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Soliris(R) Reduced Measures of Thrombosis and Inflammation, and Decreased Indicators of Pulmonary Hypertension, in Studies of Patients with PNH
New Data Presented at ASH Annual Meeting Concerning Soliris and Important Medical Complications of PNH
By: PR Newswire
Dec. 9, 2008 07:00 AM
A separate study found that Soliris was observed to reduce indicators of pulmonary artery hypertension (PAH) in patients with paroxysmal nocturnal hemoglobinuria (PNH), according to a new analysis of clinical trial data. Both sets of data were presented in oral sessions yesterday at the 50th Annual Meeting of the American Society of Hematology. "The common, severe and progressive clinical consequences of PNH are
becoming more apparent as researchers gain more experience and basic knowledge
with regard to this disease," said Blood Markers of Thrombin Generation and Inflammation Research titled "Eculizumab Therapy Results in Rapid and Sustained
Decreases in Markers of Thrombin Generation and Inflammation in Patients with
PNH" was presented yesterday in an oral session at the ASH annual meeting by
Ilene Ceil Weitz, M.D., Assistant Clinical Professor of Medicine, Jane Anne
Nohl Division of Hematology, Keck School of Medicine of the Recently published research showed that patients with PNH were observed to have 92 percent fewer blood clots (thromboses) during treatment with Soliris (1) compared to the period of time prior to Soliris treatment. To better understand the mechanism for this observed reduction, researchers used highly sensitive laboratory tests to track levels of blood markers in order to determine the effect of Soliris on markers of thrombin generation and inflammation among eight patients with PNH, only one of which had been previously diagnosed with a blood clot. Results showed that prior to treatment with Soliris, patients with PNH exhibited a hypercoagulable state as indicated by elevated levels of key inflammatory and pro-thrombotic measures. Soliris treatment was associated with statistically significant decreases in key blood measures, including LDH levels (p=0.0001), D-dimers (p=0.0057), thrombin-antithrombin complex or TAT (0.01), interleukin 6 or Il-6 (p=0.04), and tissue factor microparticles or TFMP (0.02) during the four-week induction phase of treatment. All decreases in D-dimers, TAT, Il-6, TFMP, and LDH were sustained in the maintenance phase of treatment. The authors concluded that the study patients, most of whom did not have clinical evidence of thrombosis and were also not previously transfused, exhibited a hypercoagulable state. In these patients, Soliris treatment was observed to result in a decrease in measures of thrombin generation and inflammation. These changes appeared to be independent of the observed reduction in hemolysis. "This data deepens our understanding of the complex interactions in the blood that result in dangerous inflammation and blood clots in patients with PNH," said Dr. Weitz. "It also suggests that many patients with PNH, even without a clinical thrombosis, exhibit a high risk for blood clotting, and provides hope for patients and physicians, since thrombosis is the leading cause of premature death in PNH and the most feared complication of the disease." Pulmonary Hypertension Research titled "Eculizumab Reduces Pulmonary Hypertension through
Inhibition of Hemolysis-Associated Nitric Oxide Consumption in Patients with
Paroxysmal Nocturnal Hemoglobinuria" was presented in an oral session
yesterday at the ASH annual meeting by Using data from the Phase III TRIUMPH study of Soliris, Dr. Hill and her colleagues evaluated the efficacy of Soliris in the regulation of cell-free plasma hemoglobin levels, nitric oxide depletion and subsequent cardiovascular morbidities in patients with PNH. This analysis found that 47 percent of patients with PNH (34 of 73) suffered from pulmonary hypertension before starting the trial. In this study, PAH was measured by an elevated blood level of NT-proBNP, which has been shown to be highly predictive of PAH and an independent predictor of mortality in other hemolytic diseases. (2) At the start of the study, levels of hemolysis and nitric oxide consumption were shown to be much greater in PNH (more than 6- and 10-fold, respectively) than in patients with other hemolytic diseases. Patients treated with Soliris experienced a 50 percent reduction in the incidence of PAH over the course of the 26-week treatment period, from 52.5 percent to 26.3 percent, while PAH did not change with placebo (39.4% to 43.8%) (P<0.001). Additionally, Soliris-treated PNH patients experienced significantly improved shortness of breath compared to placebo, as measured by the EORTC QLQ-C30 quality of life survey (P<0.001). "A careful analysis of blood levels in PNH patients shows that hemolysis, the red blood cell destruction that defines the disease, consumes nitric oxide in the blood which is likely to result in an increase in cardiovascular complications as shown in other hemolytic diseases," said Dr. Hill. "This study confirms that PAH is common in hemolytic PNH patients and also suggests that the anti-hemolytic effect of Soliris treatment significantly increases nitric oxide and consequently reduces pulmonary hypertension in patients with PNH." Pulmonary artery hypertension is a rare, progressive disorder characterized by high blood pressure (hypertension) of the pulmonary arteries, the blood vessels that carry blood from the heart to the lungs. Symptoms of pulmonary hypertension can be severe and include shortness of breath (dyspnea), chest pain, fatigue, and fainting episodes. Additional Data A poster titled "Modification of the Eculizumab Dose to Successfully
Manage Intravascular Breakthrough Hemolysis in Patients with Paroxysmal
Nocturnal Hemoglobinuria" was presented yesterday at the ASH annual meeting by
