ATLANTA, Oct. 22, 2014 /PRNewswire/ -- UCB, a global
biopharmaceutical company focusing on CNS and immunology treatment
and research, is sponsoring several data presentations on
Cimzia® (certolizumab pegol) at the
American College of Gastroenterology's (ACG) 2014 Annual Scientific
Meeting in Philadelphia, PA,
October 18-22. The posters present
post-hoc analyses of the 7-year open-label extension PRECiSE 3
clinical trial of Cimzia® in Crohn's
disease, which examine certain demographic and clinical
characteristics associated with treatment response and
remission.
In the U.S., Cimzia® is approved for reducing signs
and symptoms of Crohn's disease and maintaining clinical response
in adult patients with moderately to severely active disease who
have had an inadequate response to conventional therapy.
Quotes:
William Sandborn, MD,
investigator and Chief, Division of Gastroenterology, University of California San Diego:
- "These data, which are derived from post-hoc analyses of the
PRECiSE 3 study, provide insight into the impact of patient
characteristics on treatment outcomes over 7 years among adult
patients receiving Cimzia® for Crohn's
disease."
- "We are encouraged by these results, which provide valuable
insights about demographic and clinical characteristics, such as
baseline serum albumin as well as disease behavior and location,
which may affect treatment response."
Professor Dr. Iris
Loew-Friedrich, Chief Medical Officer and Executive Vice
President UCB:
- "The predictive factors examined in these analyses help us
better understand the nature of Crohn's disease, and the role that
Cimzia® can play in improving patient
outcomes."
- "At UCB we are committed to supporting research that optimizes
patient outcomes. These results provide doctors with valuable
information that can help them make the most informed treatment
decisions for their Crohn's patients."
Posters on Cimzia for Crohn's Disease at ACG
- Predictors of Maintenance of Long-Term Remission in Crohn's
Disease Patients Treated with Certolizumab Pegol: Multivariate and
Univariate Analyses from the PRECiSE 3 Study
- Date and Time: Sunday, October
19, 3:30 PM – 7:00 PM
- Location: Poster Exhibit Hall
- Poster Number: P476
- Crohn's Disease Behavior as a Risk Factor for Loss of
Maintenance of Remission in Patients Treated with Certolizumab
Pegol: Results from the PRECiSE 3 Study
- Date and Time: Tuesday, October
21, 10:30 AM – 4:00 PM
- Location: Poster Exhibit Hall
- Poster Number: P1671
- Disease activity as a Predictor of Long-term Outcomes of
Treatment with Certolizumab Pegol for Active Crohn's Disease: An
Analysis of the PRECiSE 3 Study
- Date and Time: Monday, October
20, 10:30 AM – 4:00 PM
- Location: Poster Exhibit Hall
- Poster Number: P1075
- Disease Location as a Risk Determinant for Maintenance of
Remission in Crohn's Disease Patients Treated with Certolizumab
Pegol: Results of Analyses From the PRECiSE 3 Study
- Date and Time: Tuesday, October
21, 10:30 AM – 4:00 PM
- Location: Poster Exhibit Hall
- Poster Number: P1684
- Serum Albumin as a Predictor of Long-Term Response and
Remission with Certolizumab Pegol for Crohn's Disease: Results from
7-Year Data from the PRECiSE 3 Study
- Date and Time: Sunday, October
19, 3:30 PM – 7:00 PM
- Location: Poster Exhibit Hall
- Poster Number: P478
- Clinical Correlates and Pharmacokinetic Parameters of
Certolizumab Pegol Predicted by Modeling in Patients with Crohn's
Disease
- Date and Time: Tuesday, October
21, 10:30 AM – 4:00 PM
- Location: Poster Exhibit Hall
- Poster Number: P1689
Poster on Cimzia and Pregnancy
- Pregnancy Outcomes after Exposure to Certolizumab Pegol:
Results from Safety Surveillance
- Date and Time: Sunday, October
19, 3:30 PM – 7:00 PM
- Location: Poster Exhibit Hall
- Poster Number: P447
About the PRECiSE Clinical Trial Program
PRECiSE (PEGylated antibody fragment evaluation in Crohn's disease:
