— Data Presented at 30th Annual
“These data further add to the substantial body of evidence supporting
the differentiated efficacy and safety profile of ARISTADA in the
treatment of this chronic and debilitating disease,” said
“The results from this study highlight the potential clinical benefits
of switching to ARISTADA for patients who experience inadequate response
or intolerance to INVEGA SUSTENNA, a medicine widely recognized in the
clinical community as a powerful antipsychotic agent,” stated
Data from the phase 4 study showed that treatment with a flexible dose regimen of ARISTADA 441 mg, 662 mg or 882 mg monthly, or 882 mg every six weeks resulted in significant improvement in schizophrenia symptoms at six months, as measured by the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impressions-Severity (CGI-S) scale. The mean BPRS total score decreased from 37.6 to 32.7 (p=0.002), and the mean CGI-S score decreased from 3.9 to 3.4 (p<0.001) between baseline and the six-month endpoint. Thirty-four patients (68%) completed the six-month study. The most commonly reported adverse events in the study were psychotic disorders, anxiety and suicidal ideation.
“These important data underscore the unique attributes of ARISTADA in
the market. With a strong efficacy and safety profile, along with an
unmatched range of doses and durations, ARISTADA has the potential to
become a market leader in the growing long-acting atypical antipsychotic
class,” said Richard Pops, Chief Executive Officer of
A poster on the data, titled, “Switching Patients With Schizophrenia
From Paliperidone Palmitate to Aripiprazole Lauroxil: A 6-month
Prospective Open-Label Study,” was presented at
Study Design
The six-month,
open-label, single-arm phase 4 study was designed to assess the
efficacy, safety and tolerability of ARISTADA (441 mg, 662 mg, or 882 mg
monthly; or 882 mg every six weeks) in 50 symptomatic, clinically stable
patients with schizophrenia who had an inadequate response or
intolerance to INVEGA SUSTENNA. Efficacy was evaluated in the study
based on BPRS and CGI-S scores from commencement of treatment with
ARISTADA through the end of the treatment period. Safety and
tolerability were evaluated based on reported adverse events.
Patients enrolled in the study had received at least three consecutive doses of INVEGA SUSTENNA prior to screening, with nearly half of the patients entering the study having received the highest dose of INVEGA SUSTENNA 234 mg. The primary reason for discontinuation of INVEGA SUSTENNA was insufficient control of positive symptoms (n=33, 66%). Eight patients (16%) switched due to breakthrough negative symptoms, and nine patients (18%) switched due to intolerance to INVEGA SUSTENNA.
About Schizophrenia
Schizophrenia
is a chronic, severe and disabling brain disorder. The disease is marked
by positive symptoms (hallucinations and delusions) and negative
symptoms (depression, blunted emotions and social withdrawal), as well
as by disorganized thinking. An estimated 2.4 million American adults
have schizophrenia,1 with men and women affected equally.
About ARISTADA®
ARISTADA
is an injectable atypical antipsychotic with one-month, six-week and
two-month dosing options for the treatment of schizophrenia. Oral
aripiprazole should be administered for 21 consecutive days in
conjunction with the first injection of ARISTADA. Once in the body,
ARISTADA converts to aripiprazole.
INDICATION and IMPORTANT SAFETY INFORMATION for ARISTADA® (aripiprazole lauroxil) extended-release injectable suspension, for intramuscular use
INDICATION
ARISTADA is indicated for the treatment of schizophrenia.
IMPORTANT SAFETY INFORMATION |
WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA- |
Elderly patients with dementia-related psychosis treated with
antipsychotic drugs are at an |
Contraindication: Known hypersensitivity reaction to aripiprazole. Reactions have ranged from pruritus/urticaria to anaphylaxis.
Cerebrovascular Adverse Reactions, Including Stroke: Increased incidence of cerebrovascular adverse reactions (e.g., stroke, transient ischemic attack), including fatalities, have been reported in placebo-controlled trials of elderly patients with dementia-related psychosis treated with risperidone, aripiprazole, and olanzapine. ARISTADA is not approved for the treatment of patients with dementia-related psychosis.
Neuroleptic Malignant Syndrome (NMS): A potentially fatal symptom complex sometimes referred to as NMS may occur with administration of antipsychotic drugs, including ARISTADA. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmia). Additional signs may include elevated creatine phosphokinase, myoglobinuria (rhabdomyolysis), and acute renal failure. The management of NMS should include: 1) immediate discontinuation of antipsychotic drugs and other drugs not essential to concurrent therapy; 2) intensive symptomatic treatment and medical monitoring; and 3) treatment of any concomitant serious medical problems for which specific treatments are available.
Tardive Dyskinesia (TD): The risk of developing TD (a syndrome of abnormal, involuntary movements) and the potential for it to become irreversible are believed to increase as the duration of treatment and the total cumulative dose of antipsychotic increase. The syndrome can develop, although much less commonly, after relatively brief treatment periods at low doses. Prescribing should be consistent with the need to minimize TD. Discontinue ARISTADA if clinically appropriate. TD may remit, partially or completely, if antipsychotic treatment is withdrawn.
Metabolic Changes: Atypical antipsychotic drugs have been associated with metabolic changes that include:
- Hyperglycemia/Diabetes Mellitus: Hyperglycemia, in some cases extreme and associated with ketoacidosis, coma, or death, has been reported in patients treated with atypical antipsychotics. There have been reports of hyperglycemia in patients treated with oral aripiprazole. Patients with diabetes should be regularly monitored for worsening of glucose control; those with risk factors for diabetes should undergo baseline and periodic fasting blood glucose testing. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia, including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia should also undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients require continuation of antidiabetic treatment despite discontinuation of the suspect drug.