A poster titled "Reducing Intravascular Hemolysis on Ferritin Homeostasis
in Eculizumab Treated Paroxysmal Nocturnal Hemoglobinuria (PNH) Patients" was
presented yesterday at the ASH annual meeting by About PNH PNH is a rare blood disorder that affects an estimated 8,000 to 10,000
people in PNH has been identified more commonly among patients with disorders of the bone marrow, including aplastic anemia (AA) and myelodysplastic syndromes (MDS). (7, 8, 9). In patients with thrombosis of unknown origin, PNH may be an underlying cause. (5,10) Prior to approval of Soliris, there were no therapies specifically available for the treatment of PNH. PNH treatment was limited to symptom management through periodic blood transfusions, non-specific immunosuppressive therapy and, infrequently, bone marrow transplantations -- a procedure that carries considerable mortality risk. (5,10) About Soliris Soliris was approved in Important Safety Information Soliris is generally well tolerated. The most frequent adverse events observed in clinical studies were headache, nasopharyngitis (a runny nose), back pain and nausea. Treatment with Soliris should not alter anticoagulant management because the effect of withdrawal of anticoagulant therapy during Soliris treatment has not been established. The U.S. product label for Soliris also includes a boxed warning: "Soliris increases the risk of meningococcal infections. Vaccinate patients with a meningococcal vaccine at least two weeks prior to receiving the first dose of Soliris; revaccinate according to current medical guidelines for vaccine use. Monitor patients for early signs of meningococcal infections, evaluate immediately if infection is suspected, and treat with antibiotics if necessary." During clinical studies, two out of 196 vaccinated PNH patients treated with Soliris experienced a serious meningococcal infection. Prior to beginning Soliris therapy, all patients and their prescribing physicians are enrolled in the Soliris Safety Registry which is part of a special risk management program that involves initial and continuing education and long-term monitoring for detection of new safety findings. Please see full prescribing information at www.soliris.net. About Alexion Alexion Pharmaceuticals, Inc. is a biopharmaceutical company working to
develop and deliver life-changing drug therapies for patients with serious and
life-threatening medical conditions. Alexion is engaged in the discovery,
development and commercialization of therapeutic products aimed at treating
patients with a wide array of severe disease states, including hematologic
diseases, cancer, and autoimmune disorders. In and further information about Alexion Pharmaceuticals, Inc. can be found at: www.alexionpharm.com.
[ALXN-G]
Safe Harbor Statement This news release contains forward-looking statements, including
statements related to potential health and medical benefits from Soliris.
Forward-looking statements are subject to factors that may cause Alexion's
results and plans to differ from those expected, including for example,
decisions of regulatory authorities regarding marketing approval or material
limitations on the marketing of Soliris, delays in arranging satisfactory
manufacturing capability and establishing commercial infrastructure, delays in
developing or adverse changes in commercial relationships, the possibility
that results of clinical trials are not predictive of safety and efficacy
results of Soliris in broader patient populations, the possibility that
initial results of commercialization are not predictive of future rates of
adoption of Soliris, the risk that third parties won't agree to license any
necessary intellectual property to Alexion on reasonable terms or at all, the
risk that third party payors will not reimburse for the use of Soliris at
acceptable rates or at all, the risk that estimates regarding the number of
PNH patients are inaccurate, the risk that pending litigation may be resolved
adversely, and a variety of other risks set forth from time to time in
Alexion's filings with the Securities and Exchange Commission, including but
not limited to the risks discussed in Alexion's Quarterly Report on Form 10-Q
for the period ended (1) Hillmen P, Muus P et al. Effect of the complement inhibitor eculizumab on thromboembolism in patients. Blood. 2007;110:4123-4128) (2) Machado RF, Anthi A, Martin et al. N-Terminal Pro-Brain Natriuretic Peptide Levels and Risk of Death in Sickle Cell Disease. JAMA. 2006;296(3):310. (3) Hill A, Platts PJ, Smith A et al. The incidence and prevalence of
paroxysmal nocturnal hemoglobinuria (PNH) and survival of patients in
(4) Socie G, Mary J Yves, de Gramont A, et al. Paroxysmal nocturnal haemoglobinuria: long-term follow-up and prognostic factors. Lancet. 1996: 348:573-577. (5) Parker C, Omine M, Richards S, et al. Diagnosis and management of paroxysmal nocturnal hemoglobinuria. Blood. 2005;106:3699-3709. (6) Hillmen P, Lewis SM, Bessler M, Luzzatto L, Dacie JV. Natural history of paroxysmal nocturnal hemoglobinuria. N Engl J Med. 1995; 333:1253-1258. (7) Wang H, Chuhjo T, Yasue S, Omine M, Naka S. Clinical significance of a minor population of paroxysmal nocturnal hemoglobinuria-type cells in bone marrow failure syndrome. Blood. 2002;100 (12):3897-3902. (8) Iwanga M, Furukawa K, Amenomori T, et al. Paroxysmal nocturnal haemoglobinuria clones in patients with myelodysplastic syndromes. Br J Haematol. 1998;102 (2):465-474. (9) Maciejewski JP, Risitano AM, Sloand EM, et al. Relationship between bone marrow failure syndromes and the presence of glycophosphatidyl inositol- anchored protein-deficient clones. Br J Haematol. 2001;115:1015-1022. (10) Hill A, Richards S, Hillmen P. Recent developments in the understanding and management of paroxysmal nocturnal haemoglobinuria. Br J Haematol. 2007;137 (3):181-192. SOURCE Alexion Pharmaceuticals, Inc.
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