REMICADE(R) Phase 3 Data Show Rapid and Significant Improvement and Long-Term Response in the Treatment of Moderate to Severe Psoriasis; Findings from Two Phase 3 Studies Show High-Level, Sustained Response with Maintenance Therapy.SAN FRANCISCO -- Phase 3 data show treatment with REMICADE(R) (infliximab) resulted in rapid, significant improvement and long-term response in patients with moderate to severe plaque psoriasis. Findings from the EXPRESS II trial, a placebo-controlled, dose-ranging study of REMICADE 3 mg/kg and 5 mg/kg, showed that every eight week maintenance therapy resulted in greater long-term skin clearance compared with "as-needed" therapy regimens within each dose. At week 10, after infusions at weeks 0, 2 and 6, 70 percent of patients treated with REMICADE 3 mg/kg and 75 percent of patients receiving 5 mg/kg achieved at least 75 percent improvement in psoriasis as measured by Psoriasis Area 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. 75), compared with two percent of patients receiving placebo (P less than 0.001). At week 50, patients receiving REMICADE 5 mg/kg every eight-week maintenance therapy achieved the highest level of sustained PASI improvement with the majority of the patients achieving PASI 75 versus the REMICADE 3 mg/kg eight-week maintenance therapy and the REMICADE 3 mg/kg and 5 mg/kg "as-needed" therapy regimens. Results from EXPRESS II and the previous Phase 3 EXPRESS study were presented today at the 64th annual American Academy of Dermatology The American Academy of Dermatology (AAD) is the largest organization of dermatologists in the world. The Academy grants Fellowships and Associate Memberships, as well as Fellowships for Nonresidents (of the United States of America or Canada). meeting. "We now have data showing that the majority of patients receiving scheduled REMICADE maintenance therapy achieved long-term clinical response in psoriasis, a lifelong, chronic inflammatory disease," said Alan Menter, MD, chairman, Division of Dermatology, Baylor University Medical Center Baylor University Medical Center (BUMC) is located at 3500 Gaston Avenue in east Dallas, Texas (USA). Its medical services are often listed in the annual U.S. News & World Report compilation of Best Hospitals. , and lead study investigator. "These findings support previous clinical results and show that patients treated with REMICADE achieved rapid and marked improvement in the moderate to severe category of psoriasis, which impacts the lives of nearly two million Americans." Consistency of response of REMICADE 5 mg/kg maintenance therapy: Data from EXPRESS and EXPRESS II In order to evaluate the consistency of response across both Phase 3 studies, data was analyzed from the REMICADE 5 mg/kg every eight week maintenance arm of each trial, the only regimen common to both EXPRESS and EXPRESS II. At week 10, after infusions at weeks 0, 2, and 6, the proportions of patients achieving PASI 75 were 80 percent versus three percent of placebo patients for EXPRESS and 75 percent versus two percent of placebo patients for EXPRESS II, (both P less than 0.001 versus placebo). At week 10, the proportions of patients achieving PASI 90, or nearly complete skin clearance, were 57 percent versus one percent of placebo patients for EXPRESS and 45 percent versus 0.5 percent of placebo patients for EXPRESS II, (both P less than 0.001 versus placebo). PASI 75 responses achieved at week 10 were maintained through week 26 in both EXPRESS and EXPRESS II (81 percent and 78 percent of patients achieved at least PASI 75 improvement from baseline, respectively), and the majority of patients achieved PASI 75 at week 50 in the REMICADE 5 mg/kg every eight-week maintenance groups. "These data show great potential for REMICADE in the treatment of a disease that often carries great physical and emotional challenges," said Robert Matheson, MD, Oregon Medical Research Center, and study investigator. "The potential of achieving nearly complete skin clearance is exciting and holds great promise for patients with this difficult to treat disease." Investigators reported that at week 10 patients in both EXPRESS and EXPRESS II receiving REMICADE experienced improvements in the Dermatology Life Quality Index (DLQI DLQI Dermatology Life Quality Index ) and Physician's Global Assessment (PGA (1) (Professional Graphics Adapter) An early IBM PC display standard for 3D processing with 640x480x256 resolution. It was not widely used. (2) (Programmable Gate Array) See gate array and FPGA. ), measures of quality of life and psoriasis severity, respectively. In both studies, following 5 mg/kg induction therapy, REMICADE-treated patients experienced a median improvement of nine points in DLQI, a change that is considered to be a clinically meaningful decrease in psoriasis-related burden for the patient, compared to no improvement for placebo patients (REMICADE vs. placebo, -9.0 versus 0.0, P less than 0.001 for both studies). The proportions of patients with a PGA of cleared, excellent/minimal were 83 percent vs. 4 percent (EXPRESS) and 76 percent vs. 1 percent (EXPRESS II) for the REMICADE and placebo groups respectively (both P less than 0.001 vs. placebo). The PGA scale indicates a physician's assessment of the severity of psoriasis