18.10.2017 – 12:36
Merck to Present New Data on MS Portfolio: Rebif, Mavenclad, and Evobrutinib at ECTRIMS 2017
Darmstadt, Germany (ots/PRNewswire)
Not intended for US/UK based media
Merck to Present New Data on MS Portfolio: Rebif, Mavenclad, and Evobrutinib at ECTRIMS 2017
- Important safety and immune cell analyses further characterize the selective immune reconstitution approach of Mavenclad - Continued innovation with Rebif includes analysis of NEDA and use of MAGNIMS criteria in predicting clinical outcomes out to 15 years - Pre-clinical data for investigational evobrutinib highlight potential role in patients with relapsing MS - A total of 40 abstracts will be presented by lead investigators
Merck, a leading science and technology company, today announced that data for approved and investigational multiple sclerosis (MS) treatments, MAVENCLAD®(Cladribine Tablets) and Rebif® (interferon beta-1a) and evobrutinib will be presented at MSParis 2017, 7th Joint ECTRIMS-ACTRIMS Meeting, 25-28 October 2017 in Paris, France. Efficacy data will be presented from the CLARITY, CLARITY Extension and ORACLE-MS trials which highlight that MAVENCLAD® delivers and sustains 4 years of disease control with a maximum of 20 days of oral treatment in the first 2 years. Additional safety analysis assessing malignancy and infection risk will be presented along with data for MAVENCLAD® which further detail how the treatment is thought to selectively target the adaptive immune system.
Data presentations for Rebif® will focus on long-term disease activity assessed by the MAGNIMS (Magnetic Resonance Imaging in MS) score. Real-world evidence presentations will evaluate relapse rates in patients newly initiating on Rebif®, and an assessment of treatment adherence rates for patients treated with Rebif® compared with dimethyl fumarate.
Furthermore, key preclinical data will be presented for Merck's investigational evobrutinib (M2951), a Bruton's tyrosine kinase (BTK) inhibitor, which is thought to be important in the development and functioning of various immune cells including B lymphocytes, specifically in patients with MS.
"The breadth of data being presented at this year's congress underpin Merck's commitment to deepening the understanding of how our portfolio of products, whether approved or investigational, target MS, and reinforce our dedication to provide differentiated treatment options to physicians and people living with MS," said Luciano Rossetti, Head of Global R&D for the biopharma business of Merck.
In addition to data presentations, two Merck-sponsored symposia will take place during the meeting:
- Balancing benefits and risks of DMDs in MS, Thursday, October 26, 18:00-19:00, Hall A - Potential solutions to treatment burden in MS, Friday, October 27, 08:00-09:00, Hall A
On Wednesday, October 25, from 9:30-11:30am CEST, Merck will be hosting a press event briefing with members of the leadership team and lead investigators. A link to view this event will be available for media offsite, please contact firstname.lastname@example.org for further information. Additionally, at 19:30pm CEST, Merck will be hosting a session highlighting data from a report which will be published during MSParis 17 entitled, Addressing the Socio-economic impact of Multiple Sclerosis on Women in Europe.
On Thursday, October 26, Merck will also be hosting the annual Grant for Multiple Sclerosis Innovation (GMSI) Award Event at the Palais des Congres, Havane Theatre. The award, first launched at ECTRIMS in 2012, supports the advancement of science and medical research in the field of MS, and provides a grant of up to EUR1,000,000 per year to one or more selected research projects.
On Friday, October 27, MS in the 21st Century (Merck sponsored initiative involving a joint Steering Group of international healthcare professionals and MS patient advocates) will host their first educational workshop titled 'Two monologues do not make a dialogue - Overcoming communications barriers between healthcare professionals and patient', to encourage better communication between healthcare professionals and people with MS. As part of this workshop, two new communication tools will also be launched: 'my/MS Priorities' and 'my/MS Commitments', both of which are designed to be used jointly with people with MS and their healthcare team to improve the quality and efficiency of clinical consultations and disease management.
