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Long-Term REMICADE Data Demonstrate Sustained Efficacy in Treatment of Active Psoriatic Arthritis; New Data Also Show Significant Improvement in Health-Related Quality-of-Life Measures in Patients with Psoriatic Arthritis.


VIENNA, Austria -- Two-year data presented today at the European League Against Rheumatism rheumatism (r`mətĭzəm), general term for a number of disorders that cause inflammation and pain in muscles, bones, joints, or nerves.  (EULAR) Annual European Congress of Rheumatology rheumatology /rheu·ma·tol·o·gy/ (-tol´ah-je) the branch of medicine dealing with rheumatic disorders, their causes, pathology, diagnosis, treatment, etc.

rheu·ma·tol·o·gy
n.
 show REMICADE(R) (infliximab) provides sustained improvement in the signs and symptoms of arthritis, psoriasis, dactylitis and enthesopathy in patients with active psoriatic arthritis Psoriatic Arthritis Definition

Psoriatic arthritis is a form of arthritic joint disease associated with the chronic skin scaling and fingernail changes seen in psoriasis.
. Additionally, data showing significant improvements in physical and mental quality-of-life measures in patients treated with REMICADE were presented. First approved in 1998, REMICADE has been used to treat over a half a million patients worldwide and is indicated for the treatment of Crohn's disease

Main article: Crohn's disease


The treatment of Crohn's disease is sequential: to treat acute disease, and then to maintain remission. Treatment initially involves the use of medications to treat any infection and to reduce inflammation.
, rheumatoid arthritis rheumatoid arthritis

Chronic, progressive autoimmune disease causing connective-tissue inflammation, mostly in synovial joints. It can occur at any age, is more common in women, and has an unpredictable course.
, ankylosing spondylitis Ankylosing Spondylitis Definition

Ankylosing spondylitis (AS) refers to inflammation of the joints in the spine. AS is also known as rheumatoid spondylitis or Marie-Strümpell disease (among other names).
 and psoriatic arthritis. REMICADE is the only tumor necrosis factor-alpha Tumor necrosis factor (TNF, cachexin or cachectin and formally known as tumor necrosis factor-alpha) is a cytokine involved in systemic inflammation and is a member of a group of cytokines that all stimulate the acute phase reaction.  (TNF-alpha) blocker approved to treat all four of these serious Immune-Mediated Inflammatory Disorders.

Findings from a 2-year, open-label extension of the Infliximab Multinational Psoriatic Arthritis Controlled Trial (IMPACT) showed that nearly 62 percent of REMICADE-treated patients (n=78) sustained at least 20 percent improvement in arthritis symptoms, according to the American College of Rheumatology scoring criteria (ACR See riser card.  20). Patients receiving REMICADE therapy also showed sustained improvement during year 2 in psoriasis symptoms. After 98 weeks of treatment, 64 percent of patients with a baseline Psoriasis Areas Severity Index (PASI PASI Psoriasis Area and Severity Index
PASI Public Authority for Social Insurance
PASI Pan American Studies Institute
PASI Professional Account Services Inc.
PASI Production, Availability, Shipments, Inventory
PASI Pioneer Air Systems, Inc.
) of at least 2.5 (n=25) achieved a PASI 75 response, representing significant and sustained improvement in skin disease. Moreover, patients maintained response in measures of dactylitis (swelling of the digits in the hands or feet) and enthesopathy (inflammation of a tendon or ligament insertion to the bone), two common disease manifestations estimated to affect more than one third of patients with psoriatic arthritis.

"These data illustrate that response to REMICADE is well maintained for up to two years in patients with psoriatic arthritis," said Arthur Kavanaugh, MD, Director, Center for Innovative Therapy, Division of Rheumatology, Allergy, and Immunology, University of California The University of California has a combined student body of more than 191,000 students, over 1,340,000 living alumni, and a combined systemwide and campus endowment of just over $7.3 billion (8th largest in the United States).  at San Diego. "Not only do patients rapidly experience improvements in joint and skin symptoms, but they experience improvements in dactylitis and enthesopathy."

Additional data were presented from the Infliximab Multinational Psoriatic Arthritis Clinical Trial 2 (IMPACT 2) showing the effect of REMICADE on health-related quality-of-life (HRQL HRQL Health-related quality of life. See Quality of life. ) in psoriatic arthritis patients. The impact of improvements in skin and joint components of the disease on HRQL were evaluated in a post-hoc analysis involving 200 patients 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.
 to receive infusions of REMICADE (5 mg/kg) or placebo at weeks 0, 2, 6, 14 and 22.

