

Depending on the results of these tests, Xofigo may be interrupted or stopped, and you may be given an alternative treatment.

However, the reasons for a possible earlier death seen in this study are not fully understood. It is thought that Xofigo, which is taken up by the bone, accumulates at sites where the bone is already damaged, for example by osteoporosis or micro-fractures, increasing the risk of fracture. In addition, 29% of patients who received the Xofigo combination had fractures, compared with 11% of patients given the placebo combination. In the study, patients given the combination with Xofigo died on average 2.6 months earlier than those given the combination with placebo. In addition, the combination used in this study is now contraindicated. The study included patients with no or only mild symptoms, whereas Xofigo is only authorised in patients with symptoms. The review of Xofigo was carried out by EMA’s Pharmacovigilance Risk Assessment Committee ( PRAC) after data from a clinical study suggested that patients given Xofigo in combination with Zytiga and prednisone/prednisolone could be at risk of dying earlier and had more fractures than patients given placebo (a dummy treatment) with Zytiga and prednisone/prednisolone.

The medicine should also not be used in patients who have no symptoms, in line with the current indication in addition, the use of Xofigo is not recommended in patients with a low number of bone metastases called osteoblastic bone metastases. Xofigo should not be used with other systemic cancer therapies, except for treatments to maintain reduced levels of male hormones (hormone therapy). Xofigo must also not be used with the medicines Zytiga (abiraterone acetate) and the corticosteroid prednisone or prednisolone.

On 26 July 2018, the European Medicines Agency concluded its review of the cancer medicine Xofigo (radium-223 dichloride), and recommended restricting its use to patients who have had two previous treatments for metastatic prostate cancer (prostate cancer that has spread to the bone) or who cannot receive other treatments. EMA restricts use of prostate cancer medicine Xofigo Medicine to be used only after two previous treatments or when other treatments cannot be taken
