From the Wires
Phase 3 Sensipar®/Mimpara® EVOLVE™ Trial Published In The New England Journal Of Medicine
Study Results Simultaneously Presented at American Society of Nephrology's Kidney Week
By: PR Newswire
Nov. 3, 2012 03:37 PM
THOUSAND OAKS, Calif., Nov. 3, 2012 /PRNewswire/ -- Amgen (NASDAQ: AMGN) today announced results of the Phase 3 EVOLVE™ (EValuation Of Cinacalcet HCl Therapy to Lower CardioVascular Events) trial, which evaluated treatment with Sensipar®/Mimpara® (cinacalcet) for the reduction of the risk of mortality and cardiovascular (CV) events among 3,883 patients with secondary hyperparathyroidism (HPT) and chronic kidney disease (CKD) receiving dialysis. The primary endpoint of the study was time to the composite event comprising all-cause mortality or first non-fatal CV event, including myocardial infarction, hospitalization for unstable angina, heart failure or peripheral vascular event. Although patients in the Sensipar/Mimpara arm experienced a seven percent reduction in the primary endpoint (Hazard Ratio 0.93, 95 percent CI 0.85 to 1.02, p=0.112), the results were not statistically significant, and the trial did not meet its primary endpoint in the intent-to-treat analysis. These data were published today in the New England Journal of Medicine and simultaneously presented at the American Society of Nephrology's Kidney Week (Abstract # 6450).
Baseline characteristics between the Sensipar/Mimpara and placebo groups were generally well-balanced with the notable exception of age – an important predictor of death and CV events. Patients in the Sensipar/Mimpara group were one-year older than those in the placebo group (median age 55 and 54 years, respectively). A pre-specified analysis adjusting for baseline imbalances showed that treatment with Sensipar/Mimpara resulted in a 12 percent reduction in the primary endpoint (Hazard Ratio 0.88, 95 percent CI 0.79 to 0.97).
Discontinuation of investigational product was common in both arms and more frequent in the placebo group (66.7 percent Sensipar/Mimpara versus 70.5 percent placebo). Reasons for discontinuation included kidney transplant, parathyroidectomy, adverse events and patient request. A pre-specified analysis, which excluded data from patients that was collected beyond six months after stopping investigational product, showed a 15 percent reduction in the primary endpoint (Hazard Ratio 0.85, 95 percent CI 0.76 to 0.95).
The above described pre-specified analyses, however, cannot be interpreted as definitive.
Cardiovascular disease is common among patients with CKD, including those treated with dialysis, among whom death due to cardiovascular disease is approximately 10 to 100-fold higher than in the general population. Secondary HPT, a disorder which is characterized by abnormal parathyroid hormone, calcium and phosphorus levels, has emerged as one of several complications of CKD thought to contribute to high rates of CV events and death in the patient population receiving dialysis.
"The EVOLVE trial is one of the largest outcomes studies ever conducted in patients on dialysis, who are among our society's most chronically ill. Cardiovascular disease is unacceptably high among these patients, accounting for nearly half of all deaths. While EVOLVE did not meet its primary endpoint, the study provides important information related to the management of these patients," said Michael Severino, M.D., senior vice president of Global Development and corporate chief medical officer at Amgen.
The most frequently reported adverse events in the Sensipar/Mimpara arm of the trial were consistent with the known safety profile of this therapy and included nausea, vomiting and hypocalcemia. As reported in the primary manuscript, rates of serious adverse events were similar in both groups. There were 115 and 90 neoplastic events (25 and 23 fatal) in the Sensipar/Mimpara and placebo groups, respectively.
Sensipar/Mimpara is an oral calcimimetic agent approved for the treatment of secondary HPT in patients with CKD receiving dialysis.
EVOLVE Trial Design
The trial consisted of a 30-day screening phase, a titration phase with visits every two weeks, and a follow-up phase with visits every eight weeks. Following the screening phase, patients were randomized to the Sensipar/Mimpara or placebo groups. Possible sequential doses of Sensipar/Mimpara or placebo included 30, 60, 90, 120, and 180 mg. Flexible use of traditional therapies, such as vitamin D derivatives and phosphate binders, were permitted in both groups.
About Secondary Hyperparathyroidism
About Sensipar/Mimpara (cinacalcet)
Secondary HPT Indication
Important Safety Information
To see the full Sensipar Safety Information, visit http://www.sensipar.com.
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 healthcare cost containment as well as 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 relating to new indications for our products is preliminary and investigative and is not part of the labeling approved by the U.S. Food and Drug Administration (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.
CONTACT: Amgen, Thousand Oaks
SOA World Latest Stories
Subscribe to the World's Most Powerful Newsletters
Subscribe to Our Rss Feeds & Get Your SYS-CON News Live!
SYS-CON Featured Whitepapers
Most Read This Week