For up-to-date information and activities during ECTRIMS 2017, follow Merck on Twitter (@MerckHealthcare or #AddressMS) or visit booth 08.
The following MAVENCLAD® and Rebif® global abstracts have been accepted for presentation at MSParis 2017, 7th Joint ECTRIMS-ACTRIMS Meeting:
MAVENCLAD (Cladribine Tablets) Presentations Abstract/ Presentation Title Lead Author Poster # Date/Time/Session Effects of Cladribine Tablets on CD4+ T Cell Subsets in the ORACLE-MS Poster Session 1 Study: Results from an Thursday 26 October Analysis of Lymphocyte 2017 Surface Markers Stuve O P667 Time: 15:30-17:00 Cladribine Tablets Produce Selective and Discontinuous Reduction of B and T Lymphocytes and Natural Killer Cells in Patients with Early and Relapsing Multiple Sclerosis (ORACLE-MS,CLARITY and CLARITY Extension) Stuve O P690 Rates of Lymphopenia Year-by-year in Patients with Relapsing Multiple Sclerosis Treated and Retreated with Cladribine Tablets 3.5mg/kg Cook S P666 Long-Term Lymphocyte Counts in Patients with Relapsing-Remitting Multiple Sclerosis (RRMS) Treated with Cladribine Tablets 3.5 mg/kg: Total Lymphocytes, B and T Cell Soelberg-Sorensen Subsets P P655 Effects of Cladribine Poster Session 2 Tablets on Radiological Friday 27 October 2017 Outcomes in High Disease Time: 15:30-17:00 Activity (HDA) Subgroups of Patients with Relapsing Poster Session 2 Multiple Sclerosis (RMS) Friday 27 October 2017 in the CLARITY Study Giovannoni G P1164 Time: 15:30-17:00 Proportions of Patients with Highly Active RMS Achieving No Evidence of Disease Activity (NEDA) in Response to Cladribine Tablets in CLARITY Giovannoni G P1143 Investigation of Cladribine Treatment Rules in Subjects with Relapsing-Remitting Multiple Sclerosis (RRMS) by means of Modelling & Simulation Terranova N P912 Infections During Periods of Grade 3 or 4 Lymphopenia in Patients Taking Cladribine Tablets 3.5 mg/kg: Data from an Integrated Safety Analysis Cook S P1142 Innate Immune Cell Counts in Patients with Relapsing-Remitting Multiple Sclerosis (RRMS) Treated with Cladribine Tablets 3.5 mg/kg in CLARITY and CLARITY Soelberg- Extension Sorensen P P1141 An analysis of malignancy Late-breaker risk in the clinical Poster Session 2 development programme of Friday 27 October 2017 cladribine tablets in Time: 15:30-17:00 patients with relapsing multiple sclerosis (RMS) Galazka A P1878 Pregnancy outcomes during Late-breaker the clinical development Poster Session 2 programme of cladribine in Friday 27 October 2017 multiple sclerosis (MS): Time: 15:30-17:00 an integrated analysis of safety for all exposed patients Galazka A P1874 Rebif (interferon beta-1a) Presentations Abstract/ Presentation Title Lead Author Poster # Date/Time/Session Disease Activity as Poster Session 1 Assessed by the MAGNIMS Thursday 26 October Score Predicts Long-Term 2017 Clinical Disease Activity Time: 15:30-17:00 Free Status and Disability Poster Session 1 Progression in Patients Thursday 26 October Treated with Subcutaneous 2017 Interferon Beta-1a Sormani MP P770 Time: 15:30-17:00 The Association between Disease Activity and Disability Progression in Patients with Relapsing-Remitting Multiple Sclerosis Spelman T P348 Clinical Characteristics and Treatment Patterns of Relapsing-Remitting Multiple Sclerosis Patients with High Disease Activity Spelman T P340 Comparing patient and healthcare professional perceptions on multiple sclerosis management and care where do their priorities differ? Results from a qualitative survey Rieckman P P814 Infertility Diagnosis and Treatment in Women With and Without Multiple Sclerosis Houtchens MK AP356 Validation of MUSIQOL among Arabic-speaking MS Patients treated with High dose INF-beta 1a sc injection New Formulation