and scores of cleared, excellent/minimal are consistent with complete or almost complete clearing of the disease. In November 2005, Centocor, Inc. announced that the United States Food and Drug Administration United States Food and Drug Administration (FDA), n.pr a unit of the Public Health Service created to protect the health of the nation against impure and unsafe foods, drugs, and cosmetics. (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. ) accepted its filing of a supplemental Biologics License Application (sBLA) for the use of REMICADE in the treatment of moderate to severe plaque psoriasis. The acceptance of the sBLA file for psoriasis follows the September 2005 European Commission approval of REMICADE for the treatment of moderate to severe plaque psoriasis in adults who failed to respond to, or have a contraindication contraindication /con·tra·in·di·ca·tion/ (-in?di-ka´shun) any condition which renders a particular line of treatment improper or undesirable. con·tra·in·di·ca·tion n. to, or are intolerant of other systemic therapy systemic therapy Therapeutics Any therapy that reaches target tissues via the systemic circulation including cyclosporine cyclosporine /cy·clo·spor·ine/ (-spor´en) a cyclic peptide from an extract of soil fungi that selectively inhibits T cell function; used as an immunosuppressant to prevent rejection in organ transplant recipients and to treat severe , 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. or psoralen psoralen /psor·a·len/ (sor´ah-len) any of the constituents of certain plants (e.g., Psoralea corylifolia ) that have the ability to produce phototoxic dermatitis on subsequent exposure of the individual to sunlight; certain plus ultraviolet light Ultraviolet light A portion of the light spectrum not visible to the eye. Two bands of the UV spectrum, UVA and UVB, are used to treat psoriasis and other skin diseases. A (PUVA PUVA n. Psoralen and ultraviolet light; a treatment for psoriasis combining the oral administration of psoralen with subsequent exposure to long wavelength ultraviolet light. ). REMICADE is approved in the U.S. and the European Union European Union (EU), name given since the ratification (Nov., 1993) of the Treaty of European Union, or Maastricht Treaty, to the European Community (EU) for the treatment of active psoriatic arthritis. About EXPRESS The European Infliximab for Psoriasis (REMICADE) Efficacy and Safety Study (EXPRESS) was a Phase 3, multi-center, 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 evaluating the efficacy and safety of REMICADE induction and maintenance therapy in 378 patients with moderate to severe plaque psoriasis who were candidates for phototherapy Phototherapy Definition Phototherapy, or light therapy, is the administration of doses of bright light in order to normalize the body's internal clock and/or relieve depression. or systemic therapy. Patients received either REMICADE 5 mg/kg or placebo administered at weeks 0, 2 and 6, followed by maintenance treatment every 8 weeks. The REMICADE group continued on maintenance treatments every 8 weeks. Beginning at week 24, patients randomized to the placebo group were crossed over to receive REMICADE 5 mg/kg at weeks 24, 26 and 30, and every 8 weeks through week 46. Through week 24 of the EXPRESS trial, adverse events (AEs) occurred at a higher incidence in the REMICADE group (82 percent) compared with the placebo group (71 percent). 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. Through week 24, markedly abnormal alanine aminotransferase (ALT) values (predefined as greater than 150 IU/L and greater than or equal to 100 percent increase from baseline) occurred in 6 percent of subjects in the REMICADE group compared with no subjects in the placebo group. There were more serious AEs (6 percent), including one fatal infection, in the REMICADE group than in the placebo group (3 percent). AEs observed were generally consistent with those described in the prescribing information, including information regarding serious infections. Please see "Important Safety Information" below. About EXPRESS II The Evaluation of Infliximab for Psoriasis (REMICADE) Efficacy and Safety Study (EXPRESS II) was a Phase 3, multi-center, randomized, double-blind, placebo-controlled trial examining the safety and efficacy of REMICADE in 835 patients with moderate to severe plaque psoriasis who were candidates for phototherapy or systemic therapy. Patients were randomized to induction doses of REMICADE 3 mg/kg or 5 mg/kg or placebo at weeks 0, 2 and 6. Patients in the active induction treatment groups were randomized again at week 14 to receive either scheduled or "as-needed" maintenance treatment at the same dose administered during the induction phase. Patients in the placebo group were crossed over at week 16 to receive REMICADE 5 mg/kg at weeks 16, 18 and 22, and every 8 weeks through week 46. In EXPRESS II, through week 14 (the placebo-controlled period), AEs occurred at a higher incidence in the REMICADE groups (63 percent and 69 percent in the 3 mg/kg and 5 mg/kg, respectively) compared with the placebo group (56 percent). Serious AEs occurred at rates of 2 percent in the placebo group, 3 percent in the 5 mg/kg group and 1 percent in the 3 mg/kg group. Laboratory