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FDA proposes new treatment approval pathway for ultrarare diseases

The FDA's draft guidance aims to facilitate approval and commercialization of personalized genetic therapies tested in few patients, addressing rare diseases often overlooked by industry.

  • On Monday, the FDA proposed a draft pathway to authorize and potentially commercialize bespoke experimental treatments, with a 60-day public comment period.
  • Because many rare conditions affect tiny populations, randomized trials are impractical and drugmakers often lack incentive, while compassionate use programs have been cumbersome and barred commercial profit.
  • Called the 'plausible mechanism' approach, the protocol requires companies to justify why randomized trials are not feasible and mandates real-world evidence collection for genome-editing therapies and RNA-based drugs.
  • Senior FDA officials said recent changes, including Monday's pathway, do not set new standards, but critics and observers note procedural concerns and say commercializing treatments could alter drugmakers' incentives.
  • Last year, researchers at Children's Hospital of Philadelphia and the University of Pennsylvania used CRISPR gene-editing to treat a baby, showing individualized medicine's promise and potential acceleration.
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FDA proposes new treatment approval pathway for ultra-rare diseases

The Food and Drug Administration (FDA) on Monday announced a new proposal for flexible drug approval pathway treatments addressing ultra-rare diseases.

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The Record broke the news in Waterloo, Canada on Monday, February 23, 2026.
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