Al Jumah M P821 RebiQoL: A telemedicine patient support program on health related quality of life and adherence in MS patients treated with Rebif Landtblom AM P826 Serum Neurofilament light chain correlates with disease activity and predicts clinical and MRI outcomes in MS Barro C P636 Impact of the Presence of Poster Session 2 Gadolinium-Enhancing Friday 27 October 2017 Lesions at Baseline on No Time: 15:30-17:00 Evidence of Disease Poster Session 2 Activity Status in Friday 27 October 2017 Patients Treated with Time: 15:30-17:00 Subcutaneous Interferon Beta-1a: A Post-Hoc Analysis of REFLEXION Freedman M P1144 Evolution of New Lesions and its Temporal Patterns in Patients with Clinically Isolated Syndrome Treated with Subcutaneous Interferon Beta-1a Vrenken H P1025 Using algorithms to identify High Disease Activity Relapsing-Remitting Multiple Sclerosis patients using electronic health record data with natural language processing Kamauu AW P877 Using United States Integrated Delivery Network (IDN) Electronic Health Records (EHR)/Natural Language Processing (NLP)-Based Algorithms to Identify Relapses in Relapsing-Remitting Multiple Sclerosis (RRMS) Patients Kamauu AW P885 Developing United States Integrated Delivery Network (IDN) Claims-Based Algorithms to Identify Relapses in Relapsing-Remitting Multiple Sclerosis (RRMS) Patients Kamauu AW P878 Rates of Pregnancy in Women With and Without Multiple Sclerosis Over Time Houtchens MK P890 Prevalence of Comorbidities in Patients With and Without Multiple Sclerosis by Age and Sex: A US Retrospective Claims Database Analysis Kresa-Reahl K P941 Infertility Treatment and Live Birth Rates in Women With and Without Multiple Sclerosis Houtchens MK P891 An Evaluation of Adherence Using Panel Survey Data From Patients With Multiple Sclerosis Treated With Subcutaneous Interferon beta-1a or Dimethyl Fumarate Perrin Ross A P1251 Real-World Assessment of Relapse in Patients With Multiple Sclerosis Newly Initiating scIFNbeta1a Compared With Oral Disease-Modifying Drugs Bowen J P1245 Interferon-beta and regulatory cells: evaluation of treatment-induced modulation of Treg, Breg and CD56bright NK cell levels in multiple sclerosis patients Martire S P1140 Risk of stroke in patients Late-breaker with multiple sclerosis Poster Session 2 treated with subcutaneous Friday 27 October 2017 interferon beta-1a Venkatesh S P1918 Time: 15:30-17:00 Creating a healthcare claims-based adaptation of Kurtzke Functional Systems Scores for assessing multiple sclerosis severity and progression Le Truong CTL EP1767 ePosters A mapping study to compare the educational offerings for patients in the fields of multiple sclerosis and HIV in Europe and Canada Rieckman P EP1838 Long-term real-life retrospective analysis on interferon beta1-a use in RRMS patients in Finland Al Jumah M EP1687 Adherence, cognition and behavioral performance in relapsing-remitting MS (RRMS) patients using the electronic autoinjector RetainSmartTM: 1 and 2 year follow-up from the German multicenter RETAINsmart study Rau D EP1692 Cerebrospinal fluid levels of neurofilament light chain, C-X-C ligand motif 13, and chitinase-3-like protein 1 reflect distinct pathological processes in multiple sclerosis Zanoni M EP1598 Brain atrophy and disease free status over 3 years in multiple sclerosis patients under interferon beta 1a subcutaneous treatment Rojas JI EP1657 Evobrutinib Presentations Abstract/ Presentation Title Lead Author Poster # Date/Time/Session Oral Presentation B cell-mediated Parallel Session 8: experimental CNS Immune Cells in Injury autoimmunity is modulated and Repair by inhibition of Bruton's Thursday 26 October 2017 tyrosine kinase Torke S 143 14:00-15:30 Design of a Phase II Dose Poster Session 1 Range Finding, Efficacy Thursday 26 October 2017 and Safety Study of the Time: 15:30-17:00 Bruton's Tyrosine Kinase Inhibitor Evobrutinib (M2951) in Relapsing Multiple Sclerosis Patients Montalban X P675 T cell mediated experimental CNS autoimmunity induced by PLP in SJL mice is modulated by Evobrutinib (M2951) a novel Bruton's tyrosine kinase inhibitor Boschert U P678
