Cimzia Effective in Reducing Signs and Symptoms of Rheumatoid Arthritis
New Data Presented at EULAR Confirms Efficacy with Either Every Two Weeksn or Monthly Dosing
BARCELONA, Spain, 14 June 2007 - 7:00 am CET - New pivotal data
(RAPID 1 and RAPID 2) presented at the Annual European Congress of
Rheumatology (EULAR) show that Cimzia (certolizumab pegol), the
first PEGylated, Fc-free anti-TNF, combined with methotrexate
therapy has a rapid and significant effect in reducing the signs
and symptoms of active rheumatoid arthritis (RA) compared with
methotrexate alone. Data from a third study, the 011
trial, presented at the conference also showed that Cimzia
given every four weeks as monotherapy is significantly more
efficacious than placebo in the treatment of patients with active
RA who had previously failed
disease-modifying anti-rheumatic drug (DMARD) therapy.
In both pivotal Phase III studies, RAPID 1 and RAPID 2,
the primary endpoint, ACR20[a] response at 24 weeks, was
significantly higher in
both CIMZIA(TM) treated arms (400 mg at week zero, week two and
week four followed by 200 mg every two weeks plus methotrexate; or
400 mg every two weeks plus methotrexate) compared with the placebo
plus methotrexate-treated arm (p<0.001). In both studies there
was no significant difference between response levels in either of
the CIMZIA(TM) treatment arms. ACR50 and ACR70 responses were also
achieved rapidly and with statistical significance in both studies
in the CIMZIA(TM) treated arms.
RAPID 1 and RAPID 2 demonstrated that effective results in the
treatment of RA can be achieved with a 200 mg every other week
dose
of CIMZIA(TM) -- the higher dose is not necessary. CIMZIA(TM) was
also shown to have a rapid onset of action: in RAPID 1, a 25.4%
ACR50 response rate was observed at week 8 in both treatment
groups.
"These results are significant. They showed, for the first time,
that the Fc region present in conventional anti-TNFs is not
required for
activity in rheumatoid arthritis - and it is this region that has
often been associated with cellular cytotoxicity," commented
Professor Edward Keystone, Professor of Medicine, University of
Toronto, Canada. "The consistency of the RAPID data confirm
that
certolizumab pegol may provide a valuable new treatment option for
patients with this condition."
The safety and tolerability profile of CIMZIA(TM) in both RAPID studies was consistent with that expected of an anti-TNF agent.
In another study presented at the meeting, the 011 trial, the
efficacy of CIMZIA(TM) 400 mg every four weeks as monotherapy was
compared with that of placebo in treating the signs and symptoms of
RA in patients who had previously failed on one or more courses of
a
DMARD. The primary endpoint, ACR20 response at 24 weeks, was
significantly higher in the CIMZIA(TM) treated arm than in
the
placebo treated arm (45.5% vs 9.3%: p<0.001). ACR50 and ACR70
responses were also both achieved with statistical
significance.
CIMZIA(TM) was also significantly superior to placebo in terms of
median time to first ACR20 response (2.0 vs 19.9 weeks,
p<0.001),
with 80.6% of ACR20 responders having achieved response by week
1.
"These data show the potential of certolizumab pegol to safely
and effectively treat patients who have previously failed
disease
modifying antirheumatic drug treatments," added Prof. Josef Smolen,
Chairman of the Department of Rheumatology, Medical University
of
Vienna, Austria. "In addition, certolizumab pegol could provide a
valuable option in patients who are unable to take or cannot
tolerate
methotrexate."
Preparation for a regulatory submission for CIMZIA(TM) in the treatment of RA is ongoing, with filing planned by the end of 2007.
Enquiries please contact:
+---------------------------------------------------------------------------------------------+
|Investor Relations
|International
Media
|U.S.
