13.12.2007 11:00:00
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Puricase(R) (pegloticase) Meets Pre-Specified Primary Efficacy Endpoint in Two Replicate Phase 3 Studies
Savient Pharmaceuticals, Inc. (NASDAQ:SVNT) is pleased to
announce statistically significant positive results for the Puricase
(pegloticase) Phase 3 program in treatment-failure gout patients, which
has been conducted under the auspices of a Special Protocol Assessment
(SPA) with the U.S. Food and Drug Administration (FDA). Puricase 8 mg
administered by a two-hour intravenous infusion every two weeks or every
four weeks met the primary efficacy endpoint in the Intent to Treat
(ITT) and Per Protocol analyses in each of two replicate, six-month
Phase 3 clinical trials, [the studies are
termed, Gout Outcomes and Urate Therapy, GOUT 1 and GOUT 2].
The primary efficacy endpoint specified under the Special Protocol
Assessment was normalization of plasma uric acid during months three and
six of the clinical trials. Moreover, the every two week dose group also
attained statistical significance for the a priori definition of
reduction of gout tophi in the pre-specified pooled analysis, while the
every four week dose group revealed a favorable numerical trend for this
secondary endpoint. Analysis of other secondary efficacy endpoints also
showed favorable numerical trends in one or both pegloticase dose
groups. There were no expedited reports of serious adverse events during
the Phase 3 trials.
The treatment-failure gout population is characterized by very severe
gout symptoms such as frequent crippling gout flares and gout tophi
representing progressive disease, as well as a very high degree of
co-morbidity such as hypertension, cardiovascular disease, diabetes,
kidney disease, obesity, osteoarthritis and, medical histories of
multiple drug hypersensitivities and diverse environmental allergies.
The combination of advanced disease progression, important
co-morbidities requiring polypharmacy, and multiple allergic histories
makes this population exceptionally difficult to treat in clinical
practice today.
"Our initial impression of the pegloticase
Phase 3 top line data is very favorable,” said
Zeb Horowitz, MD., Sr. Vice President and Chief Medical Officer. "We
believe that the Savient GOUT studies are very important in two regards.
We believe that the Phase 3 data show that pegloticase has the potential
to be the first effective therapeutic option to control uric acid in
treatment-failure gout patients. Second, we believe that our assessment
of tophi in GOUT 1 and GOUT 2 by digital photography and image analysis
uniquely demonstrates the attainment of a statistically significant and
medically relevant clinical outcome, in this most difficult to treat
gout patient population.”
The Phase 3 results confirm that the pre-specified primary efficacy
endpoint for both pegloticase treatment arms was met in each
placebo-controlled study in the ITT analysis. In the ITT analysis of the
primary endpoint all discontinued patients were imputed as
non-responders, making this a very conservative assessment of
therapeutic response. The mean responder rate for the every two week
dose group pooled across both studies was 42% (p is less than 0.001) and
the mean responder rate for the every four week dose group was 35% (p is
less than 0.001). In the Per Protocol analysis the responder rates were
higher: every two week was 61% (p is less than 0.001), and every four
week was 50% (p is less than 0.001). The placebo responder rate was zero
in both trials for both the ITT and Per Protocol analyses.
We believe that the most clinically important of the secondary efficacy
outcomes assessed in these studies was the effect of pegloticase on gout
tophi. The every two week dose arm attained statistical significance in
the pre-specified pooled analysis (p equal to 0.005) for the elimination
of gout tophi (complete elimination of at least one tophus and no new
tophi), whereas the every four week dose group did not attain
statistical significance.
Although many secondary efficacy endpoints were explored in this Phase 3
program, we have not yet finished analyzing this aspect of the data
base, and thus cannot include these in the top line results. It appears
that in some statistical analyses significance was observed and in
others, favorable numerical trends were noted.
As anticipated, patients in both dose arms showed an increase in gout
flares as compared to placebo only in the early study period. However,
in the last three months of the study period both pegloticase dose arms
showed reduced gout flare frequency compared to the first three months,
but not attaining statistical significance relative to placebo. The
numerical trend toward reduction of gout flare frequency below the
placebo rate is considered favorable. Despite the pre-study history of
frequent severe gout flares and the evidence that pegloticase treatment,
as any other uric acid lowering treatment, initially induces gout flares
in susceptible patients, unlike other uric acid lowering therapies the
increase in gout flares induced by pegloticase appears to persist only
during the early portion of the treatment period.
"We believe that achieving positive results
for controlling uric acid level and elimination of gout tophi in this
difficult to treat gout population indicates that pegloticase provides a
clinically important advancement in managing hyperuricemia in patients
with treatment-failure gout,” commented
Christopher Clement, President and Chief Executive Officer of Savient. "New
approaches are long over due for patients who suffer from this painful
and potentially crippling disease. We estimate that there are 25,000 to
100,000 treatment failure patients in the United States and currently
these patients have no alternative therapeutic options other than
symptomatic relief. If approved by the FDA, pegloticase would be the
first new therapy for treating this disease in over forty years, and the
only treatment to demonstrate control of plasma uric acid in the
treatment-failure patients.”