MAVENCLAD® (cladribine tablets) is approved in the European Union for the treatment of highly active relapsing multiple sclerosis[*] (RMS). MAVENCLAD® is a short-course oral therapy that selectively and periodically targets lymphocytes thought to be integral to the pathological process of relapsing MS (RMS). MAVENCLAD® is currently under clinical investigation and not yet approved for the treatment for any use in the United States or Canada. In August 2017, the European Commission (EC) granted marketing authorization for MAVENCLAD® for the treatment of relapsing forms of multiple sclerosis (RMS) in the 28 countries of the European Union (EU) in addition to Norway, Liechtenstein and Iceland.
The clinical development program for MAVENCLAD® includes:
- The CLARITY (Cladribine Tablets Treating MS Orally) study: a two-year Phase III placebo-controlled study designed to evaluate the efficacy and safety of MAVENCLAD® as a monotherapy in patients with RRMS. - The CLARITY extension study: a two-year Phase III placebo-controlled study following on from the CLARITY study, designed to evaluate the safety and efficacy of MAVENCLAD® over an extended administration for four years. - The ORACLE MS (Oral Cladribine in Early MS) study: a two-year Phase III placebo-controlled study designed to evaluate the efficacy and safety of MAVENCLAD®as a monotherapy in patients at risk of developing MS (patients who have experienced a first clinical event suggestive of MS). - The ONWARD (Oral Cladribine Added ON To Interferon beta-1a in Patients With Active Relapsing Disease) study: a Phase II placebo-controlled study designed primarily to evaluate the safety and tolerability of adding MAVENCLAD® treatment to patients with relapsing forms of MS, who have experienced breakthrough disease while on established interferon-beta therapy. - PREMIERE (Prospective Observational Long-term Safety Registry of Multiple Sclerosis Patients Who Have Participated in Cladribine Clinical Studies) study: interim long-term follow-up data from the prospective registry, PREMIERE, to evaluate the safety and efficacy of MAVENCLAD®. This includes more than 10,000 patient years of data with over 2,700 patients included in the clinical trial program, and more than 10 years of observation in some patients.
MAVENCLAD® (cladribine tablets) is indicated for the treatment of adult patients with highly active relapsing multiple sclerosis (RMS) as defined by clinical or imaging features.
Important EU Safety Information Contraindications: MAVENCLAD® is contraindicated in patients with hypersensitivity to the active substance, human immunodeficiency virus (HIV), active chronic infection (tuberculosis or hepatitis), active malignancy, moderate to severe renal impairment (creatinine clearance <60 mL/min), and those who are pregnant and breast-feeding. MAVENCLAD® is also contraindicated in immunocompromised patients, including patients currently receiving immunosuppressive or myelosuppressive therapy.
Special warnings and precautions for use:
The most clinically relevant adverse reactions were lymphopenia and herpes zoster.
Decreases in neutrophil count, red blood cell count, haematocrit, haemoglobin or platelet count compared to baseline values have been observed in clinical studies, although these parameters usually remain within normal limits.