safety and efficacy), one of the largest, most comprehensive
development programs for an anti-TNF for moderate to severe Crohn's
disease, is composed of two placebo-controlled studies (PRECiSE 1
and 2) and two open-label safety follow-up studies. In these
pivotal clinical trials, the primary efficacy endpoints of clinical
response were evaluated using the Crohn's Disease Activity Index
(CDAI) and defined as a decrease in CDAI score of > 100
points. CDAI is a weighted, composite index of eight items,
which requires daily completion of a diary card and calculation of
various weighting factors for one week. In 2007, the two
former studies were published in the New England Journal of
Medicine (NEJM). The studies demonstrated that
patients with moderate to severe Crohn's disease achieved and
maintained clinical response with CIMZIA® for up to 6
months, compared to placebo. In a follow-up open-label
extension study (PRECiSE 3), patients continued to receive
CIMZIA® every 4 weeks for up to 7 years. The
Harvey-Bradshaw Index (HBI), which only requires scoring from the
day before the study visit and involves a lower number of
components, was used to evaluate Crohn's disease activity in
PRECiSE 3.1,2,3,4,5,6
About Crohn's Disease
Crohn's disease is a type of inflammatory bowel disease (IBD),
which is chronic, progressive, and often destructive. It
causes inflammation of the gastrointestinal (GI) tract, most
commonly affecting the end of the small intestine (the ileum) and
the beginning of the large intestine (the colon). Crohn's disease
has been estimated to affect as many as 700,000 Americans.
Symptoms of Crohn's disease often include diarrhea, abdominal pain,
and weight loss. People with Crohn's can experience an
ongoing cycle of flare-up and remission throughout their lives. If
not effectively treated, it may result in the need for surgery and
hospitalization.7
About CIMZIA®
CIMZIA® is the only Fc-free, PEGylated anti-TNF
(Tumor Necrosis Factor). CIMZIA® has a high affinity for
human TNF-alpha, selectively neutralizing the pathophysiological
effects of TNF-alpha.
About CIMZIA® in the US8
In the US, CIMZIA® is approved for reducing signs and
symptoms of Crohn's disease and maintaining clinical response in
adult patients with moderately to severely active disease who have
had an inadequate response to conventional therapy. In addition, it
is approved for the treatment of adults with moderately to severely
active rheumatoid arthritis, adults with active psoriatic arthritis
(PsA) and adults with active ankylosing spondylitis (AS).
Important Safety Information about CIMZIA® in the
US
Risk of Serious Infections and Malignancy
Patients treated with CIMZIA® are at an increased
risk for developing serious infections that may lead to
hospitalization or death. Most patients who developed these
infections were taking concomitant immunosuppressants such as
methotrexate or corticosteroids. CIMZIA® should be
discontinued if a patient develops a serious infection or sepsis.
Reported infections include:
- Active tuberculosis, including
reactivation of latent tuberculosis. Patients with tuberculosis
have frequently presented with disseminated or extrapulmonary
disease. Patients should be tested for latent tuberculosis before
CIMZIA® use and during therapy.
Treatment for latent infection should be initiated prior to
CIMZIA® use.
- Invasive fungal infections, including
histoplasmosis, coccidioidomycosis, candidiasis, aspergillosis,
blastomycosis, and pneumocystosis. Patients with histoplasmosis or
other invasive fungal infections may present with disseminated,
rather than localized disease. Antigen and antibody testing for
histoplasmosis may be negative in some patients with active
infection. Empiric anti-fungal therapy should be considered in
patients at risk for invasive fungal infections who develop severe
systemic illness.
