KENILWORTH, N.J., Oct. 5 /PRNewswire-FirstCall/ -- Schering-Plough
Corporation (NYSE: SGP) today announced that the European Commission has
approved revised dosing instructions allowing for a shorter, 24-week course of
PEG-INTRON(R) (1.5 mcg/kg once weekly) and REBETOL(R) (800 - 1,200 mg daily)
combination therapy among a subgroup of patients with chronic hepatitis C
virus (HCV) genotype 1 infection and low viral load (less than 600,000 IU/ml)
who have achieved rapid virologic response, defined as undetectable virus
(HCV-RNA negative) at week 4 of treatment that is maintained through week 24.
The approval follows a positive opinion granted on July 28, 2005, by the
Committee for Medicinal Products for Human Use (CHMP) of the European
Medicines Agency (EMEA).
Approval of this shorter PEG-INTRON and REBETOL combination treatment
regimen cuts by half the duration of therapy for a subset of hepatitis C
patients with genotype 1 and low viral load. This is the only treatment
regimen approved in the European Union (EU) for a 24-week course of therapy in
certain genotype 1 patients. In clinical studies supporting the approval, 92
percent of patients who met the criteria for early response achieved a
sustained virologic response (SVR) with 24 weeks of treatment. In the United
States, PEG-INTRON (1.5 mcg/kg once weekly) is approved in combination with
REBETOL (800 mg daily) for a duration of treatment of 48 weeks.
"Physicians now have the opportunity to consider a shorter course of
therapy for their patients with hepatitis C genotype 1 who meet specific
criteria," said Professor Stefan Zeuzem, M.D., Saarland University, Homburg,
Germany, and lead investigator of the study supporting the approval.
"Tailoring treatment so that those with an early response are treated for only
24 weeks rather than 48 weeks may make therapy more appealing to patients,
providing comparable efficacy with better tolerability," he said.
"Approval of this shorter course of PEG-INTRON and REBETOL combination
therapy reflects the ongoing commitment of Schering-Plough to define optimal
dose and treatment schedules to better
meet the needs of hepatitis C patients," said Robert J. Spiegel, M.D., chief
medical officer and senior vice president of medical affairs, Schering-Plough
Research Institute.
The Commission approval results in Marketing Authorization with unified
labeling that is valid in the current EU 25 member states as well as in
Iceland and Norway. PEG-INTRON and REBETOL combination therapy was previously
approved in the EU for a 48-week course of therapy for all patients with
genotype 1 who exhibit virological response at week 12.
Study Results
The approved labeling change for PEG-INTRON and REBETOL is based on
results of a clinical study involving 235 patients with HCV genotype 1 and low
viral load who received 24 weeks of combination therapy with PEG-INTRON (1.5
mcg/kg once weekly) and REBETOL (800 - 1,400 mg daily); only two patients
weighing more than 105 kg received the 1,400 mg dose. In the study, 41
percent of patients (97/235) had undetectable plasma HCV-RNA levels at week 4
and week 24 of therapy. Patients in this subgroup achieved a 92 percent
(89/97) rate of sustained virological response. The high SVR in this group of
patients was identified in an interim analysis and prospectively confirmed.
Genotype 1 virus is the most common worldwide, the most difficult to treat
successfully and accounts for about 70 percent of HCV infections among
European patients overall, varying by geography. For patients with HCV
genotypes 2 or 3, the EU labeling for PEG-INTRON recommends that all patients
be treated for 24 weeks. Patients infected with HCV genotype 4 are considered
harder to treat and generally 48 weeks of therapy is recommended. In the
United States, PEG-INTRON is indicated in combination with REBETOL (800 mg
daily) for 48 weeks.
About PEG-INTRON and REBETOL Combination Therapy
PEG-INTRON and REBETOL combination therapy for chronic hepatitis C was
approved in the European Union in March 2001. The recommended dose in the EU
for combination therapy is PEG-INTRON 1.5 mcg/kg once weekly plus REBETOL 800-
1,200 mg daily, adjusted to body weight. PEG-INTRON had previously received
centralized marketing authorization in the EU and is marketed as a monotherapy
in cases of intolerance or contraindication to ribavirin for the treatment of
adult patients with chronic hepatitis C.
PEG-INTRON, recombinant interferon alfa-2b linked to a 12,000 dalton
polyethylene glycol (PEG) molecule, is a once-weekly therapy dosed according
to patient body weight that is designed to achieve an effective balance
between antiviral activity and elimination half-life. REBETOL is an oral
formulation of ribavirin, a synthetic nucleoside analog with broad-spectrum
antiviral activity.
Chronic hepatitis C is estimated to affect more than 10 million people in
major world markets, including 5 million in Europe. It is a leading cause of
chronic liver disease and one of the most common reasons for liver transplant
in Europe.
Important Information Regarding U.S. Labeling for PEG-INTRON and REBETOL
WARNING
Alpha interferons, including PEG-INTRON, cause or aggravate fatal or life-
threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders.
Patients should be monitored closely with periodic clinical and laboratory
evaluations. Patients with persistently severe or worsening signs or symptoms
of these conditions should be withdrawn from therapy. In many but not all
cases these disorders resolve after stopping PEG-INTRON therapy.