Additive haematological adverse reactions may be expected if cladribine is administered prior to or concomitantly with other substances that affect the haematological profile
Lymphocyte counts must be determined
- before initiating MAVENCLAD® in year 1, - before initiating MAVENCLAD® in year 2, - 2 and 6 months after start of treatment in each treatment year. If the lymphocyte count is below 500 cells/mm³, it should be actively monitored until values increase again.
Cladribine can reduce the body's immune defence and may increase the likelihood of infections. HIV infection, active tuberculosis and active hepatitis must be excluded before initiation of cladribine.
The incidence of herpes zoster was increased in patients on cladribine. If lymphocyte counts drop below 200 cells/mm³, anti-herpes prophylaxis according to local standard practice should be considered during the time of grade 4 lymphopenia. Interruption or delay of MAVENCLAD® may be considered until proper resolution of the infection.
Cases of progressive multifocal leukoencephalopathy (PML) have been reported for parenteral cladribine in patients treated for hairy cell leukaemia with a different treatment regimen.
In the clinical study data base of cladribine in MS (1,976 patients, 8,650 patient years) no case of PML has been reported. However, a baseline magnetic resonance imaging (MRI) should be performed before initiating MAVENCLAD® (usually within 3 months).
Rebif® (interferon beta-1a) is a disease-modifying drug used to treat relapsing forms of multiple sclerosis (MS) and is similar to the interferon beta protein produced by the human body. The efficacy of Rebif® in chronic progressive MS has not been established. Interferon ß is thought to help reduce inflammation. The exact mechanism is unknown.
Rebif®, which was approved in Europe in 1998 and in the US in 2002, is registered in more than 90 countries worldwide. Rebif® has been proven to delay the progression of disability, reduce the frequency of relapses and reduce MRI lesion activity and area[+].
Rebif® can be administrated with the RebiSmart® electronic auto-injection device (not approved in the US), or with the RebiDose® single-use disposable pen, or the manual multidose injection pen RebiSlide(TM). Rebif® can also be administered with the autoinjector Rebiject II® or by manual injection using ready-to-use pre-filled syringes. These injection devices are not approved in all countries.
In January 2012, the European commission approved the extension of the indication of Rebif® in early multiple sclerosis. The extension of the indication of Rebif®has not been submitted in the United States.
Rebif® should be used with caution in patients with a history of depression, liver disease, thyroid abnormalities and seizures. Most commonly reported side effects are flu-like symptoms, injection site disorders, elevation of liver enzymes and blood cell abnormalities. Patients, especially those with depression, seizure disorders, or liver problems, should discuss treatment with Rebif® with their doctors.
Rebif® (interferon beta-1a) is approved in the United States for relapsing forms of MS. RebiSmart®, an electronic device for self-injection of Rebif®, is also not approved in the United States. Cladribine Tablets is an investigational product and not approved for use in any indication in the United States.
[+]The exact correlation between MRI findings and the current or future clinical status of patients, including disability progression, is unknown.
Evobrutinib (M2951) is in clinical development to investigate its potential as a treatment for multiple sclerosis (MS), rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). It is an oral, highly selective inhibitor of Bruton's Tyrosine Kinase (BTK) which is important in the development and functioning of various immune cells including B lymphocytes and macrophages. Evobrutinib is designed to inhibit primary B cell responses such as proliferation and antibody and cytokine release, without directly affecting T cells. BTK inhibition is thought to suppress autoantibody-producing cells, which preclinical research suggests may be therapeutically useful in certain autoimmune diseases. Evobrutinib is currently in Phase II studies.
About Multiple Sclerosis
Multiple sclerosis (MS) is a chronic, inflammatory condition of the central nervous system and is the most common, non-traumatic, disabling neurological disease in young adults. It is estimated that approximately 2.3 million people have MS worldwide. While symptoms can vary, the most common symptoms of MS include blurred vision, numbness or tingling in the limbs and problems with strength and coordination. The relapsing forms of MS are the most common.
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