Regenxbio says FDA issues CRL regarding BLA for RGX-121

Regenxbio (RGNX) announced that the U.S. FDA has issued a Complete Response Letter regarding its Biologics License Application for RGX-121 for the treatment of Mucopolysaccharidosis II, an ultra-rare neurodegenerative disease also known as Hunter syndrome. In May 2025, the FDA accepted the RGX-121 BLA under the accelerated approval pathway. In the February 7, 2026 CRL, the FDA stated that it had agreed to the study protocol in principle and outlined several reasons for not approving the gene therapy, including uncertainty regarding the study eligibility criteria to adequately define a population with neuronopathic disease, the comparability of the natural history external control to the study population, and the appropriateness of CSF HS D2S6 as a surrogate endpoint reasonably likely to predict clinical benefit. The CRL lists several potential paths forward, including a new study, treating additional patients and conducting longer-term follow up, and using an untreated control arm, all of which would be challenging in an ultra-rare disease population, like MPS II. “This decision is devastating for the families of boys living with this progressive, life-threatening disease,” said Curran Simpson, President and CEO of Regenxbio. “We are concerned about FDA’s feedback regarding the overall development path and evaluation of the data in the context of the urgent need for this irreversible ultra-rare disease. We remain confident in the quality and volume of evidence demonstrating the long-term potential of RGX-121 to positively change the trajectory of Hunter syndrome. This program has been in development for over 10 years. We are incredibly grateful to all the patients, their families, investigators, and site staff who have supported this program and our continued efforts to bring a much-needed new treatment option to the Hunter syndrome community. We will continue those efforts.”