Ribavirin causes hemolytic anemia. Anemia associated with REBETOL therapy
may exacerbate cardiac disease that has led to fatal and nonfatal myocardial
infarctions. Patients with a history of significant or unstable cardiac
disease should not be treated with REBETOL. It is advised that complete blood
counts (CBC) be obtained at baseline and at weeks 2 and 4 of therapy or more
frequently if clinically indicated.
REBETOL and combination REBETOL/PEG-INTRON therapy must not be used by
women, or male partners of women, who are or may become pregnant during
therapy and during the 6 months after stopping therapy. REBETOL and
combination REBETOL/PEG-INTRON therapy should not be initiated until a report
of a negative pregnancy test has been obtained immediately prior to initiation
of therapy. Women of childbearing potential and men must use effective
contraception (at least two reliable forms) during treatment and during the 6-
month post-treatment follow-up period. Significant teratogenic and/or
embryocidal effects have been demonstrated for ribavirin in all animal species
in which adequate studies have been conducted. These effects occurred at
doses as low as one twentieth of the recommended human dose of REBETOL. If
pregnancy occurs in a patient or partner of a patient during treatment or
during the 6 months after treatment stops, physicians are encouraged to report
such cases by calling (800) 727-7064.
PEG-INTRON
There are no new adverse events specific to PEG-INTRON as compared to
INTRON(R) A (interferon alfa-2b, recombinant) for Injection, however, the
incidence of some (e.g., injection site reactions, fever, rigors, nausea) were
higher. The most common adverse events associated with PEG-INTRON were "flu-
like" symptoms, occurring in approximately 50% of patients, which may decrease
in severity as treatment continues. Application site disorders were common
(47%), but all were mild (44%) or moderate (4%) and no patient discontinued,
and included injection site inflammation and reaction (i.e., bruise,
itchiness, irritation). Injection site pain was reported in 2% of patients
receiving PEG-INTRON. Alopecia (thinning of the hair) is also often
associated with alpha interferons including PEG-INTRON.
Psychiatric adverse events, which include insomnia, were common (57%) with
PEG-INTRON, but similar to INTRON A (58%). Depression was most common at 29%.
Suicidal behavior including ideation, suicidal attempts, and completed
suicides occurred in 1% of patients during or shortly after completing
treatment with PEG-INTRON.
PEG-INTRON/REBETOL is contraindicated in patients with autoimmune
hepatitis, decompensated liver disease, and in patients with
hemoglobinopathies (e.g., thalassemia major, sickle-cell anemia).
The following serious or clinically significant adverse events have been
reported at a frequency less than 1% with PEG-INTRON or interferon alpha:
severe decreases in neutrophil or platelet counts, hypothyroidism,
hyperglycemia, hypotension, arrhythmia, ulcerative and hemorrhagic colitis,
development or exacerbation of autoimmune disorders including thyroiditis, RA,
systemic lupus erythematosus, psoriasis, pulmonary disorders (dyspnea,
pulmonary infiltrates, pneumonitis and pneumonia, some resulting in patient
deaths), urticaria, angioedema, bronchoconstriction, anaphylaxis, retinal
hemorrhages, and cotton wool spots.
In the PEG-INTRON/REBETOL combination trial the incidence of serious
adverse events was 17% in the PEG-INTRON/REBETOL groups compared to 14% in the
INTRON A/REBETOL group. The incidence of severe adverse events in the PEG-
INTRON/REBETOL combination therapy trial was 23% in the INTRON A/REBETOL group
and 31-34% in the PEG-INTRON/REBETOL groups. Dose reductions due to adverse
reactions occurred in 42% of patients receiving PEG-INTRON (1.5
mcg/kg)/REBETOL and in 34% of those receiving INTRON A/REBETOL.
REBETOL should not be used in patients with creatinine clearance less than
50 mL/min.
Schering-Plough Corporation 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's Web site is http://www.schering-plough.com.
SCHERING-PLOUGH DISCLOSURE NOTICE: This press release contains "forward-
looking statements" within the meaning of the Securities Litigation Reform Act
of 1995, related to the market for PEG-INTRON and REBETOL combination therapy
and the market for drugs to treat hepatitis C. Forward-looking statements
relate to expectations or forecasts of future events and not to historical
information. Schering-Plough does not assume the obligation to update any
forward-looking statement. There are no guarantees about the market
performance of PEG-INTRON and REBETOL combination therapy, Schering-Plough
stock or Schering-Plough's business. Actual results may vary materially from
Schering-Plough's forward-looking statements due to many factors and
uncertainties, which include the market acceptance of PEG-INTRON and REBETOL
combination therapy, trade buying patterns, the introduction and performance
of competitive products in the market, legislation that may impact the
pricing/availability of PEG-INTRON and REBETOL combination therapy and other
uncertainties. For further details about these factors and other risks and
uncertainties that may impact Schering-Plough's forward-looking statements,
see Schering-Plough's Securities and Exchange Commission filings, including
the company's second quarter 2005 10-Q.
SOURCE Schering-Plough Corporation
10/05/2005
CONTACT: Media, Robert J. Consalvo, +1-908-298-7409, Gail Thornton,
+1-908-298-5313 or Investors, Alex Kelly, +1-908-298-7436, all of
Schering-Plough
Web site: http://www.schering-plough.com
(SGP)