Conference Call Scheduled for 8:30 am Today
EVANSTON, Ill.--(BUSINESS WIRE)--May 23, 2007--Northfield
Laboratories, Inc. (NASDAQ: NFLD) reported today results of its
pivotal Phase III trauma trial with PolyHeme(R), its human
hemoglobin-based oxygen-carrying red blood cell substitute. The trial
was designed to seek an indication for use in the treatment of
life-threatening red blood cell loss when transfusion is required and
red blood cells are not available, not for use interchangeably with
blood. This indication addresses a critical, unmet medical need.
The primary efficacy endpoint of the study was a dual
superiority-noninferiority assessment of mortality at 30 days after
injury. The margin to assess noninferiority, using the upper limit of
the confidence interval, was set at 7% more than control. In the
primary Modified Intent to Treat population, the upper limit was
7.65%. In the As Treated population, the upper limit was 7.06%. In the
Per Protocol population, the upper limit was 6.29%.
Day 30 mortality was also a primary safety endpoint. Further
analysis of the mortality data indicates that the difference in
mortality at 30 days between patients who received PolyHeme beginning
at the scene and continuing for up to 12 hours following injury, and
control patients who received the standard of care, including early
blood, was not statistically significant.
"The results of this study are best understood in the context of
bleeding patients who do not have early access to blood transfusion,"
said Steven A. Gould, M.D., Chairman and Chief Executive Officer. "47
million Americans live more than an hour away from a trauma center
where blood is available. Mortality rates in that scenario would be
considerably higher than those observed in the control patients in the
urban setting of this trial, where transit times were relatively
short. We believe that when our data are extrapolated to patients who
need an oxygen carrier and have delayed access to blood, PolyHeme can
play an important role in saving lives."
Conference Call
Northfield will hold a conference call today, Wednesday, May 23,
2007, at 8:30 a.m. EDT to discuss the results of the study. To
participate in the call, investors may dial 866.770.7146 and reference
the passcode 56877457. Investors may also access a live audio webcast
at www.northfieldlabs.com; this will be archived for two weeks. A
telephone replay will also be available for two weeks by dialing
888-286-8010 and entering the passcode 14789842.
Analysis Populations
The study protocol pre-specified multiple patient populations for
analysis: the primary Modified Intent to Treat population (MITT); the
As Treated population (AT); and the Per Protocol population (PP).
Efficacy Analysis
The primary efficacy endpoint of the study was a dual
superiority-noninferiority assessment of mortality at 30 days after
injury. A noninferiority endpoint requires the establishment of a
relative margin around the control outcome. The margin to assess
noninferiority in this study, using the upper limit of the confidence
interval, was set at 7% more than control.
MITT Population
The MITT population is comprised of all 714 patients both
randomized and treated. In this population, patients were analyzed as
randomized, and not based on the actual treatment they received. There
were 41 randomized patients in the study who received the incorrect
treatment. Therefore, the 21 patients randomized to PolyHeme who did
not receive any PolyHeme were analyzed in the PolyHeme group.
Similarly, the 20 patients randomized to control who did receive
PolyHeme were analyzed in the control group.
AT Population
The AT population is also comprised of all 714 patients both
randomized and treated. However, in this population all patients were
analyzed according to the treatment they actually received. Therefore,
all patients who did receive PolyHeme were analyzed in the PolyHeme
group, and all patients who did not receive any PolyHeme were analyzed
in the control group. Although the AT population was pre-specified for
safety rather than efficacy, it provides a meaningful opportunity to
assess mortality as well.
PP Population
The PP population is comprised of the 586 patients both
appropriately randomized and correctly treated. The PP population does
not include 128 patients who had major protocol violations related to
eligibility or treatment regimen. Since the PP patients were treated
exactly as specified in the protocol, Northfield believes the PP
population represents the clearest opportunity to assess a treatment
effect.
In the primary MITT population, the upper limit of the confidence
interval was 7.65%. In the AT population, the upper limit was 7.06%.