Media
|
|--------------------------+----------------------------------+-------------------------------|
|Jean-Christophe Donck, UCB|Garry Daniels,
UCB
|Lisa Garman,
UCB
|
|Phone: +32 2 559 9346 |Phone : +44 7921
406996
|Phone: +1 404 291 47720
|
|E-mail:
|Email: garry.daniels@ucbgroup.com
|E-mail:
|
|jc.donck@ucb-group.com
|
|lisa.garman@ucb-group.com
|
|
|
|
|
|Mareike
Mohr
|Richard
Kenyon
|Kathryn
Mayurnik
|
|Phone: +32 2 559 9246
|Fleishman-Hillard
|Fleishman-Hillard
|
|Email:
|Phone: +44 7831
569940
|Phone: +1 212 453
2409 |
|mareike.mohr@ucb-group.com|E-mail:
|E-mail:
|
|
|richard.kenyon@fleishman.com
|kathryn.mayurnik@fleishman.com
|
|
|
|
|
+---------------------------------------------------------------------------------------------+
[a] ACR (American College of Rheumatology) response
scores measure improvement in the tender and swollen
joint count and also include assessment of
the following five parameters:
patient's global assessment, physician's global
assessment, patient's assessment of
pain, degree of disability, and level of acute-phase
reactant. ACR20 is achieved when there is 20%
improvement in the tender and swollen
joint count as well as a 20% improvement in at
least three of the five parameters. ACR50 &
ACR70 are an extension of these criteria
corresponding to a 50% and 70% improvement respectively.[1]
Notes to Editors:
RAPID Clinical Trials Program
The RAPID series of clinical trials were designed to establish the
efficacy and tolerability of CIMZIA(TM) (certolizumab pegol) in
the
treatment of rheumatoid arthritis. The RAPID clinical trial
programme is composed of two large, international,
multi-centre
placebo-controlled studies - RAPID 1 (027) and RAPID 2 (050). In
the 52-week RAPID 1 trial, 992 patients were randomly allocated to
receive one of three treatment regimens:
* 397 patients received 400 mg lyophilized CIMZIA(TM) at the start
of
the study and at weeks two and four, then 200 mg
given every two
weeks, together with methotrexate;
* 394 patients received 400 mg lyophilized CIMZIA(TM) every
two
weeks, together with methotrexate;
* 201 patients received placebo every two weeks, together
with
methotrexate.
In all three arms of the study, the dose of methotrexate was 10 mg per week or greater. Co-primary endpoints for the study RAPID 1 were the ACR20 responder rate at week 24 and the change from baseline in mTSS at week 52. These data on radiographic progression will be presented at a forthcoming rheumatology congress.
24-Week ACR Responses for RAPID 1
+-------------------------------------------------------------------+
| | Placebo &
| CIMZIA(TM))
|
CIMZIA(TM) |
| |
MTX | (certolizumab
| (certolizumab pegol) |
|
| |
pegol) 200mg & MTX | 400mg
& MTX |
|--------+-----------+--------------------+-------------------------|
| ACR 20 | 14
|
59*
|
61* |
|--------+-----------+--------------------+-------------------------|
| ACR 50 | 8
|
37*
|
40* |
|--------+-----------+--------------------+-------------------------|
| ACR 70 | 3
|
21*
|
21* |
+-------------------------------------------------------------------+
* p<0.001
In the 24-week RAPID 2 trial, 634 patients were randomly
allocated to receive one of three treatment regimens:
* 252 patients received 400 mg liquid CIMZIA(TM) at the start of
the
study and at weeks two and four, then 200 mg given every two
weeks,
together with methotrexate;
* 252 patients received 400 mg liquid CIMZIA(TM) every two
weeks,
together with methotrexate;
* 130 patients received placebo every two weeks, together
with
methotrexate.
In all three arms of the study the dose of methotrexate was 10mg per week or greater. Patients were assessed for improvement in signs and symptoms of RA. The primary endpoint for the study RAPID 2 was ACR20 responder rate at week 24.
24-Week ACR Responses for RAPID 2
+-------------------------------------------------------------------+
| | Placebo &
|
CIMZIA(TM)
| CIMZIA(TM)
|
| |
MTX | (certolizumab pegol)
| (certolizumab |
|
|
| 200mg &
MTX | pegol) 400mg & MTX
|
|--------+-----------+-------------------------+--------------------|
| ACR 20 | 9
|
57*
|
58* |
|--------+-----------+-------------------------+--------------------|
| ACR 50 | 3
|
32*
|
33* |
|--------+-----------+-------------------------+--------------------|
| ACR 70 | 1
|
16*
|
11* |
+-------------------------------------------------------------------+
* p<0.001
011 Trial
In the 24-week 011 phase III study, 220 adult patients with active
RA who had previously failed at least one DMARD were randomized
to
receive either CIMZIA(TM) 400 mg given subcutaneously every four
weeks (n=111) or placebo (n=109). Patients were assessed for
improvement in signs and symptoms of RA. The primary endpoint of
the 011 study was ACR20 responder rate, with secondary measures
including ACR50 and ACR70 responder rates.
About Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a progressive autoimmune disease which
causes chronic inflammation of the joints. It is estimated that
5
million people suffer from RA globally,[2] with 0.3% to 1% of the
population in industrialized countries suffering from RA.[3]
Prevalence is not split evenly between genders, since women are
three times more likely to be affected than men.[4] Although
it can affect
people of all ages, the onset of RA usually occurs between the ages
of 35-55 years.[5]
Symptoms of RA include joint stiffness, joint pain, inflammation
of the affected areas and an associated reduction in mobility.
These
symptoms can be intermittent and vary in severity from patient to
patient. In more severe cases RA can eventually lead to
disability.
RA patients are also at a higher risk of developing other
conditions, in particular heart disease, stroke, infections, lung
problems and
osteoporosis.[6]
As there is currently no cure for RA, treatment goals centre on
disease management. Treatment is aimed at controlling disease
progression, providing pain relief and reducing swelling,
preventing joint damage and deformity and maintaining function of
the affected joints to prevent disability.
Traditional treatments for RA include nonsteroidal
anti-Inflammatory drugs (NSAIDs), corticosteroids and disease
modifying antirheumatic
drugs (DMARDs), with biological therapies a more recent addition to
the list of treatment options. Anti-TNF (TNF-alpha; Tumour
Necrosis
Factor) therapies are specific types of monoclonal antibody
(biological therapies) which have been approved for use in patients
with RA. They may be given alone but are usually given in
combination with methotrexate or another immunosuppressant.
Anti-TNF therapies
have proven to be effective treatments, with the potential to
prevent joint damage. They work by inhibiting the action of
TNF-alpha, an
inflammatory mediator, either directly or indirectly responsible
for damaging the joint.[6]
About CIMZIA(TM) (certolizumab pegol)
CIMZIA(TM) (certolizumab pegol) is an investigational drug product.
CIMZIA(TM) is the first and only PEGylated Fc-free anti-TNF (Tumour
Necrosis Factor), and is being evaluated in RA at a dosing of once
every two weeks and once every four weeks, via subcutaneous
administration. CIMZIA(TM) has demonstrated efficacy without
the possible cytotoxicity mediated by the Fc portion present in
conventional anti-TNFs.
CIMZIA(TM) has a high affinity for human TNF-alpha, selectively
targeting TNF-alpha in inflamed tissue. Over the past decade,
TNF-alpha has emerged as a major target of basic research and
clinical investigation. This cytokine plays a key role in
mediating
pathological inflammation, and excess TNF-alpha production has been
directly implicated in a wide variety of diseases.
UCB filed a Biologics License Application (BLA) with the Food and Drug Administration (FDA) for CIMZIA(TM) in the treatment of Crohn's disease on February 28, 2006 and on April 28, 2006 submitted a Marketing Authorization Application (MAA) to the European Medicines Agency (EMEA) for the same indication.
About UCB
Headquartered in Brussels (Belgium), UCB (www.ucb-group.com) is a leading
global biopharmaceutical company dedicated to the research,
development and commercialization of innovative pharmaceutical and
biotechnology products in the fields of central nervous system
disorders, allergy/respiratory diseases, immune and inflammatory
disorders and oncology. UCB focuses on securing a leading
position
in severe disease categories. Employing more than 8,400 people in
over 40 countries, UCB achieved revenue of 2.5 billion euro in
2006. UCB is listed on the Euronext Brussels Exchange and owns
87.6% of Schwarz Pharma.
References
[1] American College of Rheumatology Subcommittee on
Rheumatoid
Arthritis Guidelines. Guidelines for the Management of
Rheumatoid
Arthritis 2002 update. Arthritis & Rheumatism, 2002 Vol. 46,
No. 2
[2] Stakeholder Insight: Rheumatoid Arthritis, Biologics battle
up
the treatment algorithm, Data Monitor, 7 September 2006
[3] Woolf AD & Pfleger B, Burden of major musculoskeletal
conditions:
Bulletin of the World Health Organization 2003, 81 (9)
[4] Panayi G What is RA? National Rheumatoid Arthritis Society,
June
2006
[5] Hellier, J et al, HLA-DRB1 genes and patients with late
onset
rheumatoid arthritis, Annals of Rheumatic Disease,
2001;60:531-533
[6] Firestein G, Rheumatoid Arthritis, ACP Medicine WebMD
Publishing,
August 2004
Posted: June 2007
