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Gilead Announces Presentation of Long-Term Data for Ambrisentan, a Potential Treatment for Patients With Pulmonary Arterial Hypertension.


Data From Two Long-term Studies Presented at the International Conference of the American Thoracic Society American Thoracic Society (ATS ), established in 1905, is an independently incorporated, international, educational and scientific society, serving its 18,000 members world-wide who are dedicated in respiratory and critical care medicine.  

SAN FRANCISCO -- Gilead Sciences, Inc. (Nasdaq:GILD) today announced results of two long-term studies evaluating ambrisentan, an investigational endothelin receptor antagonist A endothelin receptor antagonist (ERA) is a drug which blocks endothelin receptors.

Two main kinds of ERAs exist:
  • selective ERA (e.g. sitaxsentan), which affect endothelin A.
  • dual ERAs,(e.g. bosentan) which affect both endothelin A and B .
 (ERA) for the treatment of patients with pulmonary arterial hypertension (PAH). These long-term data are from patients who originally participated in the two pivotal Phase III ARIES Aries (âr`ēz) [Lat.,=the ram], constellation lying on the ecliptic (the sun's apparent path through the heavens) between Taurus and Pisces; it is one of the constellations of the zodiac. It contains the bright star Hamal (Alpha Arietis).  studies and AMB-222, a Phase II study of patients who had previously discontinued other ERAs because of liver function abnormalities. These studies were selected for oral presentation at ATS 2007, the International Conference of the American Thoracic Society, taking place in San Francisco, California “San Francisco” redirects here. For other uses, see San Francisco (disambiguation).

The City and County of San Francisco (EN IPA: [sænfrənˈsɪskoʊ] 
, May 18-23.

"Pulmonary arterial hypertension is a progressive, life-threatening disease for which new therapies are clearly needed," said Ronald J. Oudiz, MD, Associate Professor of Medicine, UCLA School of Medicine and Director, Liu Center for Pulmonary Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center Harbor-UCLA Medical Center is a hospital located within the city of Torrance, California, USA. The hospital was founded in 1946, and is funded by Los Angeles County

Harbor-UCLA serves as the Level I Trauma Center for the South Bay area.
. "The long-term clinical profile observed in these ambrisentan studies is very encouraging."

About the Studies

In the first presentation (Abstract #2307), Dr. Oudiz presented results from an integrated analysis of an ongoing, long-term extension study (ARIES-E) involving patients from the two 12-week Phase III placebo-controlled studies (ARIES-1 and ARIES-2). A total of 383 patients with idiopathic PAH or PAH associated with connective tissue disease connective tissue disease Autoimmune disease, collagen-vascular disease Any of the diseases affecting connective tissues, with an autoimmune component, and immunologic/inflammatory defects Clinical Arthritis, connective tissue defects, endocarditis, myositis, , HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States.  infection, or anorexigen use who received at least one dose of ambrisentan (2.5, 5 or 10 mg once-daily) in ARIES-1, ARIES-2 or ARIES-E were included in the integrated analysis, which reflect data available as of February 2006 (mean exposure = 39 weeks; maximum exposure = 109 weeks).

Improvements in the non placebo-corrected 6-minute walk distance observed during the first 12 weeks of ambrisentan treatment (+37.7 meters) were sustained for at least 48 weeks (+36.4 meters). Improvements in WHO functional class and Borg dyspnea index were also maintained with long-term ambrisentan treatment. In addition, the one-year probability of survival was 95 percent for patients receiving ambrisentan.

Ambrisentan adverse events were similar in nature to those reported in the previous 12-week placebo-controlled studies. The most common adverse event was peripheral edema which was generally reported to be mild or moderate and did not lead to discontinuation of ambrisentan.

As of October 2006 (mean exposure = 1.4 years; maximum exposure = 2.8 years), 2.1 percent of patients developed liver enzyme (aminotransferase) elevations greater than three times the upper limit of normal, which was similar to the incidence observed for the placebo groups (2.3 percent) in the 12-week ARIES-1 and ARIES-2 studies. One patient required discontinuation of ambrisentan due to liver enzyme abnormalities.

Long-term results from the AMB-222 study (Abstract #2171) were presented by Michael McGoon, MD, Professor of Medicine, Mayo Clinic, Rochester, Minnesota. This open-label study evaluated 36 patients who had previously discontinued the ERAs bosentan (86 percent), sitaxsentan (6 percent), or both (8 percent) due to the development of liver function abnormalities. In this study, patients with idiopathic PAH or PAH associated with connective tissue disease, congenital heart defects Congenital heart defects
Congenital means conditions which are present at birth. Congenital heart disease includes a variety of defects that babies are born with.