Throughout the study period patient safety was assessed by frequent
review of adverse events and laboratory findings, and real-time
assessment of serious adverse events (SAEs). No signal for adverse
safety findings has appeared in preliminary analysis of the unblinded
data set, except for the occurrence of infusion-related adverse events.
Three deaths occurred in the treatment phase of the pooled ITT
population, including death in one patient who voluntarily withdrew
consent for renal dialysis. [A fourth
patient, not included in the ITT population, died after completing the
study when she elected to withdraw from antibiotic treatment of MRSA
sepsis.] None of the patient deaths appear to
be causally related to pegloticase treatment, as judged by the clinical
investigators and Savient medical monitors.
In the pooled ITT population, infusion reactions occurred at some time
during the studies in 56 pegloticase treated patients (33%): 22 were in
the every two week dose group and 34 were in the every four week dose
group. Two placebo patients (5%) experienced an infusion reaction.
Typically, an infusion reaction involved back or chest pain, muscle
cramps, sweating, and flushing. Infusion reactions were most often mild
or moderate in severity and usually controlled by slowing the infusion
rate and/or giving diphenhydramine. However, infusion reactions could be
severe, especially in terms of chest or back pain. Nineteen patients
(11% of pegloticase treated patients) experienced an infusion reaction
termed serious or severe: 6 in the every two week group and 13 in the
every four week group. Sixteen patients (9%) reported infusion reaction
as the reason for withdrawal from the studies, 8 patients in each of the
every two week and every four week dose groups.
The occurrence of infusion reactions as a proportion of total infusions
administered in the pooled ITT population is another way to view this
adverse event representing lack of tolerability. The number of infusion
reactions as a proportion of all infusions administered was 5% (43/851)
for the every two week dose group, 8% (70/846) for the every four week
dose group, and 0.8 % (4/502) for the placebo group.
Infusion reactions that involved symptoms of transient lingual swelling,
peri-oral edema, wheezing, or hypotension occurred in two patients in
each treatment group, or 2.4% of patients who were exposed to
pegloticase. Only one of the four patients was administered epinephrine
and two were administered corticosteroids. All patients recovered fully,
some very rapidly and others within approximately 60 minutes. None of
the four were re-challenged and all withdrew. Although we continue to
have uncertainty as to whether some or all of these patients actually
experienced an anaphylactic reaction to the drug, these symptoms have
been interpreted to represent anaphylaxis in other drug programs and may
be interpreted so in the GOUT trials as well.
In one circumstance, a multiply allergic patient developed urticaria
five days after pegloticase dose administration. Although suggestive of
delayed type hypersensitivity, the multiply allergic condition of this
patient and other factors makes assigning causality to any level of
certainty difficult.
"We believe that the statistically sound and
clinically meaningful results of the Phase 3 program in this difficult
to treat gout population, most of whom have severe, progressive disease,
are tremendously encouraging,” said Dr.
Horowitz. "We embarked on these gout trials
using new methods and new endpoints in a population for whom no therapy
is currently available. Both dose arms met the test of statistical
significance for the normalization of plasma uric acid in both trials in
the ITT and Per Protocol analyses. Moreover, we believe that the success
of the pre-specified pooled analysis for the every two week dose group
for the effect on gout tophi is of great importance, because the
presence of gout tophi is considered to be a hallmark of advanced
disease progression.
"Our early analysis of safety results appears
to be favorable, with recognition that some patients may not be able to
tolerate pegloticase infusions due to unacceptably severe infusion
reactions,” continued Dr. Horowitz. "We
believe that this safety risk is manageable in the clinical practice
setting, as it is for other biologics, because it is anticipated that
only qualified specialists and trained infusion nurses will be involved
in the administration of pegloticase. Still pending are the extensive
and complex analyses of immunological assessments. In summary, we
believe that the preliminary top line results indicate a favorable
risk-benefit ratio justifying the use of pegloticase to control
hyperuricemia and potentially to control the clinical consequences of
hyperuricemia in the treatment-failure gout population.”
The company plans to file a Biologics Licenses Applications (BLA) with
the FDA in 2008 based on the positive results from its Phase 3 trials,
following a pre-BLA meeting with the reviewing Division.
ABOUT PURICASE (pegloticase)
Puricase (pegloticase) is a pegylated recombinant mammalian urate
oxidase, in development to control hyperuricemia and its clinical
consequences in patients for whom conventional therapy is
contraindicated or has been ineffective. The two Phase 3 pivotal trials
assessed the safety and efficacy of a six-month course of pegloticase
therapy in patients with treatment-failure gout, under the auspices of a
Special Protocol Assessment from the U.S. Food and Drug Administration.
Savient has licensed worldwide rights to the technology related to
Puricase (pegloticase) from Duke University and Mountain View
Pharmaceuticals, Inc. Puricase is a registered trademark of Mountain
View Pharmaceuticals, Inc.
