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Alexion Announces Results of Two Independent Phase II Acute Myocardial Infarction Clinical Trials Presented at the American Heart Association's Scientific Sessions 2002
- Mortality Reduction Seen in Patients Treated with Pexelizumab in COMMA Primary Angioplasty Trial -
CHESHIRE, Conn., Nov. 18 /PRNewswire-FirstCall/ -- Alexion Pharmaceuticals Inc. (Nasdaq: ALXN) announced today that Dr. Christopher Granger, M.D., FACC, Associate Professor of Medicine, Director, Cardiac Care Unit of the Duke University Medical Center and Co-Director of Clinical Trials, Duke Clinical Research Institute, presented the preliminary results of two independent Phase II clinical trials, COMMA and COMPLY, evaluating the use of pexelizumab in acute myocardial infarction (AMI) patients. Alexion is developing pexelizumab together with Procter & Gamble Pharmaceuticals. (Photo: http://www.newscom.com/cgi-bin/prnh/20021118/NYM032 ) COMMA Trial: The first study, called the COMMA trial, evaluated the possible benefits of pexelizumab treatment in acute myocardial infarction patients who underwent primary percutaneous transluminal coronary angioplasty (PTCA). Results from COMMA, or "Complement Inhibition in Myocardial Infarction Treated with PTCA", showed that pexelizumab did not reach its primary endpoint of infarct size reduction as measured at 72 hours. However, pexelizumab administration was associated with a dose-dependent and statistically significant 70% reduction in 90 day mortality (placebo 5.9% vs. pexelizumab bolus/infusion 1.8%, p=.014), an important prospectively defined secondary endpoint. Dr. Granger, who is Chairman of the COMMA and COMPLY Steering Committee, commented, "The COMMA results are very exciting because this is the only recent trial to find a mortality reduction with an adjunct to reperfusion therapy. The fact that mortality was reduced but that measured infarct size was not suggests that the effect may be through a completely novel mechanism of action. Inhibiting complement appears to prevent a variety of inflammatory pathways, including production of cytokines, programmed cell death, and nitric oxide, each of which could contribute to death following acute MI." In COMMA, pexelizumab 2.0 mg/kg (n=262), pexelizumab 2.0 mg/kg followed by a 20 hour infusion at 0.05 mg/kg/hr (n=281), or placebo (n=271) was administered in a double-blind and randomized manner at 92 North American sites to 814 acute myocardial infarction patients who received angioplasty. Pexelizumab appeared to be well tolerated with the most common adverse events being chest pain, hypotension, nausea, and ventricular tachycardia. The mortality benefit with pexelizumab bolus/infusion observed at 90 days was maintained through 180 days. At 180 days, pexelizumab bolus/infusion was still associated with a significant 57% relative reduction in mortality compared to placebo administration (placebo 7.4% vs. pexelizumab bolus/infusion 3.2%, p=0.035). The incidence of cardiogenic shock was also lower with pexelizumab bolus/infusion (placebo 5.2% vs. pexelizumab bolus/infusion 2.8%, p=0.19) compared to placebo. As shown in the included survival analysis figure of the COMMA trial, pexelizumab administration was associated with an immediate, dose-dependent reduction in mortality that was sustained throughout the observation period (p=0.018 for the entire six month observation period). This significant reduction in mortality with pexelizumab was observed in the context of excellent overall care, with the concomitant treatment of approximately 90% - 95% of patients in each treatment arm with aspirin, coronary stents, IIb/IIIa antagonists, and beta blockers.