- Bacterial, viral and other infections due
to opportunistic pathogens, including Legionella and
Listeria.
The risks and benefits of treatment with CIMZIA®
should be carefully considered prior to initiating therapy in
patients with chronic or recurrent infection. Patients should be
closely monitored for the development of signs and symptoms of
infection during and after treatment with CIMZIA®,
including the possible development of tuberculosis in patients who
tested negative for latent tuberculosis infection prior to
initiating therapy.
Lymphoma and other malignancies, some fatal, have been
reported in children and adolescent patients treated with TNF
blockers, of which CIMZIA® is a member.
CIMZIA® is not indicated for use in pediatric
patients.
Patients treated with CIMZIA® are at an increased
risk for developing serious infections involving various organ
systems and sites that may lead to hospitalization or death.
Opportunistic infections due to bacterial, mycobacterial, invasive
fungal, viral, parasitic, or other opportunistic pathogens
including aspergillosis, blastomycosis, candidiasis,
coccidioidomycosis, histoplasmosis, legionellosis, listeriosis,
pneumocystosis and tuberculosis have been reported with TNF
blockers. Patients have frequently presented with disseminated
rather than localized disease.
Treatment with CIMZIA® should not be initiated in
patients with an active infection, including clinically important
localized infections. CIMZIA® should be discontinued if
a patient develops a serious infection or sepsis. Patients greater
than 65 years of age, patients with co-morbid conditions, and/or
patients taking concomitant immunosuppressants (e.g.,
corticosteroids or methotrexate) may be at a greater risk of
infection. Patients who develop a new infection during treatment
with CIMZIA® should be closely monitored, undergo a
prompt and complete diagnostic workup appropriate for
immunocompromised patients, and appropriate antimicrobial therapy
should be initiated. Appropriate empiric antifungal therapy should
also be considered while a diagnostic workup is performed for
patients who develop a serious systemic illness and reside or
travel in regions where mycoses are endemic.
Malignancies
During controlled and open-labeled portions of
CIMZIA® studies of Crohn's disease and other diseases,
malignancies (excluding non-melanoma skin cancer) were observed at
a rate of 0.5 per 100 patient-years among 4,650
CIMZIA®-treated patients versus a rate of 0.6 per 100
patient-years among 1,319 placebo-treated patients. In studies of
CIMZIA® for Crohn's disease and other investigational
uses, there was one case of lymphoma among 2,657
CIMZIA®-treated patients and one case of Hodgkin
lymphoma among 1,319 placebo-treated patients. In
CIMZIA® RA clinical trials (placebo-controlled and open
label), a total of three cases of lymphoma were observed among
2,367 patients. This is approximately 2-fold higher than expected
in the general population. Patients with RA, particularly those
with highly active disease, are at a higher risk for the
development of lymphoma. The potential role of TNF blocker therapy
in the development of malignancies is not known.
Malignancies, some fatal, have been reported among children,
adolescents, and young adults who received treatment with
TNF-blocking agents (initiation of therapy <18 years of age), of
which CIMZIA® is a member. Approximately half of the
cases were lymphoma (including Hodgkin's and non-Hodgkin's
lymphoma), while the other cases represented a variety of different
malignancies and included rare malignancies associated with
immunosuppression and malignancies not usually observed in children
and adolescents. Most of the patients were receiving concomitant
immunosuppressants.
Cases of acute and chronic leukemia have been reported with
TNF-blocker use. Even in the absence of TNF-blocker therapy,
patients with RA may be at a higher risk (approximately 2-fold)
than the general population for developing leukemia.
Postmarketing cases of hepatosplenic T-cell lymphoma (HSTCL), a
rare type of T-cell lymphoma that has a very aggressive disease
course and is usually fatal, have been reported in patients treated
with TNF blockers, including CIMZIA®. The majority
of reported TNF blocker cases occurred in adolescent and young
adult males with Crohn's disease or ulcerative colitis.
