor
FexinidazolefexinidazoleNN#N/AYY2021YaP01Not submitted
FirdapseamifampridineYYa2009YY2018NN07
Galafoldmigalastat hydrochlorideYYa2016YY2018NA16
Gamifantemapalumab-lzsgNN#N/AYY2018YL04Refused
GavretopralsetinibYN2021YY2020NL01
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
GivlaarigivosiranYY2020YY2019NA16
Hemgenixetranacogene dezaparvovec-drlbYYa2023YY2022NB02
HepcludexbulevirtideYY2020NN#N/AYJ05Still in review
IdefiriximlifidaseYY2020NN#N/AYL04Not submitted
ImcivreesetmelanotideYY2021YY2020NA08
ImjudotremelimumabactlYN2023YY2022NL01
Inmazebatoltivimab, maftivimab, and odesivimab-ebgnNN#N/AYY2020YJ05Not submitted
Inqovidecitabine and cedazuridineYN2023YY2020NL01
InrebicfedratinibYY2021YY2019NL01
IsturisaosilodrostatYY2020YY2020NH02
KimmtraktebentafuspYY2022YY2022NL01
KoselugoselumetinibYY2021YY2020NL01
KrazatiadagrasibYN2024YY2022NL01
KrintafeltafenoquineNN#N/AYY2018YP01Not submitted
KymriahtisagenlecleucelYY2018YYa2017NL01
LampitnifurtimoxNN#N/AYY2020YP01Not submitted
Lamzedevelmanase alfaYY2018YYa2023NA16
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Brand nameGeneric NameApproved by EMAEMA Approved as OrphanEMA Approval YearApproved by FDAFDA Approved as OrphanFDA Approval YearDivergent DecisionTherapeutic AreaReason for non-approval in EMAReason for non-approval in FDA
LibmeldyAutologous CD34+ cells encoding ARSA geneYY2020YY2024NN07
Livmarlimaralixibat chlorideYY2022YY2021NA05
LivtencitymaribavirYY2022YY2021NJ05
LorbrenalorlatinibYN2019YY2018NL01
LumakrassotorasibYN2022YY2021NL01
Lumoxitimoxetumomab pasudotox-tdfkNN#N/AYY2018YL01Withdrawn by the sponsor
LunsumioMosunetuzumabYY2022YY2022NL01
Lutatheralutetium (177Lu) oxodotreotideYYa2017YY2018NV10
Luxturnavoretigene neparvovecYY2018YYa2017NS01
LytgobifutibatinibYN2023YY2022NL01
MektovibinimetinibYN2018YY2018NL01
Mepseviivestronidase alfaYY2018YYa2017NA16
Monjuvitafasitamab-cxixYY2021YY2020NL01
MoxidectinmoxidectinNN#N/AYY2018YP02Not submitted
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
MYALEPT (BLA #125390)METRELEPTINYY2018YYa2014NA16
Mylotarggemtuzumab ozogamicinYY2018YYa2000NL01
Nexviazymeavalglucosidase alfa-ngptYN2022YY2021NA16
NgenlasomatrogonYY2022YYa2023NH01
Nulibryfosdenopterin hydrobromide dihydrateYY2022YY2021NA16
Omegavenfish oil triglyceridesNN#N/AYY2018YB05Not submitted
Onpattropatisiran sodiumYY2018YY2018NN07
Opdualagnivolumab, relatlimabYN2022YY2022NL01
OrladeyoberotralstatYN2021YY2020NB06
OxbrytavoxelotorYY2022YY2019NB06
Oxervaterecombinant human nerve growth factor (rhNGF)YYa2017YY2018NS01
OxlumolumasiranYY2020YY2020NA16
PalynziqpegvaliaseYY2019YY2018NA16
PemazyrepemigatinibYY2021YY2020NL01
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Brand nameGeneric NameApproved by EMAEMA Approved as OrphanEMA Approval YearApproved by FDAFDA Approved as OrphanFDA Approval YearDivergent DecisionTherapeutic AreaReason for non-approval in EMAReason for non-approval in FDA
Pepaxtomelphalan flufenamide hydrochlorideYYa2022YY2021NL01
Polivypolatuzumab vedotinYY2020YY2019NL01
PoteligeomogamulizumabYY2018YY2018NL01
DovprelapretomanidYY2020YY2019NJ04
PrevymisletermovirYY2018YYa2017NJ05
Pyrukyndmitapivat sulfateYY2022YY2022NB06
QinlockripretinibYY2021YY2020NL01
ReblozylluspaterceptYY2020YY2019NB03
Relyvriosodium phenylbutyrate and taurursodiolNN#N/AYY2022YN07Refused
RetevmoselpercatinibYN2021YY2020NL01
RevcovielapegademaselvlrNN#N/AYY2018YL03Not submitted
RezlidhiaolutasidenibNN#N/AYY2022YL01Not submitted
Rezurockbelumosudil mesylateNN#N/AYY2021YL04Not submitted
Roctavianvaloctocogene roxaparvovecYY2022YYa2023NB02
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
RozlytrekentrectinibYN2020YY2019NL01
RubracarucaparibYY2018YYa2016NL01
Rylazeasparaginase erwinia chrysanthemi (recombinant)rywnYN2023YY2021NL01
SarclisaisatuximabYN2020YY2020NL01
Scemblixasciminib hydrochlorideYY2022YY2021NL01
ScenesseafamelanotideYYa2014YY2019ND02
Skysonaelivaldogene autotemcelYY2021YY2022NA16
SkytrofalonapegsomatropinYY2022YY2021NH01
SogroyasomapacitanYY2021YN2020NH01
SpevigospesolimabYN2022YY2022NL04
SunosisolriamfetolYN2020YY2019NN06
Symdekotezacaftor; ivacaftorYY2018YY2018NR07
Tabrectacapmatinib dihydrochloride monohydrateYN2022YY2020NL01
TakhzyrolanadelumabYY2018YY2018NB06
TavalissefostamatinibYN2020YY2018NB02
TavneosavacopanYY2022YY2021NL04
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Brand nameGeneric NameApproved by EMAEMA Approved as OrphanEMA Approval YearApproved by FDAFDA Approved as OrphanFDA Approval YearDivergent DecisionTherapeutic AreaReason for non-approval in EMAReason for non-approval in FDA
TazveriktazemetostatNN#N/AYY2020YL01Not submitted
Tecartusbrexucabtagene autoleucelYY2020YY2020NL01
TecvayliteclistamabYN2022YY2022NL01
Tegsediinotersen sodiumYY2018YY2018NN07
TepezzateprotumumabtrbwNN#N/AYY2020YL04Not submitted
Tepmetkotepotinib hydrochloride monohydrateYN2022YY2021NL01
TerlivazterlipressinNN#N/AYY2022YH01Not submitted
TibsovoivosidenibYYa2023YY2018NL01
TPOXXtecovirimatYN2022YY2018NJ05
TRIKAFTA (copackaged)elexacaftor, ivacaftor, tezacaftorYY2020YY2019NR07
TrogarzoibalizumabYN2019YY2018NJ05
Truseltiqinfigratinib phosphateNN#N/AYY2021YL01Withdrawn by the sponsor
TukysatucatinibYN2021YY2020NL01
TURALIOpexidartinib hydrochlorideNN#N/AYY2019YL01Refused
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Ukoniqumbralisib tosylateNN#N/AYY2021YL01Not submitted
UltomirisravulizumabYN2019YY2018NL04
UpliznaInebilizumabYN2022YY2020NL04
Upstazaeladocagene exuparvovecYY2022NN#N/AYN07Still in review
ViltepsoviltolarsenNN#N/AYY2020YM09Not submitted
Vitrakvilarotrectinib sulfateYN2019YY2018NL01
Vizimprodacomitinib monohydrateYN2019YY2018NL01
VonjopacritinibNN#N/AYY2022YL01Withdrawn by the sponsor
VoraxazeglucarpidaseYY2022YYa2012NV03
VoxzogovosoritideYY2021YY2021NM05
VYNDAQELtafamidis meglumineYYa2011YY2019NN07
VYONDYS 53golodirsenNN#N/AYY2019YM09Not submitted
Vyvgartefgartigimod alfaYY2022YY2021NL04
WakixpitolisantYYa2016YY2019NN07
Waylivravolanesorsen sodiumYY2019NN#N/AYC10Complete Response
Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
Brand nameGeneric NameApproved by EMAEMA Approved as OrphanEMA Approval YearApproved by FDAFDA Approved as OrphanFDA Approval YearDivergent DecisionTherapeutic AreaReason for non-approval in EMAReason for non-approval in FDA
WeliregbelzutifanNN#N/AYY2021YL01Not submitted
Xenpozymeolipudase alfaYY2022YY2022NA16
Xospatagilteritinib fumarateYY2019YY2018NL01
XPOVIOselinexorYN2021YY2019NL01
Yescartaaxicabtagene ciloleucelYY2018YYa2017NL01
ZepzelcalurbinectedinNN#N/AYY2020YL01Not submitted
ZokinvylonafarnibYY2022YY2020NA16
Zolgensmaonasemnogene abeparvovecYY2020YY2019NM09
ZtalmyganaxoloneYYa2023YY2022NN03
Zynlontaloncastuximab tesirineYY2022YY2021NL01
Zynteglobetibeglogene autotemcelYY2019YY2022NB06

