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Amgen Launches Landmark Trial to Evaluate the Impact of Treating Anemia on Cardiovascular Risks in Patients with Chronic Kidney Disease and Type 2 Diabetes.


ST. LOUIS -- Sensipar(R) (cinacalcet HCl) Data Also Presented at American Society of Nephrology nephrology

Branch of medicine dealing with kidney function and diseases. An understanding of kidney physiology is important not only in treating kidney disease but in knowing the effect of drugs, diet, and hypertension on kidney disease, and vice versa.
 Meeting Underscores Amgen's Commitment to Chronic Kidney Disease Chronic kidney disease (CKD), also know as chronic renal disease, is a progressive loss of renal function over a period of months or years through five stages. Each stage is a progression through an abnormally low and progressively worse glomerular filtration rate, which is  Patients with Secondary Hyperparathyroidism secondary hyperparathyroidism Endocrinology ↑ Parathyroid activity with overproduction of PTH due to parathyroid hyperplasia in response to an extraparathyroid defect that results in ↓ Ca2+ Etiology Rickets, vitamin D deficiency, chronic renal failure  

Amgen Inc. (Nasdaq:AMGN), the world's largest biotechnology company, today announced that the company has initiated a landmark trial to evaluate the impact of treating anemia on cardiovascular outcomes in patients with chronic kidney disease (CKD See count-key-data. ) and type 2 diabetes type 2 diabetes
n.
See diabetes mellitus.
. TREAT (Trial to Reduce cardiovascular Events with Aranesp(R) (darbepoetin alfa darbepoetin alfa

Aranesp

Pharmacologic class: Recombinant human erythropoietin

Therapeutic class: Hematopoietic

Pregnancy risk category C

FDA Boxed Warning

) Therapy) is one of the largest clinical trials in the company's 25-year history. The TREAT study design as well as additional Sensipar(R) data was presented at the American Society of Nephrology (ASN (1) (Autonomous System Number) A unique identifier of an autonomous system on the Internet. Of the 65 thousand ASNs available, more than 30 thousand have been assigned to ISPs and NSPs. ISPs usually have only one ASN, but NSPs may have more than one. ) annual meeting in St. Louis.

"Current research suggests that anemia is an augmenter of cardiovascular risk in individuals with CKD and type 2 diabetes," said TREAT lead investigator Marc Pfeffer, M.D., Ph.D., chief of medicine at Brigham and Women's Hospital Brigham and Women's Hospital (BWH) is a hospital in the Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill. With Massachusetts General Hospital, it is one of the two founding members of Partners HealthCare.  and a professor at Harvard Medical School Harvard Medical School (HMS) is one of the graduate schools of Harvard University. It is a prestigious American medical school located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts. . "TREAT will be the definitive study to determine if treating anemia with Aranesp does, in fact, lower the risk of death and non-fatal cardiovascular events in individuals with CKD and type 2 diabetes."

TREAT is an international 4,000 patient, multicenter, randomized ran·dom·ize  
tr.v. ran·dom·ized, ran·dom·iz·ing, ran·dom·iz·es
To make random in arrangement, especially in order to control the variables in an experiment.
, double-blind, placebo-controlled trial. The primary endpoint of TREAT is a composite index of time to mortality or non-fatal cardiovascular event, including myocardial infarction, myocardial ischemia, stroke and heart failure.

Anemia is a common complication of CKD and becomes more common as kidney function declines. Aranesp has been shown to be effective in correcting anemia with less frequent dosing than other treatments. In TREAT, patients will receive Aranesp once monthly, which is the same dosing approved by the European Committee for Medicinal Products for Human Use “CHMP” redirects here. For French language Canadian radio station, see CHMP-FM.

CPMP, Committee for Proprietary Medicinal Products, now CHMP Committee for Medicinal Products for Human Use
 (CHMP CHMP Committee for Medicinal Products for Human Use
CHMP Cultural Heritage Management Plan
CHMP Centrale Humanitaire Médico-Pharmaceutique
CHMP Certified Hazardous Materials Practitioner (Institute of Hazardous Materials Managers) 
) in August 2004. In the U.S., Aranesp is approved to be administered once a week if a patient was receiving Epoetin alfa two to three times weekly. Aranesp should be administered once every two weeks if a patient was receiving Epoetin alfa once per week.

"The work surrounding the initiation of TREAT and the continued studies for Sensipar demonstrate Amgen's commitment to treating grievous illnesses and improving the lives of patients with chronic kidney disease," said Beth Seidenberg, M.D., chief medical officer and senior vice president of global development at Amgen.

Sensipar for the Treatment of Secondary Hyperparathyroidism (HPT HPT Human Performance Technology
HPT Hyperparathyroidism
HPT Heartland Poker Tour
HPT Home Pregnancy Test
HPT High Pressure Turbine
HPT Host Print Transform
HPT High-Performance Team
HPT high-payoff target (US DoD) 
)

in CKD Patients on Dialysis

Additional study results presented at ASN collectively confirm that Sensipar enables significantly more patients to achieve the four key National Kidney Foundation Not to be confused with American Kidney Fund.