"Inflammatory diseases such as psoriatic arthritis can severely impact patients' abilities to function and lead normal, everyday lives," said Arthur Kavanaugh, MD. "These results demonstrate that treatment with infliximab provides a significant clinical benefit, which may lead to a positive effect on patients' physical and emotional well-being."

Study results revealed that REMICADE patients achieving both ACR 20 (58 percent vs. 11 percent of patients receiving placebo, P less than 0.001) and PASI 75 (64 percent vs. 2 percent of patients receiving placebo, P less than 0.001) demonstrated the greatest improvement in HRQL, as measured by Physical Component Summary (PCS (1) (Personal Communications Services) Refers to wireless services that emerged after the U.S. government auctioned commercial licenses in 1994 and 1995. This radio spectrum in the 1. ) and Mental Component Summary (MCS) according to the Short-form (SF-36) scoring system, and the Health Assessment Questionnaire Disability Index (HAQ HAQ Health Assessment Questionnaire
HAQ Harvard Asia Quarterly
). Baseline mean PCS (32) and MCS (46.2) scores were similar between treatment groups and were below the general U.S. population, indicating substantially impaired HRQL. At week 14, mean improvements in PCS (9.1 vs. 1.1, P less than 0.001), MCS (3.8 vs. -1.2, P = 0.001) and eight scales of SF-36 (P less than 0.01) and mean percent improvement in HAQ (48.6 percent vs. -18.4 percent, P less than 0.001) were significantly greater for patients receiving REMICADE therapy versus the placebo group.

In May 2005, REMICADE was approved in the U.S. for reducing signs and symptoms of active arthritis in patients with psoriatic arthritis. In September 2004, REMICADE received European Union approval, in combination with methotrexate methotrexate, drug used in halting the growth of actively proliferating tissues. Introduced in the 1950s, it is used in the treatment of leukemia, psoriasis, and non-Hodgkin's lymphoma. , for the treatment of active and progressive psoriatic arthritis in patients who have responded inadequately to disease-modifying anti-rheumatic drugs (DMARDs).

About IMPACT

IMPACT was a randomized, double-blind, placebo-controlled study that involved 104 patients with active psoriatic arthritis (defined as affecting at least five joints) who were enrolled at nine centers in the U.S., Canada and Europe. The trial was designed to study the efficacy and safety of REMICADE compared with placebo in patients with active psoriatic arthritis. Patients received either REMICADE (5 mg/kg) or placebo administered at weeks 0, 2, 6 and 14. The REMICADE group continued on maintenance treatments every 8 weeks. Beginning at week 16, patients randomized to the placebo group received an induction regimen of REMICADE followed by maintenance treatment every 8 weeks.

In year 2, patients received infusions of REMICADE every 8 weeks from week 54 to week 94, with final study assessments at week 98. The primary efficacy outcome was an improvement of at least 20 percent from baseline according to the American College of Rheumatology (ACR) criteria at week 98. The proportions of patients achieving ACR 50 and ACR 70 response were also determined. Additional predefined clinical efficacy assessments included PASI, the Disease Activity Score (DAS 28), the Health Assessment Questionnaire (HAQ), ratings of enthesopathy and dactylitis and the Psoriatic Arthritis Response Criteria (PsARC).

REMICADE was generally well tolerated in this study, with similar proportions of patients experiencing adverse events (AEs) in each group. No deaths, cases of tuberculosis or other opportunistic infections were reported and serious infections and infusion reactions were uncommon. Most common side effects in the placebo-controlled period were similar in both the placebo and REMICADE groups and included upper respiratory tract infection upper respiratory tract infection URI Infectious disease A nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx, and larynx, the prototypic URI is the common cold; flu/influenza is a systemic illness involving the URT , headache, bronchitis and influenza-like symptoms. Overall, there was a similar number of patients with serious AEs in the REMICADE and placebo treatment groups. Through year 1, the most common AEs included upper respiratory tract infection, nonproductive non·pro·duc·tive  
adj.
1. Not yielding or producing: nonproductive land.

