|Amgen And UCB Report New Data At ENDO 2017 Examining The Option Of A Second Course Of Treatment With EVENITY™ (romosozumab)|
In the study, postmenopausal women with low bone mass (lumbar spine, total hip or femoral neck T score between -2.0 and -3.5) were initially randomized to various doses of EVENITY or placebo for 24 months and then re-randomized to receive denosumab (Prolia®) or placebo for the next 12 months (24 to 36 months), as previously reported. For months 36 to 48, all of these patients were then treated with EVENITY (210 mg) for 12 months.
In patients who initially received 210 mg of EVENITY followed by placebo and then a second course of EVENITY (n=19), the second course led to significant increases in bone mineral density (BMD) to an extent similar to the initial EVENITY treatment: lumbar spine (12.7 percent), total hip (5.8 percent) and femoral neck (6.3 percent) during months 36 to 48. In those patients who received a second course of EVENITY after denosumab, EVENITY further increased BMD by 2.8 percent at the lumbar spine, while maintaining BMD at the total hip and femoral neck.
"Since osteoporosis is a chronic condition, which may lead to debilitating fractures, the option of providing a second course of bone-building therapy may benefit some patients with severe osteoporosis," said
A similar adverse event (AE) profile was observed in the EVENITY groups, regardless of prior treatment group (placebo or denosumab). In patients treated with EVENITY for months 36 to 48, serious AEs were reported for five percent of patients who initially received EVENITY (n=7/140) and four percent who initially received placebo (n=1/27). The AEs reported by these patients for months 36 to 48 include hypersensitivity (7.4 percent, initial placebo; 7.9 percent, initial EVENITY), injection-site reactions (7.4 percent, initial placebo; 7.1 percent, initial EVENITY), malignancies (3.7 percent, initial placebo; 3.6 percent, initial EVENITY) and osteoarthritis (11.1 percent, initial placebo; 2.1 percent, initial EVENITY). There were no reports of osteonecrosis of the jaw or atypical femoral fracture.
In the same oral session,
The pivotal romosozumab Phase 3 studies have all been designed with patients receiving 12 months (single course) of romosozumab followed by treatment with an anti-resorptive therapy such as denosumab.
About EVENITY™* (romosozumab)
About Prolia® (denosumab)
Prolia® is indicated for treatment to increase bone mass in men with osteoporosis at high risk for fracture, defined as a history of osteoporotic fracture, or multiple risk factors for fracture; or patients who have failed or are intolerant to other available osteoporosis therapy.
Prolia® is indicated as a treatment to increase bone mass in men at high risk for fracture receiving androgen deprivation therapy for nonmetastatic prostate cancer. In these patients Prolia® also reduced the incidence of vertebral fractures.
Prolia® is indicated as a treatment to increase bone mass in women at high risk for fracture receiving adjuvant aromatase inhibitor therapy for breast cancer.
Important Safety Information (U.S.)
Same Active Ingredient
Osteonecrosis of the Jaw (ONJ)
For patients requiring invasive dental procedures, clinical judgment should guide the management plan of each patient. Patients who are suspected of having or who develop ONJ should receive care by a dentist or an oral surgeon. Extensive dental surgery to treat ONJ may exacerbate the condition. Discontinuation of Prolia® should be considered based on individual benefit-risk assessment.
Atypical Femoral Fractures
During Prolia® treatment, patients should be advised to report new or unusual thigh, hip, or groin pain. Any patient who presents with thigh or groin pain should be evaluated to rule out an incomplete femur fracture. Interruption of Prolia® therapy should be considered, pending a risk/benefit assessment, on an individual basis.
Multiple Vertebral Fractures (MVF) Following Discontinuation of Prolia® Treatment
Endocarditis was also reported more frequently in Prolia®-treated patients. The incidence of opportunistic infections and the overall incidence of infections were similar between the treatment groups. Advise patients to seek prompt medical attention if they develop signs or symptoms of severe infection, including cellulitis.
Patients on concomitant immunosuppressant agents or with impaired immune systems may be at increased risk for serious infections. In patients who develop serious infections while on Prolia®, prescribers should assess the need for continued Prolia® therapy.
Dermatologic Adverse Reactions
Suppression of Bone Turnover
In women with postmenopausal osteoporosis, the overall incidence of new malignancies was 4.3% in the placebo group and 4.8% in the Prolia® group. In men with osteoporosis, new malignancies were reported in no patients in the placebo group and 4 (3.3%) patients in the Prolia® group. A causal relationship to drug exposure has not been established.
The most common (per patient incidence ≥ 10%) adverse reactions reported with Prolia® in patients with bone loss receiving ADT for prostate cancer or adjuvant AI therapy for breast cancer are arthralgia and back pain. Pain in extremity and musculoskeletal pain have also been reported in clinical trials. Additionally, in Prolia®‐treated men with nonmetastatic prostate cancer receiving ADT, a greater incidence of cataracts was observed.
Denosumab is a human monoclonal antibody. As with all therapeutic proteins, there is potential for immunogenicity.
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Moreover, sales may be impacted by international and domestic trends toward managed care and health care cost containment and the reimbursement policies imposed by third-party payers as well as legislation affecting biopharmaceutical pricing and reimbursement.
CONTACT: UCB, Brussels
* The trade name EVENITY™ is provisionally approved for use by the
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