The National Kidney Foundation, Inc. (NKF) is a major voluntary health organization in the United States. Its mission is to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and
 Kidney Disease Outcomes Quality Initiative (K/DOQI K/DOQI Kidney Disease Outcomes Quality Initiative ) bone metabolism and disease goals independent of vitamin D dose. Sensipar data from 210 patients in the phase 3 studies demonstrated that Sensipar sustained reductions in parathyroid hormone (PTH PTH
abbr.
parathyroid hormone


Parathyroid hormone (PTH)
A chemical substance produced by the parathyroid glands. This hormone is a major element in regulating calcium in the body.
) and calcium-phosphorus product out to one year of treatment. In two additional phase 3b studies where vitamin D doses were reduced, Sensipar enabled significantly more patients to achieve the K/DOQI targets for PTH and calcium-phosphorus product as compared to the baseline values. In one 3b study, Sensipar was highly effective in controlling PTH while simultaneously lowering calcium-phosphorus product in patients who were within the K/DOQI target range for PTH but above the range for calcium-phosphorus product.

"The one-year study results further confirm that Sensipar effectively lowers PTH and the calcium-phosphorus product offering dialysis patients the benefit of long-term control of secondary HPT," said David Bushinsky, M.D., study investigator, University of Rochester The University of Rochester (UR) is a private, coeducational and nonsectarian research university located in Rochester, New York. The university is one of 62 elected members of the Association of American Universities. . "The additional clinical trials emphasize that Sensipar simultaneously controls the four key parameters, PTH, calcium-phosphorus product, calcium and phosphorus, of secondary HPT and is efficacious with small doses of vitamin D."

Prior to the approval of Sensipar, the only available medical treatments for patients with secondary HPT were phosphate binders and vitamin D sterols sterols (ster´ôlz),
n.pl steroids having one or more hydroxyl groups and no carbonyl or carboxyl groups (e.g., cholesterol).
, which may elevate calcium levels. As a consequence, treatment is frequently interrupted, resulting in inadequate control of PTH. Sensipar provides targeted treatment of secondary HPT with its unique mechanism of action that acts directly on the calcium-sensing receptor, the primary regulator of PTH.

Secondary HPT is characterized by elevations in PTH, calcium and phosphorus levels. If left untreated, patients with secondary HPT can develop bone disease, bone pain and fractures, vascular and soft tissue calcifications, which are frequently associated with an increased risk of hospitalization and death. According to Dr. Bushinsky, "we expect that achieving the K/DOQI targets will be associated with better clinical outcomes."

On October 26, the European Medicines Evaluation Agency approved marketing authorization in the European Union (EU) following a positive opinion issued in July from the CHMP. The drug will be marketed as Mimpara(R) (cinacalcet) in the EU.

About Aranesp

Aranesp(R) is a recombinant erythropoietic Erythropoietic
Referring to the creation of new red blood cells.

Mentioned in: Porphyrias


erythropoietic

emanating from or pertaining to erythropoiesis.
 protein (a protein that stimulates production of oxygen-carrying red blood cells Red blood cells
Cells that carry hemoglobin (the molecule that transports oxygen) and help remove wastes from tissues throughout the body.

Mentioned in: Bone Marrow Transplantation

red blood cells 
). Amgen revolutionized anemia treatment with the discovery of recombinant erythropoietin erythropoietin /eryth·ro·poi·e·tin/ (-poi´e-tin) a glycoprotein hormone secreted by the kidney in the adult and by the liver in the fetus, which acts on stem cells of the bone marrow to stimulate red blood cell production , epoetin alfa, which is currently marketed in the U.S. by Amgen as EPOGEN(R) (Epoetin alfa)(i) and by Ortho Biotech Products, LP, as Procrit(R) (Epoetin alfa)(ii). Building on this heritage, Amgen developed Aranesp, which contains two additional sialic acid-containing carbohydrate chains than the Epoetin alfa molecule, resulting in more activity, with the added benefit of less-frequent administration.

Aranesp was approved by the U.S. Food and Drug Administration (FDA FDA
abbr.
Food and Drug Administration


FDA,
n.pr See Food and Drug Administration.

FDA,
n.pr the abbreviation for the Food and Drug Administration.
) in September 2001 for the treatment of anemia associated with chronic renal failure chronic renal failure Chronic kidney failure Nephrology A slow decline in renal function, which may be 2º to chronic HTN, DM, CHF, SLE, or sickle cell anemia and, if extreme, leads to ESRD, mandating kidney dialysis; an abrupt decline in renal function may be , also known as CKD, for patients on dialysis and patients not on dialysis. In July 2002, Aranesp was approved by the FDA for the treatment of chemotherapy-induced anemia in patients with nonmyeloid malignancies.