Mentioned in: Heart Failure, Heart Surgery for Congenital Defects
, HIV infection, or anorexigen use received once-daily doses of ambrisentan -- 2.5 mg/day for four weeks, 5 mg/day for 20 weeks, and 2.5, 5 or 10 mg/day thereafter -- for up to 18 months. Twenty-five of the 36 patients enrolled were also receiving concomitant sildenafil sildenafil /sil·den·a·fil/ (sil-den´ah-fil?) a phosphodiesterase inhibitor that relaxes the smooth muscle of the penis, facilitating blood flow to the corpus cavernosum; used as the citrate salt to treat erectile dysfunction.  and/or prostanoid treatment. The primary endpoint of the study was the incidence of liver function abnormalities during 12 weeks of therapy that resulted in discontinuation of drug.

No patients had liver function abnormalities that required discontinuation of ambrisentan during the 12-week primary endpoint period. Of the 36 patients evaluated, two patients discontinued due to adverse events not related to liver toxicity. As of October 2006 (mean exposure = 1.1 years, maximum duration 1.4 years), one patient had developed a transient liver function abnormality that was greater than three times the upper limit of normal and this patient continued receiving treatment with ambrisentan. The long-term adverse event profile appeared similar to results from previous ambrisentan clinical studies and included peripheral edema, headache, dyspnea and flushing.

"Endothelin receptor antagonism has well-established clinical benefits in patients with PAH, but liver toxicity, which frequently leads to discontinuation of treatment, has limited the usefulness of these drugs in some patients," said Dr. McGoon. "The results of this study support the potential of ambrisentan in newly diagnosed patients with PAH, as well as patients who have failed other ERA therapies due to liver function abnormalities."

"PAH is a chronic disease and, as such, we recognize the importance of evaluating the long-term efficacy and safety profile of ambrisentan," said Michael J. Gerber, MD, Senior Vice President, Clinical Research at Gilead. "We will continue to work with the clinical investigators and follow patients from each of these studies so we can better understand the benefits and risks of ambrisentan with long-term treatment."

In addition to these long-term ambrisentan data presentations, two posters describing an integrated analysis of 12-week ARIES-1 and ARIES-2 data are also being presented at ATS. The first poster (Abstract #3192) titled "Ambrisentan Therapy for Pulmonary Arterial Hypertension: An Integrated Analysis of the ARIES-1 and ARIES-2 Studies" was presented today by Nazzareno Gali[c], MD, Professor of Cardiology at the University of Bologna Nowadays, the University counts about 100,000 students in its 23 faculties. It has branch centers in Reggio nell'Emilia, Imola, Ravenna, Forlì, Cesena and Rimini and a branch center abroad in Buenos Aires.  in Bologna, Italy. The second poster (Abstract #2873) titled "Ambrisentan Improves Exercise Capacity and Dyspnea in WHO Functional Class II and Class III Patients with Pulmonary Arterial Hypertension" will be presented on Wednesday, May 23 by Horst Olschewski, MD, Professor of Medicine in the Division of Pulmonology pul·mo·nol·o·gy
n.
The branch of medicine that deals with diseases of the respiratory system.


pulmonology The study of the lungs and respiratory function
 at the Medical University of Graz The Medical University of Graz is a university in Graz, Austria. History
The faculty of medicine at the Karl-Franzens-University in Graz was established in 1863 by Franz Joseph I.. In 2004 the former faculty became an independent university.
 in Graz, Austria.

About Ambrisentan

Ambrisentan is a non-sulfonamide, propanoic acid-class, endothelin receptor antagonist that is selective for the endothelin type-A (ETA) receptor. Activation of the ETA receptor by endothelin, a small peptide hormone, leads to vasoconstriction vasoconstriction /vaso·con·stric·tion/ (-kon-strik´shun) decrease in the caliber of blood vessels.vasoconstric´tive

va·so·con·stric·tion
n.
 (narrowing of blood vessels) and cell proliferation. PAH is associated with elevated endothelin blood levels. Ambrisentan has been granted orphan drug designation for the treatment of PAH in both the United States and European Union.

