28.05.2008 10:30:00
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Denosumab Achieved Superior Bone Mineral Density Gains in Head-to-Head Trial versus Weekly Alendronate (FOSAMAX(R))
Amgen (NASDAQ: AMGN) today announced complete results from a
head-to-head, double-blind study comparing the effects of twice-yearly
subcutaneous injections of denosumab versus weekly oral doses of
alendronate (FOSAMAX®)
on bone mineral density (BMD) in postmenopausal women with low BMD. The
results were presented during a late breaking session at this year’s
35th Annual European Symposium on Calcified
Tissues (ECTS) meeting. Top-line results of this study were previously
reported in January 2008.
In the non-pivotal Phase 3 study, administration of denosumab resulted
in significantly greater BMD gains at all sites measured, compared with
alendronate.
"This study is the first of any
investigational or approved therapy to show greater BMD gains compared
with alendronate at all skeletal sites measured,”
said Jacques Brown, lead study investigator, Laval University and Le
Centre hospitalier, Universitaire de Québec. "We
may be seeing a greater effect with denosumab at all sites measured
because as a RANK Ligand inhibitor, denosumab may be able to target all
osteoclasts – wherever they are found in bone
tissue throughout the skeleton – and at
all stages of their formation and function.”
For the primary endpoint, denosumab resulted in significant increases in
BMD at the total hip compared with alendronate (3.5 percent vs. 2.5
percent, p<0.0001). Denosumab also
resulted in significant increases in BMD compared with alendronate at
the trochanter (4.5 percent vs. 3.5 percent), 1/3 radius (1.1
percent vs. 0.6 percent), lumbar spine (5.3 percent vs. 4.2 percent),
and femoral neck (2.2 percent vs. 1.6 percent) (p=0.0003
at all sites). The company is awaiting results of its pivotal Phase 3
registrational trial later this year that will assess the potential
anti-fracture efficacy of denosumab.
The incidence and types of adverse events and serious adverse events
observed in this study were similar between the denosumab and
alendronate treatment groups. The most common adverse events across both
treatment arms were arthralgia, back pain, constipation, and dyspepsia.
"The results of the head-to-head study
presented here at ECTS are encouraging because they demonstrate that
administration of denosumab can result in significantly greater BMD
gains compared with alendronate,” said Javier
San Martin, Global Development Lead for the denosumab osteoporosis
program. "The novel means by which denosumab
inhibits osteoclast-mediated bone breakdown shows the promise of RANK
Ligand inhibition.” Study Design
A total of 1,189 women with postmenopausal osteoporosis were randomized
1:1 to receive denosumab or alendronate, and subsequently followed for
one year to assess changes in BMD. The study primary endpoint was to
evaluate the effect of denosumab on percent change from baseline in BMD
at the total hip compared to alendronate. Secondary endpoints were to
evaluate the effect of denosumab on percent change from baseline in BMD
at the lumbar spine, hip trochanter, femoral neck, and 1/3 radius
compared to alendronate.
Denosumab: Clinical Studies in Bone Loss and Destruction
Denosumab is an investigational fully-human monoclonal antibody in
late-stage clinical development that specifically targets RANK Ligand,
an essential regulator of osteoclasts (the cells that break down bone).
Underscoring Amgen’s commitment to science,
its researchers have instituted a broad clinical development program for
denosumab as they explore the bone biology of various diseases
associated with the RANK Ligand pathway. In addition to four Phase 3 and
two Phase 2 trials in postmenopausal osteoporosis, Amgen has evaluated
denosumab’s effects on bone erosions in
rheumatoid arthritis in a Phase 2 study. In the oncology setting,
denosumab is being evaluated in four Phase 3 and two Phase 2 studies in
advanced cancer patients with, or at risk for, bone metastases. In a
Phase 2 study, denosumab is being evaluated as a possible treatment for
patients with multiple myeloma.
Osteoporosis: Impact and Prevalence
Often referred to as the "silent epidemic,”
osteoporosis is a global problem that is increasing in significance as
the population of the world both increases and ages. The World Health
Organization (WHO) has recently identified osteoporosis as a priority
health issue along with other major non-communicable diseases.
Although fractures to the vertebrae and hip are the most commonly
discussed osteoporotic fractures, they do not account for the majority
of fractures. In fact, fractures at skeletal sites such as the wrist,
pelvis, humerus, clavicle, femur, and lower leg (tibia/fibula) make up
an estimated 59 percent of all osteoporotic fractures in the United
States (U.S.).i
The economic burden of osteoporosis is comparable to that of other major
chronic diseases; for example, in the U.S. the costs associated with
osteoporosis-related fractures are equivalent to those of cardiovascular
disease and asthmaii,iii,iv. It has been
reported that osteoporosis results in more hospital bed-days than
stroke, myocardial infarction or breast cancer.v About Amgen
Amgen discovers, develops, manufactures and delivers innovative human
therapeutics. A biotechnology pioneer since 1980, Amgen was one of the
first companies to realize the new science's promise by bringing safe
and effective medicines from lab, to manufacturing plant, to patient.
Amgen therapeutics have changed the practice of medicine, helping
millions of people around the world in the fight against cancer, kidney
disease, rheumatoid arthritis, and other serious illnesses. With a deep
and broad pipeline of potential new medicines, Amgen remains committed
to advancing science to dramatically improve people's lives. To learn
more about our pioneering science and our vital medicines, visit www.amgen.com.