Aranesp is contraindicated in patients with uncontrolled hypertension. Erythropoietic therapies may increase the risk of thrombotic and other serious events; dose reductions are recommended if the hemoglobin increase exceeds 1.0 g/dL in any two-week period. The most commonly reported side effects in Aranesp(R) trials were fatigue, edema edema (ĭdē`mə), abnormal accumulation of fluid in the body tissues or in the body cavities causing swelling or distention of the affected parts. , nausea, vomiting, diarrhea, fever and dyspnea dyspnea /dysp·nea/ (disp-ne´ah) labored or difficult breathing.dyspne´ic

paroxysmal nocturnal dyspnea
.

About Sensipar

Sensipar is an innovative, first-in-class oral calcimimetic indicated for the treatment of secondary HPT in CKD patients on dialysis, and for the treatment of elevated calcium levels (hypercalcemia Hypercalcemia Definition

Hypercalcemia is an abnormally high level of calcium in the blood, usually more than 10.5 milligrams per deciliter of blood.
) in patients with parathyroid parathyroid /par·a·thy·roid/ (-thi´roid)
1. situated beside the thyroid gland.

2. see under gland.


par·a·thy·roid
adj.
1.
 carcinoma. On March 8, 2004, after a priority review, Sensipar was approved for marketing by the U.S. Food and Drug Administration.

In clinical trials in patients with secondary HPT on dialysis, Sensipar was safe and effective in reducing PTH, calcium-phosphorus product, calcium and phosphorus in a broad range of patients regardless of age, gender, race, years on dialysis or disease severity. Sensipar was effective in patients receiving vitamin D, as well as those not receiving vitamin D.

In a clinical trial in patients with hypercalcemia due to parathyroid carcinoma, Sensipar lowered calcium levels.

Sensipar is safe and well-tolerated in a broad range of patients. Sensipar lowers serum calcium. Significant reductions in calcium may lower the threshold for seizures. Secondary HPT patients, particularly those with a history of a seizure disorder, should be carefully monitored for the occurrence of low serum calcium or symptoms of hypocalcemia Hypocalcemia Definition

Hypocalcemia, a low bood calcium level, occurs when the concentration of free calcium ions in the blood falls below 4.0 mg/dL (dL = one tenth of a liter). The normal concentration of free calcium ions in the blood serum is 4.0-6.
. The most commonly reported side effects were nausea and vomiting Nausea and Vomiting Definition

Nausea is the sensation of being about to vomit. Vomiting, or emesis, is the expelling of undigested food through the mouth.
.

Amgen licensed Sensipar from NPS NPS National Park Service
NPS Naval Postgraduate School
NPS Net Promoter Score (customer management)
NPS Non-Point Source pollution
NPS Native Plant Society
NPS Norfolk Public Schools (Virginia) 
 Pharmaceuticals Inc. in 1996. Amgen has applied for regulatory approval in Australia and New Zealand. Approval has been granted in Canada.

About Amgen

Amgen is a global biotechnology company that discovers, develops, manufactures and markets important human therapeutics based on advances in cellular and molecular biology.

Forward-Looking Statements

This news release contains forward-looking statements that involve significant risks and uncertainties, including those discussed below and others that can be found in Amgen's Form 10-K for the year ended December 31, 2003, and in Amgen's periodic reports on Form 10-Q and Form 8-K. Amgen is providing this information as of the date of this news release and does not undertake any obligation to update any forward-looking statements contained in this document as a result of new information, future events or otherwise.

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 side effects or manufacturing problems with our products after they are on the market. In addition, sales of our products are affected by the availability of reimbursement and the reimbursement policies imposed by third party payors, including governments, private insurance plans and managed care providers, and may be affected by domestic and international trends toward managed care and healthcare cost containment as well as possible U.S. legislation affecting pharmaceutical pricing and reimbursement. Government 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 it 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 im·pli·cate  
tr.v. im·pli·cat·ed, im·pli·cat·ing, im·pli·cates
1. To involve or connect intimately or incriminatingly: evidence that implicates others in the plot.

2.
 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 related to our product candidates is preliminary and investigative. Such product candidates are not approved by the U.S. Food and Drug Administration (FDA), and no conclusions can or should be drawn regarding the safety or effectiveness of the product candidates. Only the FDA can determine whether the product candidates are safe and effective for the use(s) being investigated.

Further, 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.

Note: Copies of the study abstracts are available upon request. Full prescribing information is available on the Web for Aranesp(R) at www.aranesp.com and for Sensipar(R) at www.sensipar.com.

EDITOR'S NOTE: An electronic version of this news release may be accessed via our Web site at www.amgen.com. Journalists and media representatives may sign up to receive all news releases electronically at time of announcement by filling out a short form in the Media section of the Web site.

(i)EPOGEN(R) is a registered trademark of Amgen Inc.

(ii)Procrit(R) is a registered trademark of Ortho Biotech Products, L.P.
COPYRIGHT 2004 Business Wire
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2004, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Geographic Code:1USA
Date:Nov 1, 2004
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