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New REMICADE Safety Data Presented at the American College of Gastroenterology Annual Meeting.


ORLANDO, Fla. -- Data from TREAT Patient Registry, Largest Registry of its Kind, Suggest Crohn's Disease Medications Were Not Associated with a Risk of Intestinal Stricture stricture /stric·ture/ (strik´chur) stenosis.

stric·ture
n.
A circumscribed narrowing of a hollow structure.
, Stenosis or Obstruction

Centocor announced today that safety data from a sub-analysis of the Crohn's Disease Therapy, Evaluation and Assessment Tool (TREAT) registry indicate that while severity and duration of disease were associated with the development or exacerbation of intestinal strictures, stenosis or obstruction, the use of REMICADE(R) (infliximab) and other Crohn's disease medications did not appear to contribute to this risk. The research results were presented today at the 69th American College of Gastroenterology The American College of Gastroenterology (ACG) is a Bethesda, Maryland-based medical association of gastroenterologists.

The association was founded in 1932 and holds annual meetings and regional postgraduate continuing education courses, establishes research grants,
 Annual Meeting and Postgraduate Course.

"These data help address the important question of whether the use of particular Crohn's disease medications increases a patient's risk of stricture. These results support what we know about the role of disease duration and severity in the development of strictures," said Gary R. Lichtenstein, MD, Professor of Medicine and Director, IBD IBD
abbr.
inflammatory bowel disease


Inflammatory bowel disease (IBD)
Disease in which the lining of the intestine becomes inflamed.

Mentioned in: Amebiasis


IBD

1.
 Center, University of Pennsylvania School of Medicine The University of Pennsylvania's School of Medicine, presently located in the University City section of Philadelphia, Pennsylvania, was the United States's first school of medicine, founded at the College of Philadelphia, as the University was then called. , and study author. "The benefit of REMICADE in 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.
 continues to be evident as we gather more important information for this and other Crohn's therapies from the TREAT patient registry," added Dr. Lichtenstein.

REMICADE, first approved for Crohn's disease in 1998, is used to treat patients with moderate-to-severe disease who have had an inadequate response to conventional therapies. The safety and efficacy of REMICADE have been well established in clinical trials over the past 12 years. REMICADE has been used to treat nearly 600,000 patients worldwide for autoimmune conditions such as rheumatoid arthritis (RA) and Crohn's disease (CD). REMICADE is a monoclonal antibody that specifically targets and binds to 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) on the cell membrane and in the blood. Overproduction o·ver·pro·duce  
tr.v. o·ver·pro·duced, o·ver·pro·duc·ing, o·ver·pro·duc·es
To produce in excess of need or demand.



o
 of TNF-alpha is believed to play a role in RA and CD and in a wide range of Immune-Mediated Inflammatory Disorders (I.M.I.D.) in which REMICADE is currently being studied.

About TREAT

As of February 2004, 6283 patients were enrolled in the TREAT registry with 4247 patient years (pt-yrs) of follow-up for those who received REMICADE (infliximab or IFX IFX - ["Type Reconstruction with First-Class Polymorphic Values", J. O'Toole et al, SIGPLAN Notices 24(7):207-217 (Jul 1989)]. ), and 3541 pt-yrs of follow-up for those who received treatments other than IFX. At enrollment, more IFX-treated patients had moderate-to-severe (33.9 percent vs 11.1 percent, p (less than) 0.0001) or severe-fulminant (2.9 percent vs 0.6 percent, p (less than) 0.0001) CD; more had been hospitalized (28.9 percent vs. 19.7 percent, p (less than) 0.0001) or undergone surgery (18.5 percent vs. 13.7 percent, p (less than) 0.0001) in the previous year; and more were taking corticosteroids Corticosteroids Definition

Corticosteroids are group of natural and synthetic analogues of the hormones secreted by the hypothalamic-anterior pituitary-adrenocortical (HPA) axis, more commonly referred to as the pituitary gland.
 (28.4 percent vs. 16.5 percent, p (less than) 0.0001), or immunomodulators (50.0 percent vs. 32.9 percent, p (less than) 0.0001).

A total of 93 strictures, stenosis or obstruction (SSO See single sign-on and CSO.

SSO - single sign-on
) events occurred in patients treated with infliximab, and 41 SSO events occurred in patients treated with other treatments (2.1 events per 100 pt-yrs vs 1.2; RR=1.89). The analysis suggested that moderate, severe or fulminant ful·mi·nant
adj.
Occurring suddenly, rapidly, and with great severity or intensity, usually of pain.



ful
 disease (RR=1.99, 95 percent CI 1.03-3.81, p (less than) 0.05), duration of CD (RR = 1.03, 95 percent CI 1.003-1.05, p (less than) 0.05) and ileal ileal /il·e·al/ (il´e-ahl) pertaining to the ileum.

il·e·al
adj.
Of or relating to the ileum.



ileal, ileac

pertaining to the ileum.
 disease (RR=1.87, 95 percent CI 1.15-3.03, p (less than) 0.05) were associated with SSO events, but not prior IFX therapy (RR 1.06, 95 percent CI 0.63-1.79, p=NS), immunomodulator use (RR= 1.40, 95 percent CI 0.81-2.42, p=NS), or corticosteroid use (RR=1.62, 95 percent CI 0.98-2.70, p=NS).

Intestinal stenosis and obstruction have been reported in clinical trials; patient follow-up in the TREAT registry is ongoing and will be the subject of future reports.

About Crohn's disease

CD is a chronic inflammatory bowel disorder that commonly affects the lower part of the small intestine and the large intestine and typically begins in late childhood or early adulthood. The disease causes inflammation of the gastrointestinal tract, typically resulting in symptoms such as diarrhea, fever, abdominal pain and weight loss. It is estimated that 500,000 Americans and more than 400,000 people in Europe and Canada suffer from this gastrointestinal disorder.

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 RA and CD in North America, the European Union and Japan, and was the first biologic approved for ankylosing spondylitis in the European Union. In the EU, REMICADE is indicated for the treatment of ankylosing spondylitis 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 September, the European Commission gave approval for expanded labeling for REMICADE, 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 Disease Modifying Anti-Rheumatic Drugs (DMARDs)
A class of antirheumatic drugs, including chloroquine, methotrexate, cyclosporine, and gold compounds, that influence the disease process itself and do not only treat its symptoms.

Mentioned in: Antirheumatic Drugs
.

REMICADE is the only biologic indicated for the treatment of patients with moderately-to-severely active Crohn's disease 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 Crohn's disease.

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 and CD patients, 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.

Important 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) and sepsis. 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. 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, 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, 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 accompanying patient information sheet).

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 and parts of the Far East where Tanabe Seiyaku, Ltd. markets the product.
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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Publication:Business Wire
Date:Nov 2, 2004
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