Almost all of these patients had received treatment with the
immunosuppressants azathioprine and/or 6-mercaptopurine (6-MP)
concomitantly with a TNF blocker at or prior to diagnosis.
Carefully assess the risks and benefits of treatment with
CIMZIA®, especially in these patient types.
Periodic skin examinations are recommended for all patients,
particularly those with risk factors for skin cancer.
Heart Failure
Cases of worsening congestive heart failure (CHF) and new onset
CHF have been reported with TNF blockers, including
CIMZIA®. CIMZIA® has not been formally
studied in patients with CHF. Exercise caution when using
CIMZIA® in patients who have heart failure and monitor
them carefully.
Hypersensitivity
Symptoms compatible with hypersensitivity reactions, including
angioedema, dyspnea, hypotension, rash, serum sickness, and
urticaria, have been reported rarely following CIMZIA®
administration. Some of these reactions occurred after the
first administration of CIMZIA®. If such reactions
occur, discontinue further administration of CIMZIA® and
institute appropriate therapy.
Hepatitis B Reactivation
Use of TNF blockers, including CIMZIA®, has been
associated with reactivation of hepatitis B virus (HBV) in patients
who are chronic carriers of this virus. Some cases have been fatal.
Test patients for HBV infection before initiating treatment with
CIMZIA®. Exercise caution in prescribing
CIMZIA® for patients identified as carriers of HBV, with
careful evaluation and monitoring prior to and during treatment. In
patients who develop HBV reactivation, discontinue
CIMZIA® and initiate effective anti-viral therapy with
appropriate supportive treatment.
Neurologic Reactions
Use of TNF blockers, including CIMZIA®, has been
associated with rare cases of new onset or exacerbation of clinical
symptoms and/or radiographic evidence of central nervous system
demyelinating disease, including multiple sclerosis, and with
peripheral demyelinating disease, including Guillain-Barre
syndrome. Rare cases of neurological disorders, including seizure
disorder, optic neuritis, and peripheral neuropathy have been
reported in patients treated with CIMZIA®. Exercise
caution in considering the use of CIMZIA® in patients
with these disorders.
Hematologic Reactions
Rare reports of pancytopenia, including aplastic anemia, have
been reported with TNF blockers. Medically significant cytopenia
(e.g., leukopenia, pancytopenia, thrombocytopenia) has been
infrequently reported with CIMZIA®. Advise all patients
to seek immediate medical attention if they develop signs and
symptoms suggestive of blood dyscrasias or infection (e.g.,
persistent fever, bruising, bleeding, pallor) while on
CIMZIA®. Consider discontinuation of CIMZIA®
therapy in patients with confirmed significant hematologic
abnormalities.
Drug Interactions
An increased risk of serious infections has been seen in
clinical trials of other TNF blocking agents used in combination
with anakinra or abatacept. Formal drug interaction studies have
not been performed with rituximab or natalizumab; however, because
of the nature of the adverse events seen with these combinations
with TNF blocker therapy, similar toxicities may also result from
the use of CIMZIA® in these combinations. Therefore, the
combination of CIMZIA® with anakinra, abatacept,
rituximab, or natalizumab is not recommended. Interference with
certain coagulation assays has been detected in patients treated
with CIMZIA®. There is no evidence that
CIMZIA® therapy has an effect on in vivo coagulation.
CIMZIA® may cause erroneously elevated aPTT assay
results in patients without coagulation abnormalities.
Autoimmunity
Treatment with CIMZIA® may result in the formation of
autoantibodies and, rarely, in the development of a lupus-like
syndrome. Discontinue treatment if symptoms of lupus-like syndrome
develop.
Immunizations
Do not administer live vaccines or live-attenuated vaccines
concurrently with CIMZIA®.
