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New data presented at 29th ECTRIMS Congress reinforce the clinical profile of investigational laquinimod on disease progression and inflammation in relapsing-remitting multiple sclerosis

Posted: 4 October 2013 | | No comments yet

Pooled data analysis of Phase III ALLEGRO and BRAVO studies add to our understanding of investigational laquinimod for relapsing-remitting Multiple Sclerosis…

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Teva Pharmaceutical Industries Ltd. (NYSE:TEVA) and Active Biotech (NASDAQ OMX NORDIC:ACTI) announced today the presentation of additional analyses of the Phase III ALLEGRO and BRAVO studies supporting the hypothesis that once-daily, oral laquinimod may have an effect on both inflammation and the broader underlying mechanisms associated with disease progression in relapsing-remitting multiple sclerosis. Various new laquinimod data will be featured in 16 scientific posters and presentations at the 29th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Copenhagen, Denmark, October 2-5, 2013.

“Continued analysis of the ALLEGRO and BRAVO Phase III studies demonstrates that the trend of efficacy results was maintained in the analysis of data pooled from the two studies, and is consistent with the proposed mechanism of action for laquinimod,” said Dr. Michael Hayden, President of Global R&D and Chief Scientific Officer for Teva Pharmaceutical Industries Ltd. “Teva remains committed to the laquinimod clinical development program in MS and in other diseases characterized by a neurodegenerative pathology, and to addressing the needs of these patients worldwide.”

Results from a post-hoc subgroup analysis of pooled data from the Phase III double-blind ALLEGRO and BRAVO studies showed there were some patients who experienced disease progression without experiencing a relapse during the studies. Regardless of treatment arm and despite relapse status, 12 percent of patients studied experienced disability progression after two years; of those patients who progressed, approximately one-third did not experience a relapse. Results specific to treatment with laquinimod showed that both relapsing and relapse-free patients treated with laquinimod experienced less disease progression than those treated with placebo. Specifically, 19 percent of relapsing patients on laquinimod progressed compared to 22 percent on placebo and 4.8 percent of relapse-free patients on laquinimod progressed compared to 7.6 percent on placebo. Overall, laquinimod reduced disability progression by 26.7 percent in relapsing patients (P=0.058) and 38.9 percent in relapse-free patients (P=0.036) compared to placebo.

Both the ALLEGRO and BRAVO studies found that laquinimod demonstrated a tolerable clinical profile compared to placebo. The overall frequencies of adverse events, including incidence of infections, were comparable to those observed in the placebo group. The most commonly reported adverse events were headaches, nasopharyngitis and back pain. The incidence of liver enzyme elevation was higher in laquinimod treated patients; however, these elevations were transient, asymptomatic and reversible. No deaths were reported in laquinimod-treated patients.

“We have made significant progress in understanding the pathology of multiple sclerosis however it remains a complex and often unpredictable disease,” said Professor Giancarlo Comi, Director of the Department of Neurology and Institute of Experimental Neurology at the San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy. “When patients show disease progression but do not experience a relapse, it suggests that disability progression and relapses are not solely mediated through a common pathway. The data presented at ECTRIMS support the theory that laquinimod may have a dual effect on inflammation and broader underlying mechanisms of outside of inflammation.”

Results of this study will be presented at the ECTRIMS Congress on Friday, October 4, 15:30 – 17:00 CET (P1036, Poster Session: Long-term treatment monitoring).

ABOUT THE ALLEGRO STUDY

ALLEGRO was a two-year, multi-national, multi-center randomized, double blind, placebo-controlled study designed to evaluate the efficacy, safety and tolerability of laquinimod in MS patients. The study was conducted at 139 sites in 24 countries and enrolled 1,106 MS patients. Patients were randomized to receive a once-daily oral dose of 0.6 mg laquinimod or matching placebo. The primary outcome measure was the number of confirmed relapses; secondary measures included confirmed disability progression and changes in MRI active lesions.

In the ALLEGRO study, laquinimod showed a statistically significant 23 percent reduction in annualized relapse rate (p=0.0024), the primary endpoint, along with a significant 36 percent reduction in the risk of confirmed disability progression, as measured by Expanded Disability Status Scale (EDSS) (p=0.0122). Treatment with laquinimod was also associated with a significant reduction in brain tissue loss, as measured by a 33 percent reduction in progression of brain atrophy (p<0.0001).

Eighty percent of laquinimod and 77 percent of placebo patients completed the two-year study. Patients who completed the ALLEGRO study were offered to join an open-label extension phase, in which they are being treated with laquinimod 0.6 mg daily.

ABOUT THE BRAVO STUDY

BRAVO was a two-year, multi-national, multi-center, randomized, double-blind, parallel-group, placebo-controlled study designed to compare the safety, efficacy and tolerability of a once-daily oral dose of 0.6 mg laquinimod over placebo and to provide a descriptive comparison of the risk-benefit profiles of laquinimod and interferon beta-1a. The primary outcome measure was to assess the efficacy of 0.6 mg daily dose of laquinimod as measured by the relapse rate. Secondary outcome measures included impact on the accumulation of disability and brain atrophy. The BRAVO study completed enrollment in June 2009, recruiting more 1,331 patients at 153 sites worldwide, including in the U.S., Europe, Russia, Israel and South Africa.

Results showed that the BRAVO study did not achieve its primary endpoint of reducing the annualized relapse rate (p=0.075).

ABOUT LAQUINIMOD

Laquinimod is an oral, investigational, CNS-active immunomodulator with a novel mechanism of action being developed for the treatment of relapsing-remitting MS (RRMS). The global Phase III clinical development program evaluating oral laquinimod in MS includes two pivotal studies, ALLEGRO and BRAVO. A third Phase III laquinimod trial, CONCERTO, is evaluating two doses of the investigational product (0.6mg and 1.2mg) in approximately 1,800 patients for up to 24 months. The primary outcome measure will be time to confirmed disability progression as measured by the EDSS.

In addition to the MS clinical studies, laquinimod is currently in Phase II of development for Crohn’s disease and lupus nephritis. Further studies are planned to determine the effectiveness of laquinimod in treating patients with Huntington’s disease and Alzheimer’s disease.