2. Not engaged in the direct production of goods: nonproductive personnel.

n.
 cough, headache and influenza-like symptoms. The incidence and type of AEs observed in year 2 were similar to those observed during first year of treatment. Two patients had serious AEs relating to neoplasms, a benign mucinous mucinous /mu·ci·nous/ (mu´si-nus) resembling, or marked by formation of, mucin.

mucinous

relating to, resembling or containing mucin.
 abdominal cystoma and a ductal adenocarcinoma of the pancreas 3 months after week 98, both considered unrelated to study medication. See "Important Safety Information" below.

About IMPACT 2

IMPACT 2 was a Phase 3 randomized, double-blind, placebo-controlled study of 200 patients with active psoriatic arthritis (defined as affecting at least five joints). The study evaluated the safety and efficacy of REMICADE in patients who had an inadequate response to DMARDs or nonsteroidal anti-inflammatory drugs Nonsteroidal Anti-Inflammatory Drugs Definition

Nonsteroidal anti-inflammatory drugs are medicines that relieve pain, swelling, stiffness, and inflammation.
 (NSAIDs). Patients received REMICADE (5mg/kg) or placebo at weeks 0, 2, 6 and every 8 weeks until week 22. In patients with greater than or equal to 3 percent body surface area (BSA 1. BSA - Business Software Alliance.
2. BSA - Bidouilleurs Sans Argent.
) psoriasis involvement at baseline, psoriasis activity was assessed using PASI at baseline and weeks 2, 6, 14 and 24.

Through 24 weeks, a similar proportion of patients experienced AEs in each treatment group. No deaths, cases of tuberculosis or other opportunistic infections or serious infusion reactions were reported and serious infections were uncommon. Within 24 weeks of treatment one placebo-treated patient was diagnosed with basal cell carcinoma basal cell carcinoma
n.
A slow-growing, locally invasive, but rarely metastasizing neoplasm of the skin derived from basal cells of the epidermis or hair follicles. Also called basal cell epithelioma.
. During the continued treatment with REMICADE beyond week 24, one REMICADE patient was diagnosed with Hodgkin lymphoma. Laboratory abnormalities were uncommon, with an elevation in liver function tests Liver Function Tests Definition

Liver function tests, or LFTs, include tests for bilirubin, a breakdown product of hemoglobin, and ammonia, a protein byproduct that is normally converted into urea by the liver before being excreted by the kidneys.
 being the most common abnormality. There were more patients with serious AEs in the REMICADE group (8.7 percent) than in the placebo group (6.2 percent). See "Important Safety Information" below.

About Psoriatic Arthritis

Psoriatic arthritis involves joint pain and swelling that can lead to debilitation debilitation

being in a state of debility.
 coupled with inflamed, scaly scal·y
adj.
1. Covered or partially covered with scales.

2. Shedding scales or flakes; flaking.



scaly

skin condition characterized by scales; scalelike.
, red patches of psoriasis. Symptoms may include stiffness and tenderness of the joints and surrounding tissue, reduced range of motion, nail changes and redness and pain of the eye. Joints of the hands, wrists, knees, ankles, feet, lower back and neck are commonly affected. Approximately one million Americans have psoriatic arthritis, and the disease affects both men and women equally, most commonly between the ages of 30 and 50. According to the Arthritis Research Campaign Arthritis Research Campaign is a British medical research charity dedicated to curing arthritis. External links
  • Official site
, approximately 1 in 50 people have psoriasis in the United Kingdom and about 1 in 14 of these individuals will develop psoriatic arthritis.

About REMICADE

REMICADE is the global market leader among anti-tumor necrosis factor alpha (TNF-alpha) therapies and the only agent approved for the treatment of both rheumatoid arthritis (RA) and Crohn's disease (CD) in North America, the European Union (EU) and Japan. In the EU and in the U.S., REMICADE is approved for the treatment of active ankylosing spondylitis (AS) and psoriatic arthritis.

In the EU, REMICADE is indicated for the treatment of severe, active CD in patients who have not responded despite a full and adequate course of therapy with a corticosteroid corticosteroid /cor·ti·co·ster·oid/ (-ster´oid) any of the steroids elaborated by the adrenal cortex (excluding the sex hormones) or any synthetic equivalents; divided into two major groups, the glucocorticoids and  and an immunosuppressant immunosuppressant /im·mu·no·sup·pres·sant/ (-sah-pres´ant) an agent capable of suppressing immune responses.

im·mu·no·sup·pres·sant
n.
An agent that suppresses the body's immune response.
; or who are intolerant to or have medical contraindications for such therapies. REMICADE also is indicated for the treatment of fistulizing, active CD in patients who have not responded despite a full and adequate course of therapy with conventional treatment (including antibiotics, drainage and immunosuppressive therapy).