ABOUT THE TREATMENT-FAILURE GOUT POPULATION
Approximately three to five-million Americans suffer from gout, many of
whom experience only limited success in the long term management of
their painful symptoms. Within this group, we estimate that allopurinol,
the mainstay of therapy for control of uric acid, is contraindicated or
has failed to achieve therapeutic success at appropriate dosages in
approximately 25,000 to 100,000 patients, meaning that today tens of
thousands of gout patients have no effective treatment option. It is for
these treatment-failure patients that pegloticase potentially offers a
unique benefit and for which the product has been granted Orphan drug
designation.
CONFERENCE CALL
Savient Pharmaceuticals, Inc. Senior Management will hold a one-hour
conference call to answer questions related to this announcement on
December 13th, 2007 at 8:00 a.m. Eastern Time.
Those interested in listening to the conference call live via the
Internet may do so by visiting the Investor Relations section of Savient
Pharmaceuticals’ website at www.savientpharma.com.
The webcast will be available for 14 days on the Company website
beginning approximately one hour after the conclusion of the conference
call.
A telephone replay will be available from 11:00 a.m. Eastern time on
December 13th through December 23rd
at 11:59 p.m. Eastern time by dialing (800) 642-1687 (domestic) or (706)
645-9291 (international) and entering conference ID number 27984783.
ABOUT SAVIENT PHARMACEUTICALS, INC.
Savient Pharmaceuticals is a biopharmaceutical company engaged in
developing and distributing pharmaceutical products that target unmet
medical needs in both niche and broader markets. The company’s
product development candidate, Puricase (pegloticase) for
treatment-failure gout, has reported positive Phase 1 and 2 clinical
data. Patient dosing in the Phase 3 clinical studies began in June 2006;
patient enrollment was completed in March 2007; and the Phase 3 clinical
studies were completed in October 2007. Savient's experienced management
team is committed to advancing its pipeline and expanding its product
portfolio by in-licensing late-stage compounds and exploring
co-promotion and co-development opportunities that fit the Company's
expertise in specialty pharmaceuticals and biopharmaceuticals with an
initial focus in rheumatology. Savient also manufactures and supplies
Oxandrin® (oxandrolone tablets, USP) CIII in
the U.S. Puricase is a registered trademark of Mountain View
Pharmaceuticals, Inc. Further information on Savient can be accessed by
visiting: http://www.savient.com.
FORWARD-LOOKING LANGUAGE
It is important to note that in reporting these preliminary results the
Company is reporting its views and opinions regarding the preliminary
data and that the Company cannot forecast how the FDA or other
regulatory authorities will view or consider the data upon review, or
how any of the data set will be translated into label language, if
approved. FDA typically conducts its own analyses from the original data
sets and possibly may come to different conclusions than Savient has
reached. Furthermore, the data reported here are preliminary data in as
much as these are initial results, still to be extensively analyzed for
possible inconsistencies and errors.
This news release contains forward-looking statements that are subject
to certain risks, trends and uncertainties that could cause actual
results and achievements to differ materially from those expressed in
such statements. These risks, trends and uncertainties are in some
instances beyond Savient's control. Words such as "anticipate,"
"believe," "estimate," "expect," "intend," "plan," "will" and other
similar expressions help identify forward-looking statements, although
not all forward-looking statements contain these identifying words.
These forward-looking statements involve important risks and
uncertainties and are based on current expectations, assumptions,
estimates and projections about Savient's business and the
biopharmaceutical and specialty pharmaceutical industries in which
Savient operates. Forward-looking statements in this news release
include, without limitation, statements regarding the results of Savient’s
two pivotal six month Phase 3 clinical trials for Puricase®
(pegloticase), the filing of a Biologics License Application with the
FDA and the absence of other therapies to treat gout. Important factors
that may affect Savient’s ability to achieve
the matters addressed in these forward-looking statements include, but
are not limited to, Savient's stock price and market conditions, delay
or failure in developing Puricase (pegloticase) delay in achieving or
failure to achieve FDA approval of Puricase (pegloticase), difficulties
of expanding Savient's product portfolio through in-licensing,
fluctuations in buying patterns of Oxandrin®,
potential future returns of Oxandrin or other products, Savient's
continuing to incur substantial net losses for the foreseeable future,
difficulties in obtaining financing, potential development of
alternative technologies or more effective products by competitors,
reliance on third-parties to manufacture, market and distribute
Savient's products, economic, political and other risks associated with
foreign operations, risks of maintaining protection for Savient's
intellectual property, risks of an adverse determination in ongoing or
future intellectual property litigation, risks associated with stringent
government regulation of the biopharmaceutical industry and the other
risks discussed or referenced in our most recent annual report on Form
10-K, quarterly report on Form 10-Q and other current reports, each
filed by Savient with the SEC. Savient may not actually achieve the
plans, intentions or expectations disclosed in Savient's forward-looking
statements. Actual results or events could differ materially from the
plans, intentions and expectations disclosed in the forward-looking
statements that Savient makes. Stockholders should not place undue
reliance on the forward-looking statements, which speak only as to the
date of this press release. Savient's forward-looking statements do not
reflect the potential impact of any future acquisitions, mergers,
dispositions, joint ventures or investments that Savient may make.
Savient does not assume any obligation to update any forward-looking
statements.
SVNT-I
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