In the PP population, the upper limit was 6.29%. The data are shown in
Table 1.
TABLE 1
DAY 30 MORTALITY
PolyHeme Control Upper Limit
(deaths/N) % (deaths/N) %
------------------------- ---------- ----- ---------- ---- -----------
MITT 47/350 13.4 35/364 9.6 7.65%
------------------------- ---------- ----- ---------- ---- -----------
AT 46/349 13.2 36/365 9.9 7.06%
------------------------- ---------- ----- ---------- ---- -----------
PP 31/279 11.1 28/307 9.1 6.29%
------------------------- ---------- ----- ---------- ---- -----------
Secondary efficacy endpoints of the study included Day 1 mortality
(Table 2), the incidence of multiple organ failure, the use of donated
blood through Day 1, and an analysis of mortality by the mechanism of
injury (blunt versus penetrating trauma). The incidence of transfusion
of donated blood was significantly lower in the PolyHeme group at 41%
than the control group at 51% (p(less than or =)0.05). There was no
statistically significant difference between PolyHeme and control
patients for the other efficacy endpoints.
TABLE 2
DAY 1 MORTALITY
PolyHeme Control
(deaths/N) % (deaths/N) %
------------------------------------- ---------- ---- ---------- ----
MITT 34/350 9.7 27/364 7.4
------------------------------------- ---------- ---- ---------- ----
AT 33/349 9.5 28/365 7.7
------------------------------------- ---------- ---- ---------- ----
PP 20/279 7.2 21/307 6.8
------------------------------------- ---------- ---- ---------- ----
Safety Analysis
The primary safety endpoints in the study were Day 1 mortality,
Day 30 mortality, and durable serious adverse events (SAEs). Durable
serious adverse events were prospectively defined as SAEs which
resulted in a "permanently disabling" outcome. There were two durable
SAEs in each group. There was no statistically significant difference
between the PolyHeme and control groups for any of these endpoints.
Additional Safety Data
All adverse events (AEs), serious adverse events (SAEs), cardiac
SAEs, and myocardial infarction (MI) were also analyzed. The overall
incidence of AEs in the PolyHeme group of 93% (324 patients) was
higher than that in the control group of 88% (322 patients), (p(less
than or =)0.05). The most common AEs in both groups were: anemia,
fever, and electrolyte imbalances. The overall incidence of SAEs in
the study was 40% (141 patients) in the PolyHeme group and 35% (126
patients) in the control group (pgreater than or 0.05). The most
common SAEs in both groups were: shock, pneumonia, and respiratory
failure.
The incidence of cardiac AEs was 35% (123 patients) in the
PolyHeme group and 29% (105 patients) in the control group (pgreater
than0.05). The incidence of cardiac SAEs was 7% (23 patients) in the
PolyHeme group and 4% (16 patients) in control (pgreater than0.05).
The overall incidence of MI in the study as reported by investigators
was 2%: eleven PolyHeme patients and three control patients (p(less
than or =)0.05). Three PolyHeme patients and one control patient died.
The medical literature documents the difficulty of making an
accurate diagnosis of MI in trauma patients for multiple reasons,
including direct trauma to the chest. Myocardial infarction and
myocardial ischemia are traditionally assessed by EKGs and the cardiac
enzymes Troponin I and CK-MB, both of which can be altered by direct
trauma. Approximately 75% of the patients in this study had abnormal
EKGs or elevated cardiac enzymes. Because of the disparity between the
low number of reported MIs and the high incidence of abnormal EKGs and
elevated cardiac enzymes, Northfield has established an independent
panel of cardiac experts to review the cardiac profiles of all 720
randomized patients in a blinded fashion to categorize MIs in the
study.
Summary
"This was a seminal study. This summary represents our initial
opportunity to explore the data on safety and efficacy in detail. We
continue to believe there is a potential benefit to using PolyHeme in
patients with delayed access to blood, whose expected mortality
without oxygen-carrying replacement would be considerably greater,"
said Dr. Gould.
