--Database to be Unlocked and Reanalyzed--
--Conference Call Scheduled for 5:00 pm E.T., December 19, 2006--
EVANSTON, Ill.--(BUSINESS WIRE)--Dec. 19, 2006--Northfield
Laboratories Inc. (Nasdaq: NFLD) announced today preliminary top-line
results from its pivotal Phase III trial assessing the safety and
efficacy of PolyHeme(R), its human hemoglobin based oxygen-carrying
red blood cell substitute in the treatment of severely injured and
bleeding patients when blood is needed but not immediately available.
However, because of discrepancies in the initial data, the database
will be unlocked and corrected prior to finalizing the statistical
analyses.
Northfield received the initial draft top-line data from its
contract research organization (CRO) on December 14, 2006. During its
review and interpretation of these results, two discrepancies in the
dates of death for patients in the study, in which mortality is the
primary endpoint, were identified. The CRO was notified and agreed
that these data points were inaccurate. It is necessary to unlock the
study database to make the corrections. To ensure absolute accuracy
before the database is relocked, Northfield has requested verification
by the CRO of all critical variables and has also initiated an
independent verification. FDA has been notified but the study results
will not be submitted until final. Because of the interest in the
study, however, Northfield has made the decision to report the
preliminary results as provided.
The primary efficacy endpoint of the study is a dual superiority
and noninferiority test of Day 30 mortality in the modified intent to
treat population. In order to achieve the superiority endpoint, the
upper limit of the confidence interval (CI) surrounding the observed
difference in mortality between the treatment and control groups
needed to be less than zero; for the noninferiority endpoint, the
upper limit of the CI needed to be 7% or less. The noninferiority
boundary is based on the potential to provide a benefit in situations
where transfusion of blood is indicated but not available.
The preliminary results received by Northfield indicate that in
the primary modified intent to treat (MITT) population (those who were
randomized and received some treatment) the upper limit of the CI
exceeded the 7% threshold by 0.3%. However, in the pre-specified per
protocol (PP) population (those who both received the correct
treatment and did not otherwise violate the protocol), the upper limit
of the CI was below the threshold, at 5.8%.
"This was a logistically complex study with many variables and a
high incidence of protocol violations. We believe these preliminary
results in the per protocol population represent the clearest evidence
to assess the potential benefit of PolyHeme in this setting. We
continue to move forward toward submission of a Biologics License
Application, and will review the data and submit to FDA once we
receive the final results. We believe that there is an unmet medical
need for a hemoglobin-based oxygen-carrying red blood cell substitute
and that PolyHeme is that product," said Dr. Gould.
Efficacy Analysis
Of the total of 722 patients in the study, (intent to treat
population, or ITT), 712 patients were randomized and received some
study treatment (modified intent to treat population, or MITT); 349 in
the PolyHeme group and 363 in the control group. Due to the complexity
of the protocol, 20% of the PolyHeme group (70 patients) and 15% of
the control group (56 patients) represented protocol violations,
leaving a total of 586 patients (279 PolyHeme, 307 control) in the per
protocol population (PP). Protocol violations include errors related
to eligibility and treatment regimen. The per protocol group
represents those patients appropriately randomized, enrolled, treated,
and followed as specified in the study protocol. The MITT population
is therefore the sum of the per protocol and protocol violation
populations.
In the MITT population, there were 46 deaths (13.2%) in the
PolyHeme group and 35 deaths (9.6%) in the control group, resulting in
an upper CI limit of 7.3%. In the PP population, there were 30 deaths
(10.8%) in the PolyHeme group and 28 deaths (9.1%) in the control,
with an upper CI limit of 5.8%. In the protocol violation group, there
were 16 deaths (22.8%) in the PolyHeme group and 7 deaths (12.5%) in
control. The data are summarized in Table 1.