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.
) recently accepted for filing and granted a Priority Review for Gilead's New Drug Application (NDA (Non Disclosure Agreement) An agreement signed between two parties that have to disclose confidential information to each other in order to do business. In general, the NDA states why the information is being divulged and stipulates that it cannot be used for any ) for marketing approval of ambrisentan (5 mg and 10 mg) for the once-daily treatment of PAH. The FDA has established a target review date, under the Prescription Drug User Fee Act The Prescription Drug User Fee Act (PDUFA) was a law passed by the United States Congress in 1992 which allowed the Food and Drug Administration (FDA) to collect fees from drug manufacturers to fund the new drug approval process.  (PDUFA PDUFA Prescription Drug User Fee Act of 1992 (USA) ), of June 18, 2007.

As an investigational compound, ambrisentan has not yet been determined safe or efficacious in humans.

GlaxoSmithKline holds rights to commercialize ambrisentan for PAH in territories outside of the United States. A Marketing Authorisation Application (MAA MAA
abbr.
macroaggregated albumin
) for ambrisentan was filed with the European Medicines Agency The European Medicines Agency (EMEA) is a European agency for the evaluation of medicinal products. Until 2004, the European Medicines Agency was known as The European Agency for the Evaluation of Medicinal Products.

Roughly parallel to the U.S.
 (EMEA) earlier this year.

About Pulmonary Arterial Hypertension

PAH is a debilitating de·bil·i·tat·ing
adj.
Causing a loss of strength or energy.


Debilitating
Weakening, or reducing the strength of.

Mentioned in: Stress Reduction
 disease characterized by constriction of the blood vessels in the lungs leading to high pulmonary arterial pressures. These high pressures make it difficult for the heart to pump blood through the lungs to be oxygenated. Patients with PAH suffer from shortness of breath Shortness of Breath Definition

Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity.
 as the heart struggles to pump against these high pressures, causing such patients to ultimately die of heart failure. PAH can occur with no known underlying cause, or it can occur secondary to diseases such as connective tissue disease, congenital heart defects, cirrhosis of the liver Cirrhosis of the liver
A type of liver disease, most often caused by chronic alcohol abuse. It is characterized by scarring of the liver, which leads to an increase in the blood pressure in the portal veins.

Mentioned in: Bleeding Varices
 and HIV infection. PAH afflicts approximately 200,000 patients worldwide.

About Gilead Sciences

Gilead Sciences is a biopharmaceutical company that discovers, develops and commercializes innovative therapeutics in areas of unmet medical need. The company's mission is to advance the care of patients suffering from life-threatening diseases worldwide. Headquartered in Foster City, California
This article is about the town in California. For the unincorporated community in Michigan, see Breen Township, Michigan.
Foster City is an affluent planned city located in San Mateo County, California.
, Gilead has operations in North America, Europe and Australia. For more information on Gilead Sciences, please visit the company's website at www.gilead.com or call Gilead Public Affairs at 1-800-GILEAD-5 or 1-650-574-3000.

This press release includes forward-looking statements, within the meaning of the Private Securities Litigation Reform Act The Private Securities Litigation Reform Act of 1995 (PSLRA) implemented several significant substantive changes affecting certain cases brought under the federal securities laws, including changes related to pleading, discovery, liability, class representation and awards fees and  of 1995, that are subject to risks, uncertainties and other factors, including risks related to Gilead's ability to successfully commercialize ambrisentan for PAH. For example, the FDA may not approve ambrisentan for the treatment of PAH in the United States, and marketing approval, if granted, may have significant limitations on its use. In addition, future discussions with the FDA may impact the amount of data needed and timelines for review, which may differ materially from Gilead's current projections. Further, safety and efficacy data from additional clinical studies may not warrant further development of this compound and completing our clinical studies may take longer or cost more than expected. These risks, uncertainties and other factors could cause actual results to differ materially from those referred to in the forward-looking statements. The reader is cautioned not to rely on these forward-looking statements. These and other risks are described in detail in Gilead's Annual Report on Form 10-K for the year ended December 31, 2006 and its Report on Form 10-Q for the first quarter of 2007, filed with the U.S. Securities and Exchange Commission. All forward-looking statements are based on information currently available to Gilead, and Gilead assumes no obligation to update any such forward-looking statements.
COPYRIGHT 2007 Business Wire
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2007, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Publication:Business Wire
Article Type:Clinical report
Date:May 21, 2007
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