COMMA Trial: Dose-Dependent Reduction in Mortality graph available at: http://www.newscom.com/cgi-bin/prnh/20021118/NYM032
COMPLY Trial: The second study, called the COMPLY trial, evaluated the possible benefits of pexelizumab treatment in patients who sustained an AMI and were treated with a thrombolytic. COMPLY, or "Complement Inhibition in Myocardial Infarction Treated with Thrombolytics", which was conducted globally, did not reach its primary endpoint of infarct size reduction measured at 72 hours. In COMPLY, pexelizumab 2.0 mg/kg (n=304), pexelizumab 2.0 mg/kg followed by a 20 hour infusion at 0.05 mg/kg/hr (n=309), or placebo (n=307) was administered in a double-blind and randomized manner at 87 North American sites, 22 Eastern European sites, and 10 South American sites to 920 acute myocardial infarction patients who received thrombolytics. Pexelizumab appeared to be well tolerated with the most common adverse events being headache, chest pain, hypotension, and ventricular tachycardia. The North American (n=434) population appeared to differ from the Eastern European (n=408) and South American (n=78) populations in several respects, both at baseline prior to drug administration and in terms of standard medical practice after hospital admission. Patients outside North America had greater cardiac damage at baseline and also lower utilization of revascularization procedures after study entry than did patients in North America. There was no reduction in mortality at 90 days in the overall COMPLY population. However, a prespecified analysis of the pooled COMMA and North American COMPLY population (n=1248 in the total North American population) showed that, in this population, pexelizumab bolus/infusion was associated with a significant 55% reduction in 90 day mortality (placebo 6.3% vs. pexelizumab bolus/infusion 2.8%, p=.019). Separately, stroke, a complication of thrombolytic therapy, was reduced in the overall COMPLY population (placebo 2.6% vs. pexelizumab bolus/infusion 1.3%, p=0.26). Overall, in the combined COMMA and COMPLY population, pexelizumab appeared to be well-tolerated. The incidence of serious adverse events was similar in placebo (30%) and pexelizumab bolus (28%) and pexelizumab bolus/infusion (25%) treated patients. "We are particularly encouraged by the apparently robust improvement in long-term mortality associated with pexelizumab administration demonstrated in the Phase II COMMA trial," stated Leonard Bell, M.D., Chief Executive Officer of Alexion Pharmaceuticals, Inc. "Certainly, in patients suffering life- threatening acute cardiovascular disorders, mortality remains the clinical gold standard. From a development point of view, the dose-dependent and sustained reduction in mortality observed in the COMMA trial with pexelizumab is consistent with the reduction in mortality observed with pexelizumab in the pooled COMMA and North American COMPLY population and with pexelizumab in the Phase IIb coronary artery bypass graft surgery trial reported at last year's AHA meetings. Together with our partner Procter & Gamble, we are planning to complete our analyses and then discuss these encouraging preliminary clinical results with the FDA so as to plan appropriate subsequent development of pexelizumab in patients suffering an acute myocardial infarction." According to the 2002 Heart and Stroke Statistical Update from the American Heart Association, approximately 850,000 Americans are predicted to be admitted to a hospital with an AMI during the current year. From recent studies in patients with AMI (refs 1-3), it is expected that approximately 5- 10% of such patients would die within approximately 6 months of their index admission. Hence, approximately, 42,500-85,000 patients of these 850,000 patients would be expected to die from their acute myocardial infarction within this timeframe. Alexion is engaged in the discovery and development of therapeutic products aimed at treating patients with a wide array of severe disease states, including cardiovascular and autoimmune disorders, inflammation and cancer. Alexion's two lead product candidates, pexelizumab and eculizumab, are currently in eight clinical development programs. Alexion is developing pexelizumab, an antibody fragment, in collaboration with Procter & Gamble Pharmaceuticals. Together the firms have initiated a Phase III clinical study with pexelizumab in cardiopulmonary bypass patients, and have completed two large Phase II studies with pexelizumab in acute myocardial infarction patients. Alexion's other lead product candidate, eculizumab, is being studied in a Phase IIb trial for the treatment of rheumatoid arthritis. In addition to the Phase II clinical trials in membranous nephritis and lupus nephritis, eculizumab is in earlier stage clinical development for the treatment of paroxysmal nocturnal hemoglobinuria and dermatomyositis. Through its wholly owned subsidiary, Alexion Antibody Technologies, Inc., Alexion is engaged in discovering and developing a portfolio of additional antibody therapeutics targeting severe unmet medical needs. This press release and further information about Alexion Pharmaceuticals, Inc. can be found on the World Wide Web at: http://www.alexionpharm.com .
(1) Anderson et al. a Contemporary Overview of Percutaneous Coronary Interventions: The American College of Cardiology-National Cardiovascular Data Reigstry (ACC-NCDR).J Am Coll Cardiol. 2002;39:1096-1103. (2) Shihara et al. In-Hospital and One-Year Outcomes for Patients Undergoing Percutaneous Coronary Intervention for Acute Myocardial Infarction. Am J Cardio. 2002;90:932-936. (3) Every et al. A Comparison of Thrombolytic Therapy With Primary Coronary Angioplasty for Acute Myocardial Infarction. N Engl J Med 1996;335:1253-60.
This news release contains forward-looking statements. Such statements are subject to certain factors which may cause Alexion's plans to differ or results to vary from those expected, including the results of pre-clinical or clinical studies (including termination or delay in clinical programs or inability to move forward to the next Phase of clinical development), the need for additional research and testing, delays in developing or arranging satisfactory manufacturing capability, inability to access capital and funding on a timely basis and on favorable terms, delays in development of or adverse changes in status of commercial relationships, the possibility that favorable results of earlier clinical trials are not predictive of safety and efficacy results in later clinical trials, dependence on Procter & Gamble Pharmaceuticals for performance of development and commercial matters related to pexelizumab, the risk that third parties won't agree to license us on reasonable terms their intellectual property necessary for us to develop and commercialize our products, 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 Annual Report on Form 10-K for the year ended July 31, 2002. Except in special circumstances in which a duty to update arises under law when prior disclosure becomes materially misleading in light of subsequent events, Alexion does not intend to update any of these forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events.
Contacts: Alexion Pharmaceuticals, Inc. Leonard Bell, M.D. Chief Executive Officer (203) 272-2596
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