TABLE 1
DAY 30 MORTALITY
DRAFT ANALYSIS
POLYHEME CONTROL
(deaths/N) % (deaths/N) % Delta % CI
----------------------------------------------------------------------
MITT 46/349 13.2 35/363 9.6 3.5 7.3
----------------------------------------------------------------------
PP 30/279 10.8 28/307 9.1 1.6 5.8
----------------------------------------------------------------------
PROTOCOL
VIOLATIONS 16/70 22.9 7/56 12.5 10.4 --
----------------------------------------------------------------------
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 pre-defined as SAEs occurring in any
subject which results in a "permanently disabling" outcome. The
statistical test for these endpoints is inferiority to control.
With respect to Day 1 and Day 30 mortality in the MITT population,
the preliminary analysis reveals there was no statistically
significant difference between the treatment and control groups. There
were 33 deaths (9.5%) in the PolyHeme group and 27 deaths (7.4%) in
the control group on Day 1. The PP population was characterized by
fewer deaths in the PolyHeme group (19 versus 21 deaths) and identical
mortality rates (6.8%). There were two durable SAEs in each group.
These data are summarized in Table 2.
TABLE 2
DAY 1 MORTALITY
DRAFT ANALYSIS
POLYHEME CONTROL
(deaths/N) % (deaths/N) % Delta %
-----------------------------------------------------------------
MITT 33/349 9.5 27/363 7.4 2.0
-----------------------------------------------------------------
PP 19/279 6.8 21/307 6.8 0.0
-----------------------------------------------------------------
PROTOCOL
VIOLATIONS 14/70 20.0 6/56 10.7 9.3
-----------------------------------------------------------------
Study Design
This randomized, controlled open-label, multi-center pivotal Phase
III study was designed to evaluate the safety and efficacy of
PolyHeme(R) 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.
The study was conducted to seek an indication for the use of
Polyheme that addresses a critical, unmet medical need. It was the
first study in the U.S. to evaluate the use of an oxygen-carrying
fluid starting at the scene, and was designed to assess the
life-sustaining capability of PolyHeme when blood is indicated but not
available. Blood is not commonly used in the prehospital setting or
during ambulance transport to the hospital. The current approach to
resuscitation of the trauma victim begins with the rapid infusion of a
solution that does not carry oxygen, such as salt water. The second
stage of resuscitation involves infusion of blood or red blood cells.
At the hospital, patients requiring urgent blood transfusion have
immediate access to Type O blood, but it takes approximately 45
minutes to one hour to obtain fully cross-matched compatible blood.
PolyHeme provides volume replacement in lieu of salt water, and also
provides oxygen-carrying capacity. Because PolyHeme is universally
compatible, it is immediately available for use as an initial
resuscitative fluid.
This challenging trial, in which more than 3500 emergency medical
personnel and 300 ambulances participated, was conducted in 18 states
throughout the U.S. , at 32 Level I trauma centers, and included more
than 150 physicians and thousands of laboratory and other hospital
staff.
This was an active-control dual superiority-noninferiority trial
comparing the survival of PolyHeme patients to those who received
standard treatment (salt water plus blood). Survival was assessed with
respect to seven covariates: age, gender, injury severity score,
mechanism of injury (blunt versus penetrating), systolic blood
pressure at randomization, Glasgow Coma Score, and volume of
crystalloid received prior to randomization. The noninferiority
boundary was based on the potential to provide a benefit in situations
where transfusion of blood was indicated but not available.
Future Announcements of Study Data
Once the preliminary study data have been verified and any
discrepancies corrected, Northfield will issue a press release
describing the final study data. It is possible that the final results
may differ from the preliminary results provided today. In addition,
Northfield expects that additional safety data will be provided by its
CRO in four to six weeks; this will also be reported via press
release.
Conference Call Information
Northfield has scheduled a conference call and webcast today,
Tuesday, December, 19, 2006, at 5:00 p.m. ET. Steven A Gould, M.D.,
Northfield's Chairman and CEO, will discuss top-line results from the
trial. To access the call, investors may dial 866.831.6270 and enter
the passcode 34502416. International investors may dial 617.213.8858
and enter the same passcode. Investors may also access a live webcast
of the call at www.northfieldlabs.com. A replay will be available and
will be archived until January 2, 2007. The replay number is
888-286-8010, passcode 17196716.
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 the final data from our Phase III clinical trial,
once available, 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 Fast Track
designation and 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.