abnormalities were uncommon, with an elevation in liver function tests being the most common abnormality. Through week 50, markedly abnormal alanine aminotransferase (ALT) values (predefined as greater than 150 IU/L and greater than or equal to 100 percent increase from baseline) occurred in 5 percent of REMICADE-treated subjects in EXPRESS II. Through week 50, there were two cases of tuberculosis in the REMICADE treatment groups. AEs observed were generally consistent with those described in the prescribing information, including information regarding serious infections. Please see "Important Safety Information" below. About Psoriasis Psoriasis is a chronic, immune-mediated disease, which results when skin cells over-produce and accumulate on the surface causing red, scaly scal·y adj. 1. Covered or partially covered with scales. 2. Shedding scales or flakes; flaking. scaly skin condition characterized by scales; scalelike. plaques that may itch and bleed. This chronic inflammation is driven in part by tumor necrosis factor tumor necrosis factor n. Abbr. TNF A protein that is produced in the presence of an endotoxin, especially by monocytes and macrophages, is able to attack and destroy tumor cells, and exacerbates chronic inflammatory diseases. alpha, or TNF-alpha, a cytokine Cytokine Any of a group of soluble proteins that are released by a cell to send messages which are delivered to the same cell (autocrine), an adjacent cell (paracrine), or a distant cell (endocrine). involved in the body's normal immune response. TNF-alpha is found at increased levels in psoriatic plaques and plays a crucial part in their formation and continued existence. It is estimated that two percent of the U.S. population has psoriasis, and about 30 percent of people with psoriasis have cases that are considered moderate to severe. About REMICADE REMICADE is the global market leader among anti-tumor necrosis factor alpha (TNF-alpha) therapies and has demonstrated broad clinical utility in rheumatoid arthritis (RA), Crohn's disease (CD), psoriatic arthritis (PsA), ulcerative colitis (UC), and ankylosing spondylitis (AS). The safety and efficacy of REMICADE have been well established in clinical trials over the past 13 years and through commercial experience with over 700,000 patients treated worldwide. 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`ch lə), 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 reducing signs and symptoms in patients with active AS. In May 2005, REMICADE was approved for reducing signs and symptoms of active arthritis in patients with PsA. Additionally, in September 2005, REMICADE was approved for reducing signs and symptoms, achieving clinical remission and mucosal healing, and eliminating 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 use in patients with moderately to severely active UC who have had an inadequate response to conventional therapy. This approval makes REMICADE the first and only biologic approved for the treatment of moderate to severe UC. 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 (3 mg/kg), CD (5 mg/kg), PsA (5 mg/kg), and UC (5 mg/kg), REMICADE is a two-hour infusion administered every 8 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 (5 mg/kg), REMICADE is a two-hour infusion administered every 6 weeks, following a standard induction regimen that requires treatment at weeks 0, 2 and 6. Centocor discovered REMICADE and has exclusive marketing rights to the product in the United States. Schering-Plough markets 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 and in China where Xian-Janssen markets REMICADE. Important Safety Information 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. 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 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 a type of blood cancer called lymphoma in patients on REMICADE or other TNF TNF abbr. tumor necrosis factor TNF, n an abbreviation for tumor necrosis f blockers are rare but occur more often than expected for people in general. People who have been treated for rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, or psoriatic arthritis for a long time, particularly those with highly active disease may be more prone to develop lymphoma. Cancers, other than lymphoma, have also been reported. If you take REMICADE or other TNF blockers, your risk for developing lymphoma or other cancers may increase. You should also tell your doctor if you have had or develop lymphoma or other cancers while you are taking REMICADE. 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. About Centocor Centocor is harnessing the power of world-leading research and biomanufacturing to deliver innovative biomedicines that transform patients' lives. Centocor has already brought innovation to the treatment of 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, ankylosing spondylitis, psoriatic arthritis and ulcerative colitis. The world leader in monoclonal antibody production and technology, Centocor has brought critical biologic therapies to patients suffering from 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 immune disorders. Centocor, Inc. 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. |
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