Forward-Looking Statements
This news release contains forward-looking statements that are based on
management’s current expectations and beliefs
and are subject to a number of risks, uncertainties and assumptions that
could cause actual results to differ materially from those
described. All statements, other than statements of historical fact, are
statements that could be deemed forward-looking statements, including
estimates of revenues, operating margins, capital expenditures, cash,
other financial metrics, expected legal, arbitration, political,
regulatory or clinical results or practices, customer and prescriber
patterns or practices, reimbursement activities and outcomes and other
such estimates and results. Forward-looking statements involve
significant risks and uncertainties, including those discussed below and
more fully described in the Securities and Exchange Commission (SEC)
reports filed by Amgen, including Amgen’s
most recent annual report on Form 10-K and most recent periodic reports
on Form 10-Q and Form 8-K. Please refer to Amgen’s
most recent Forms 10-K, 10-Q and 8-K for additional information on the
uncertainties and risk factors related to our business. Unless otherwise
noted, Amgen is providing this information as of May 28, 2008 and
expressly disclaims any duty to update information contained in this
news release.
No forward-looking statement can be guaranteed and actual results may
differ materially from those we project. Discovery or identification of
new product candidates or development of new indications for existing
products cannot be guaranteed and movement from concept to product is
uncertain; consequently, there can be no guarantee that any particular
product candidate or development of a new indication for an existing
product will be successful and become a commercial product. Further,
preclinical results do not guarantee safe and effective performance of
product candidates in humans. The complexity of the human body cannot be
perfectly, or sometimes, even adequately modeled by computer or cell
culture systems or animal models. The length of time that it takes for
us to complete clinical trials and obtain regulatory approval for
product marketing has in the past varied and we expect similar
variability in the future.
We develop product candidates internally and through licensing
collaborations, partnerships and joint ventures. Product candidates that
are derived from relationships may be subject to disputes between the
parties or may prove to be not as effective or as safe as we may have
believed at the time of entering into such relationship. Also, we or
others could identify safety, side effects or manufacturing problems
with our products after they are on the market. Our business may be
impacted by government investigations, litigation and products liability
claims. We depend on third parties for a significant portion of our
manufacturing capacity for the supply of certain of our current and
future products and limits on supply may constrain sales of certain of
our current products and product candidate development.
In addition, sales of our products are affected by the reimbursement
policies imposed by third-party payors, including governments, private
insurance plans and managed care providers and may be affected by
regulatory, clinical and guideline developments and domestic and
international trends toward managed care and health care cost
containment as well as United States (U.S.) legislation affecting
pharmaceutical pricing and reimbursement. Government and others’
regulations and reimbursement policies may affect the development, usage
and pricing of our products. In addition, we compete with other
companies with respect to some of our marketed products as well as for
the discovery and development of new products. We believe that some of
our newer products, product candidates or new indications for existing
products, may face competition when and as they are approved and
marketed. Our products may compete against products that have lower
prices, established reimbursement, superior performance, are easier to
administer, or that are otherwise competitive with our products. In
addition, while we routinely obtain patents for our products and
technology, the protection offered by our patents and patent
applications may be challenged, invalidated or circumvented by our
competitors and there can be no guarantee of our ability to obtain or
maintain patent protection for our products or product candidates. We
cannot guarantee that we will be able to produce commercially successful
products or maintain the commercial success of our existing products.
Our stock price may be affected by actual or perceived market
opportunity, competitive position, and success or failure of our
products or product candidates. Further, the discovery of significant
problems with a product similar to one of our products that implicate an
entire class of products could have a material adverse effect on sales
of the affected products and on our business and results of operations.
The scientific information discussed in this news release related to our
product candidates is preliminary and investigative. Such product
candidates are not approved by the U.S. Food and Drug Administration
(FDA), and no conclusions can or should be drawn regarding the safety or
effectiveness of the product candidates. Only the FDA can determine
whether the product candidates are safe and effective for the use(s)
being investigated. Further, the scientific information discussed in
this news release relating to new indications for our products is
preliminary and investigative and is not part of the labeling approved
by the FDA for the products.
The products are not approved for the investigational use(s) discussed
in this news release, and no conclusions can or should be drawn
regarding the safety or effectiveness of the products for these uses.
Only the FDA can determine whether the products are safe and effective
for these uses. Healthcare professionals should refer to and rely upon
the FDA-approved labeling for the products, and not the information
discussed in this news release.
FOSAMAX is a registered trademark of Merck & Co., Inc.
i Johnell O, Kanis JA. Osteoporosis Int. 2006;
17:1726-1733.
ii Burge R, et al. J Bone Miner Res. 2007;
22:465-475
iii "Osteoporosis
Fast Facts.” Washington (DC): National
Osteoporosis Foundation. Accessed at http://www.nof.org/osteoporosis/stats.html.
iv "Economic Cost of
Cardiovascular Diseases.” Dallas (TX):
American Heart Association. Accessed at http://www.americanheart.org/statistics/10econom.html.
v Lippuner K, et al. "Incidence
and direct medical costs of hospitalisations due to osteoporotic
fractures in switzerland.” Osteoporosis
International. 1997;7:414-25.
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