For RA patients in the EU, REMICADE, in combination with methotrexate, is indicated for the reduction of signs and symptoms as well as the improvement in physical function in patients with active disease when the response to disease-modifying drugs, including methotrexate, has been inadequate, and in patients with severe, active and progressive disease not previously treated with methotrexate or other DMARDs. In these patient populations, a reduction in the rate of the progression of joint damage, as measured by X-ray, has been demonstrated.

In the EU, REMICADE is also indicated for treatment of AS in patients who have severe axial symptoms, elevated serological serological

pertaining to or emanating from serology.


serological test
one involving examination of blood serum usually for antibody.
 markers of inflammatory activity and who have responded inadequately to conventional therapy.

In addition, REMICADE, in combination with methotrexate, is approved for the treatment of active and progressive psoriatic arthritis in patients who have responded inadequately to disease-modifying anti-rheumatic drugs.

In the U.S., REMICADE, in combination with methotrexate, is indicated for reducing signs and symptoms, inhibiting the progression of structural damage, and improving physical function in patients with moderately-to-severely active RA. REMICADE is the only biologic indicated for the treatment of patients with moderately-to-severely active CD who have had an inadequate response to conventional therapy. REMICADE is also indicated for reducing the number of draining enterocutaneous and rectovaginal fistulas and maintaining fistula fistula (fĭs`chlə), abnormal, usually ulcerous channellike formation between two internal organs or between an internal organ and the skin.  closure in patients with fistulizing CD. In December 2004, REMICADE was approved for the treatment of active AS and in May 2005, REMICADE was approved for reducing signs and symptoms of active arthritis in patients with psoriatic arthritis in the U.S.

REMICADE is unique among available anti-TNF biologic therapies. Unlike self-administered therapies that require patients to inject themselves frequently, REMICADE is the only anti-TNF biologic administered directly by caregivers in the clinic or office setting. In RA, CD, and psoriatic arthritis, REMICADE is a two-hour infusion administered every eight weeks, following a standard induction regimen that requires treatment at weeks 0, 2 and 6. As a result, REMICADE patients may require as few as six treatments each year. In AS, REMICADE is a two-hour infusion (5 mg/kg) administered every six weeks, following a standard induction regimen that requires treatment at weeks 0, 2 and 6. The safety and efficacy of REMICADE have been well established in clinical trials over the past 12 years and through commercial experience with over a half a million patients treated worldwide.

Important Safety Information

Many people with heart failure should not take REMICADE; so prior to treatment you should discuss any heart condition with your doctor. Tell your doctor right away if you develop new or worsening symptoms of heart failure (such as 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.
 or swelling of your ankles or feet).

There are reports of serious infections, including tuberculosis (TB), sepsis and pneumonia. Some of these infections have been fatal. Tell your doctor if you have had recent or past exposure to people with TB. Your doctor will evaluate you for TB and perform a skin test. If you have latent (inactive) TB, your doctor should begin TB treatment before you start REMICADE. REMICADE can lower your ability to fight infections, so if you are prone to or have a history of infections, or develop any signs of an infection such as fever, fatigue, cough, or the flu while taking REMICADE, tell your doctor right away. Also tell your doctor if you have lived in a region where histoplasmosis histoplasmosis: see fungal infection.  or coccidioidomycosis coccidioidomycosis (kŏksĭd'ēoi'dōmīkō`sĭs), systemic fungus disease (see fungal infection) endemic to arid regions of the Americas, contracted by inhaling dust containing spores of the fungus Coccidioides immitis.  is common.

There have been rare cases of serious liver injury in people taking REMICADE, some fatal. Contact your doctor immediately if you develop symptoms such as jaundice jaundice (jôn`dĭs, jän`–), abnormal condition in which the body fluids and tissues, particularly the skin and eyes, take on a yellowish color as a result of an excess of bilirubin.  (yellow skin and eyes), dark brown urine, right-sided abdominal pain, fever, or severe fatigue.