As the data have not been submitted to FDA, Northfield is
preparing a detailed summary of the study data for submission to FDA
for review.
About the Study
This randomized, controlled open-label, multi-center, active
control pivotal Phase III study of 720 patients was designed to
evaluate the safety and efficacy of PolyHeme when used to treat
patients in hemorrhagic shock following traumatic injuries beginning
in the prehospital setting. Treatment began at the scene of injury,
continued in the ambulance during transport, and for up to 12 hours
post-injury or a total of 6 units. Patients then received donated
blood if they continued to bleed. Patients in the control group
received the standard of care: saline in the field and during
transport, followed by blood upon arrival at the hospital. Thirty-two
Level I trauma centers participated in the study, which was conducted
to seek an indication for the use of PolyHeme that addresses a
critical, unmet medical need: the unavailability of blood.
In December 2006, Northfield announced that it had received the
preliminary draft top-line data from its contract research
organization. Northfield indicated that due to certain discrepancies
in the data identified during its initial review, it became necessary
to resolve the discrepancies and unlock the study database to make any
necessary corrections. The process has now been completed, the study
database relocked, and the data reanalyzed. Northfield has also had
the opportunity to further analyze the study data, including
additional safety data. These data have not been submitted to or
reviewed by FDA.
About Northfield Laboratories
Northfield Laboratories, Inc., is a leader in developing an
oxygen-carrying red blood cell substitute for the treatment of
life-threatening blood loss, when an oxygen-carrying fluid is required
and red blood cells are not available. PolyHeme(R) is a solution of
chemically modified human hemoglobin that requires no cross matching
and is, therefore, compatible with all blood types. It has a shelf
life in excess of 12 months. For further information, visit
www.northfieldlabs.com.
Forward Looking Statement
This press release may contain forward-looking statements
concerning, among other things, Northfield's future business plans and
strategies and clinical and regulatory developments affecting our
PolyHeme red blood cell substitute product. These forward-looking
statements are identified by the use of such terms as "intends,"
"expects," "plans," "estimates," "anticipates," "should," "believes"
and similar terms. These forward-looking statements involve inherent
risks and uncertainties. Our actual results may therefore differ
materially from those predicted by the forward-looking statements
because of various factors and possible events, including the
possibility that since the data from our Phase III clinical trial have
not been submitted to, or reviewed by, FDA, they may not be sufficient
to demonstrate the safety or effectiveness of PolyHeme, our ability to
obtain FDA approval to market PolyHeme commercially, our ability to
obtain priority review, the availability of capital to finance our
clinical trials and ongoing business operations, our ability to obtain
adequate supplies of raw materials and to manufacture PolyHeme in
commercial quantities, our ability to market PolyHeme successfully,
the possibility that competitors will develop products that will
render PolyHeme obsolete or non-competitive, our ability to protect
our intellectual property rights, the outcome of certain governmental
inquiries and purported class action lawsuit as described in our most
recently filed annual report on Form 10-K and quarterly report on Form
10-Q, the possibility that we may be subject to product liability
claims and other legal actions, our dependency on a limited number of
key personnel, the uncertainty of third party reimbursement for our
product and other risks and uncertainties described from time to time
in our periodic reports filed with the Securities and Exchange
Commission, including our most recently filed annual report on Form
10-K and quarterly report on Form 10-Q. These forward-looking
statements speak only as of the date of this press release. We do not
undertake any obligation to update or publicly release any revisions
to forward-looking statements to reflect events, circumstances or
changes in expectations after the time such statement is made. All
subsequent written and oral forward-looking statements attributable to
Northfield or any person acting on our behalf are qualified by this
cautionary statement.
CONTACT: Northfield Laboratories Inc.
Sophia H. Twaddell, 847-864-3500
Vice President, Corporate Communications
stwaddell@northfieldlabs.com
or
Fleishman-Hillard
Tom Laughran, 312-751-3519
tom.laughran@fleishman.com
SOURCE: Northfield Laboratories Inc.