- Dyslipidemia: Undesirable alterations in lipids have been observed in patients treated with atypical antipsychotics.
- Weight Gain: Weight gain has been observed with atypical antipsychotic use. Clinical monitoring of weight is recommended.
Pathological Gambling and Other Compulsive Behaviors: Compulsive or uncontrollable urges to gamble have been reported with use of aripiprazole. Other compulsive urges less frequently reported include sexual urges, shopping, binge eating and other impulsive or compulsive behaviors which may result in harm for the patient and others if not recognized. Closely monitor patients and consider dose reduction or stopping ARISTADA if a patient develops such urges.
Orthostatic Hypotension: Aripiprazole may cause orthostatic hypotension which can be associated with dizziness, lightheadedness, and tachycardia. Monitor heart rate and blood pressure, and warn patients with known cardiovascular or cerebrovascular disease and risk of dehydration and syncope.
Falls: Antipsychotics including ARISTADA may cause somnolence, postural hypotension or motor and sensory instability which may lead to falls and subsequent injury. Upon initiating treatment and recurrently, complete fall risk assessments as appropriate.
Leukopenia, Neutropenia, and Agranulocytosis: Leukopenia, neutropenia, and agranulocytosis have been reported. Patients with a history of clinically significant low white blood cell count (WBC)/absolute neutrophil count (ANC) and history of drug-induced leukopenia/neutropenia should have frequent complete blood count (CBC) during the first few months of receiving ARISTADA. Consider discontinuation of ARISTADA at the first sign of a clinically significant decline in WBC count in the absence of other causative factors. Monitor patients with clinically significant neutropenia for fever or other symptoms or signs of infection and treat promptly if such symptoms or signs occur. Discontinue ARISTADA in patients with severe neutropenia (absolute neutrophil count <1000/mm3) and follow their WBC until recovery.
Seizures: ARISTADA should be used with caution in patients with a history of seizures or with conditions that lower the seizure threshold.
Potential for Cognitive and Motor Impairment: ARISTADA may impair judgment, thinking, or motor skills. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are certain ARISTADA does not affect them adversely.
Body Temperature Regulation: Disruption of the body’s ability to reduce core body temperature has been attributed to antipsychotic agents. Advise patients regarding appropriate care in avoiding overheating and dehydration. Appropriate care is advised for patients who may exercise strenuously, may be exposed to extreme heat, receive concomitant medication with anticholinergic activity, or are subject to dehydration.
Dysphagia: Esophageal dysmotility and aspiration have been associated with antipsychotic drug use; use caution in patients at risk for aspiration pneumonia.
Concomitant Medication: Decreasing the ARISTADA dosage is
recommended in patients taking strong CYP3A4 inhibitors and/or strong
CYP2D6 inhibitors for longer than 2 weeks. Increasing the ARISTADA
dosage from 441 mg to 662 mg is recommended in patients taking CYP3A4
inducers for longer than 2 weeks. No ARISTADA dosage changes are
recommended for patients taking
Most Commonly Observed Adverse Reaction: The most common adverse reaction (≥5% incidence and at least twice the rate of placebo reported by patients treated with ARISTADA 441 mg and 882 mg monthly) was akathisia.
Injection-Site Reactions: Injection-site reactions were reported by 4%, 5%, and 2% of patients treated with 441 mg ARISTADA (monthly), 882 mg ARISTADA (monthly), and placebo, respectively. Most of these were injection-site pain and associated with the first injection and decreased with each subsequent injection. Other injection-site reactions (induration, swelling, and redness) occurred at less than 1%.
Dystonia: Symptoms of dystonia, prolonged abnormal contractions of muscle groups, may occur in susceptible individuals during the first days of treatment and at low doses.
Pregnancy/Nursing: May cause extrapyramidal and/or withdrawal symptoms in neonates with third trimester exposure. Advise patients to notify their healthcare provider of a known or suspected pregnancy. Inform patients that there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ARISTADA during pregnancy. Aripiprazole is present in human breast milk. The benefits of breastfeeding should be considered along with the mother’s clinical need for ARISTADA and any potential adverse effects on the infant from ARISTADA or from the underlying maternal condition.
Please see FULL PRESCRIBING INFORMATION, including Boxed Warning, for ARISTADA.
About
Note Regarding Forward-Looking Statements
Certain statements set forth in this press release constitute
“forward-looking statements” within the meaning of the Private
Securities Litigation Reform Act of 1995, as amended, including, but not
limited to, statements concerning the potential therapeutic and
commercial value of ARISTADA for the treatment of schizophrenia. The
company cautions that forward-looking statements are inherently
uncertain. Although the company believes that such statements are based
on reasonable assumptions within the bounds of its knowledge of its
business and operations, the forward-looking statements are neither
promises nor guarantees and they are necessarily subject to a high
degree of uncertainty and risk. Actual performance and results may
differ materially from those expressed or implied in the forward-looking
statements due to various risks and uncertainties. These risks and
uncertainties include whether results of ARISTADA’s development
activities are predictive of real-world results and those described
under the heading “Risk Factors” in the company’s Annual Report on Form
10-K for the year ended
ARISTADA® is a registered trademark of
INVEGA SUSTENNA® is a registered
trademark of
1
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Source:
Alkermes plc
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