Adverse Reactions
In controlled Crohn's clinical trials, the most common adverse
events that occurred in >5% of CIMZIA® patients
(n=620) and more frequently than with placebo (n=614) were upper
respiratory infection (20% CIMZIA®, 13% placebo),
urinary tract infection (7% CIMZIA®, 6% placebo), and
arthralgia (6% CIMZIA®, 4% placebo). The proportion of
patients who discontinued treatment due to adverse reactions in the
controlled clinical studies was 8% for CIMZIA® and 7%
for placebo.
In controlled RA clinical trials, the most common adverse events
that occurred in >3% of patients taking CIMZIA® 200
mg every other week with concomitant methotrexate (n=640) and more
frequently than with placebo with concomitant methotrexate (n=324)
were upper respiratory tract infection (6% CIMZIA®, 2%
placebo), headache (5% CIMZIA®, 4% placebo),
hypertension (5% CIMZIA®, 2% placebo), nasopharyngitis
(5% CIMZIA®, 1% placebo), back pain (4%
CIMZIA®, 1% placebo), pyrexia (3% CIMZIA®, 2%
placebo), pharyngitis (3% CIMZIA®, 1% placebo), rash (3%
CIMZIA®, 1% placebo), acute bronchitis (3%
CIMZIA®, 1% placebo), fatigue (3% CIMZIA®, 2%
placebo). Hypertensive adverse reactions were observed more
frequently in patients receiving CIMZIA® than in
controls. These adverse reactions occurred more frequently among
patients with a baseline history of hypertension and among patients
receiving concomitant corticosteroids and non-steroidal
anti-inflammatory drugs. Patients receiving CIMZIA® 400
mg as monotherapy every 4 weeks in RA controlled clinical trials
had similar adverse reactions to those patients receiving
CIMZIA® 200 mg every other week. The proportion of
patients who discontinued treatment due to adverse reactions in the
controlled clinical studies was 5% for CIMZIA® and 2.5%
for placebo.
The safety profile for patients with Psoriatic Arthritis (PsA)
treated with CIMZIA® was similar to the safety profile
seen in patients with RA and previous experience with
CIMZIA®.
The safety profile for AS patients treated with
CIMZIA® was similar to the safety profile seen in
patients with RA.
For full prescribing information, please visit www.ucb.com
References
1. Sandborn WJ, Feagan BG, Stoinov S,et
al. Certolizumab pegol for the treatment of Crohn's disease. N
Engl J Med. 2007;357:228-38.
2. Schreiber S, Khaliq-Kareemi M,
Lawrance IC, et al. Maintenance therapy with certolizumab pegol for
Crohn's disease. N Engl J Med. 2007;357:239-250.
3. Data on file. UCB, Inc; Smyrna, GA, 2010.
4. Lichtenstein GR, Thomsen OO,
Schreiber S, et al. Clin Gastroenterol Hepatol.
2010;8(7):600-609.
5. Vermeire S, Schreiber S, Sandborn WJ,
Dubois C, Rutgeerts P. Clin Gastroenterol Hepatol.
2010;8(4):357-363.
6. Harvey RF, Bradshaw JM.
Lancet. 1980;1(8167):514.
7. What is Crohn's Disease? Crohn's
& Colitis Foundation of America. Accessed 12th September 2014 from
http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/
8. Cimzia® US Prescribing
Information. Accessed 12th September
2014 from http://www.ucb.com/
For further information, UCB:
- Amy Chandler Agan, UCB, T +1 770
970 8668, Amy.Agan@ucb.com
- Tom Rovine, Cooney Waters, T +1 212 886 2263,
trovine@cooneywaters.com
About UCB
UCB, Brussels,
Belgium (www.ucb.com) is a global biopharmaceutical company
focused on the discovery and development of innovative medicines
and solutions to transform the lives of people living with severe
diseases of the immune system or of the central nervous system.
With more than 8500 people in approximately 40 countries, the
company generated revenue of € 3.4 billion in 2013. UCB is listed
on Euronext Brussels (symbol: UCB).
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