Blood disorders have been reported, some fatal. Tell your doctor if you develop possible signs of blood disorders such as persistent fever, bruising, bleeding, or paleness while taking REMICADE. Nervous system disorders Nervous system disorders

A satisfactory classification of diseases of the nervous system should include not only the type of reaction (congenital malformation, infection, trauma, neoplasm, vascular diseases, and degenerative, metabolic, toxic, or deficiency
 have also been reported. Tell your doctor if you have or have had a disease that affects the nervous system, or if you experience any numbness, weakness, tingling tin·gle  
v. tin·gled, tin·gling, tin·gles

v.intr.
1. To have a prickling, stinging sensation, as from cold, a sharp slap, or excitement: tingled all over with joy.
, or visual disturbances while taking REMICADE. Reports of lymphoma (a type of cancer) in patients on REMICADE and other TNF TNF
abbr.
tumor necrosis factor


TNF,
n an abbreviation for tumor
necrosis
f
 blockers are rare but occur more often than in the general population. Tell your doctor if you have or have had cancer.

Serious infusion reactions have been reported with REMICADE, including hives hives (urticaria), rash consisting of blotches or localized swellings (wheals) of the skin, caused by an allergic reaction (see allergy). The swelling is caused by distention of the skin capillaries and escape of serum and white cells into the skin and tissues. , difficulty breathing, and low blood pressure. Reactions have occurred during or after infusions. In clinical studies, some people experienced the following common side effects: respiratory infections (that may include sinus infections and sore throat), coughing, and stomach pain or mild reactions to infusion such as rash or itchy skin. Please read important information about REMICADE, including full U.S. prescribing information, at www.remicade.com. For complete REMICADE EU prescribing information, call Schering-Plough Corporation at +1 908-298-7616.

About Centocor

Centocor is a leading biopharmaceutical company that creates, acquires and markets cost-effective therapies that yield long-term benefits for patients and the healthcare community. The company is dedicated to the research and development of treatments for a wide range of diseases including cancer, infectious diseases, cardiovascular and metabolic diseases and Immune-Mediated Inflammatory Disorders (I.M.I.D.), such as arthritis and inflammatory skin diseases. Centocor's products, developed primarily through monoclonal antibody technology, help physicians deliver innovative treatments to improve human health and restore patients' quality of life. Centocor is a wholly owned subsidiary Wholly Owned Subsidiary

A subsidiary whose parent company owns 100% of its common stock.

Notes:
In other words, the parent company owns the company outright and there are no minority owners.
 of Johnson & Johnson, the worldwide manufacturer of healthcare products.

Centocor discovered REMICADE and has exclusive marketing rights to the product in the United States. Schering-Plough Corporation has rights to market REMICADE in all countries outside of the United States, except in Japan, China (including Hong Kong), Taiwan and Indonesia, where Tanabe Seiyaku, Ltd. markets the product.

About Schering-Plough

Schering-Plough is a global science-based health care company with leading prescription, consumer and animal health products. Through internal research and collaborations with partners, Schering-Plough discovers, develops, manufactures and markets advanced drug therapies to meet important medical needs. Schering-Plough's vision is to earn the trust of the physicians, patients and customers served by its more than 30,000 people around the world. The company is based in Kenilworth, N.J., and its Web site is http://www.schering-plough.com.

SCHERING-PLOUGH DISCLOSURE NOTICE: The information in this press release includes certain "forward-looking statements" within the meaning of the Securities Litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute.

When a person begins a civil lawsuit, the person enters into a process called litigation.
 Reform Act of 1995, including the company's strategy and the market for drugs to treat rheumatoid arthritis. Forward-looking statements relate to expectations or forecasts of future events and use words such as "will" and "plans." Actual results may vary materially from the forward-looking statements, and there are no guarantees about the performance of Schering-Plough stock or Schering-Plough's business. Schering-Plough does not assume the obligation to update any forward-looking statement. Many factors could cause actual results to differ from Schering-Plough's forward-looking statements. These factors include uncertainties of the regulatory approval and review process and difficulties in product development. For further details about these and other factors that may impact the forward-looking statements, see Schering-Plough's Securities and Exchange Commission filings, including the company's first quarter 2005 10-Q and the 2004 annual report on Form 10-K.
COPYRIGHT 2005 Business Wire
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2005, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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