a These data points were corrected after release of the prepublication version of the report to accurately reflect the orphan status of the drugs and decisions made by FDA and EMA.

NOTES: Ga-68-DOTATOC (gallium [68Ga] edotreotide, known as Somakit TOC in Europe) was approved as an Orphan drug by FDA in 2019 and recommended for authorization as an Orphan drug by EMA in 2016. However, FDA’s orphan designation was withdrawn or revoked on December 9, 2020. Thus, the drug did not fall into the criteria for this analysis; includes approvals outside of year range, 2018–2022, if approved by the other agency within the date range.

SOURCE: Centre for Innovation in Regulatory Science, 2024 (unpublished). Data analysis and summary to help inform the National Academies committee on Processes to Evaluate the Safety and Efficacy of Drugs for Rare Diseases or Conditions in the United States and the European Union. Data analysis commissioned by the committee on Processes to Evaluate the Safety and Efficacy of Drugs for Rare Diseases or Conditions in the United States and the European Union, National Academies of Sciences, Engineering, and Medicine, Washington, DC.

Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Suggested Citation: "Appendix G: List of Orphan Approvals by FDA or EMA Between 2018 and 2022." National Academies of Sciences, Engineering, and Medicine. 2024. Regulatory Processes for Rare Disease Drugs in the United States and European Union: Flexibilities and Collaborative Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/27968.
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Next Chapter: Appendix H: Select Examples of Rare Disease Drug Products
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