Macugen(R) (pegaptanib sodium injection) Studied in Treatment of Diabetic Macular Edema (DME) and Other Diabetic Retinopathy Les
06 May 2005 - 12:19AM
PR Newswire (US)
Macugen(R) (pegaptanib sodium injection) Studied in Treatment of
Diabetic Macular Edema (DME) and Other Diabetic Retinopathy Lesions
Improvement in diabetic retinopathy score noted in review of
retinal photographs NEW YORK, May 5 /PRNewswire-FirstCall/ --
Eyetech Pharmaceuticals, Inc. (NASDAQ:EYET) announced today that
imaging data from a Phase 2 study of Macugen(R) (pegaptanib sodium
injection) in diabetic macular edema (DME) showed a reversal of
capillary microaneurysms, retinal ischemia and neovascularization
-- all important signs of diabetic retinopathy. These new
preliminary observations from the Macugen Phase 2 DME trial were
presented today at the 2005 Association for Research in Vision and
Ophthalmology annual meeting in Fort Lauderdale, Fla. Macugen is
indicated in the United States for the treatment of neovascular
age-related macular degeneration (neovascular AMD) and is not
approved for the treatment of DME. For full prescribing information
about Macugen, please visit http://www.macugen.com/. (Logo:
http://www.newscom.com/cgi-bin/prnh/20050407/EYETLOGO )
"Researchers reviewed photographs of the retina and noted evidence
of regression of retinal neovascularization and other signs of
diabetic retinopathy in patients treated with Macugen. We also
found an improvement on the diabetic retinopathy severity scale,
which suggests that Macugen may have helped slow or even reverse
the progression of the disease," said Larry Singerman, M.D.,
Clinical Professor of Ophthalmology at Case University School of
Medicine and President of Retina Associates of Cleveland. "While no
final conclusions can be drawn from these preliminary and limited
data as to the efficacy of Macugen in diabetic retinopathy, we are
encouraged by the potential implication of these findings, which
are consistent with our current understanding of the role of VEGF
in diabetic retinopathy. We look forward to future research to
confirm this important hypothesis." As previously announced,
Eyetech and Pfizer plan to conduct a pivotal Phase 2/3 DME clinical
trial that will include the diabetic retinopathy score as a
pre-specified secondary endpoint. This trial is expected to begin
in the second half of 2005. "There is a tremendous unmet medical
need for the 5.3 million of people in the U.S. who suffer from
diabetic retinopathy. We are hoping that future trials may
demonstrate that Macugen is effective in treating or preventing the
progression of diabetic retinopathy," said Anthony P. Adamis, M.D.,
Chief Scientific Officer of Eyetech. "Eyetech remains focused on
diseases affecting the back of the eye because we believe these
represent the largest unmet needs in ophthalmology. Our clinical
development program for Macugen, in partnership with Pfizer,
continues to progress." Findings in Retrospective Subgroup Analysis
of Macugen DME Phase 2 Data Researchers conducted a retrospective
analysis of 69 patients within the Macugen 0.3 mg and usual care
arms who had recognized and gradable diabetic retinopathy at both
baseline and week 36. In these two arms of the trial, patients
treated with Macugen 0.3 mg therapy showed an improvement in the
ETDRS diabetic retinopathy severity scale, a standard for
monitoring the progression of retinopathy. At week 36, 11 of the 39
Macugen 0.3 mg dosed patients (28.2 percent) showed improvement of
greater than or equal to 1 step versus four of 30 in the sham group
(13.3 percent). In addition, a higher proportion of Macugen
patients (five of 39, 12.8 percent) showed an improvement of > 2
steps at week 36 compared to sham group (one of 30, 3.3 percent).
Another retrospective analysis from these two arms of the trial
included 82 patients for whom assessment of retinal ischemia data
was available at both baseline and week 36 (43 patients receiving
0.3 mg Macugen, 39 patients receiving usual care). In this
analysis, 16 percent of Macugen patients had less capillary loss,
compared to five percent of patients receiving usual care. In
another analysis of all patients treated with Macugen, (0.3 mg, 1
mg, 3 mg doses), 13 were noted to have retinal neovascularization
upon their baseline examination. Of these 13 patients, regression
in retinal neovascularization was noted at week 36 in eight (62
percent), while no regression of neovascularization was recognized
in sham patients who had neovascularization at baseline. As well,
recurrence of neovascularization followed discontinuation of
Macugen in three of the eight subjects (38%) at week 52. More About
the Phase 2 DME Study In a Phase 2, double-masked, sham-controlled
study of 172 DME patients, 73 percent of patients receiving 0.3 mg
Macugen experienced stable or improved vision at week 36, compared
to 51 percent of patients who received sham (p=0.023). Among
Macugen 0.3 mg patients: 59 percent reported vision gain of at
least one line (5 letters) versus 34 percent of sham (p=0.010); 34
percent reported vision gain of at least two lines (10 letters)
versus 10 percent of sham (p=0.003); and 18 percent reported vision
gain of at least three lines (15 letters) versus seven percent of
sham (p=0.12). In addition, 42 percent of patients receiving
Macugen 0.3 mg showed a decrease in mean retinal thickness of at
least 100 microns, compared to 16 percent of sham. As well, at the
end of the study, only half as many patients who received Macugen
needed additional laser therapy compared to those receiving usual
care (25% vs. 48%). About Diabetic Retinopathy Diabetic retinopathy
is a disease affecting the blood vessels of the retina, resulting
in multiple abnormalities including retinal thickening or edema,
hemorrhages, impeded blood flow (retinal ischemia), excessive
leakage of fluid from blood vessels and, in the final stages,
abnormal blood vessel growth. Such blood vessel growth
(proliferative diabetic retinopathy) can lead to hemorrhages and
severe retinal damage. When the blood vessel leakage causes
swelling within the macula, it is referred to as DME. According to
the American Diabetes Association (ADA), there are at least 18
million people diagnosed with diabetes in the United States. After
10 years of disease duration, 75 percent of diabetics have
developed some form of diabetic retinopathy. Diabetes is the
leading cause of blindness in adults 20 to 74 years of age in the
United States, and DME is the leading cause of vision loss for
patients with diabetes. In the United States, there are
approximately 500,000 people suffering from DME, with approximately
75,000 new cases each year. There is a significant unmet medical
need for a new therapy for this disease. About Macugen Macugen is
indicated in the United States for the treatment of neovascular
age-related macular degeneration (neovascular AMD) and is
administered in a 0.3 mg dose once every six weeks by intravitreal
injection. Macugen is a pegylated anti-VEGF aptamer, which binds to
vascular endothelial growth factor (VEGF). VEGF is a protein that
plays a critical role in angiogenesis (the formation of new blood
vessels) and increased permeability (leakage from blood vessels),
two pathological processes that contribute to the vision loss
associated with neovascular AMD. Important Safety Information
Macugen is contraindicated in patients with ocular or periocular
infections. Intravitreal injections including those with Macugen
have been associated with endophthalmitis. Proper aseptic injection
technique -- which includes use of sterile gloves, a sterile drape,
and a sterile eyelid speculum (or equivalent) -- should always be
utilized when administering Macugen. In addition, patients should
be monitored during the week following the injection to permit
early treatment, should an infection occur. Increases in
intraocular pressure (IOP) have been seen within 30 minutes of
injection with Macugen. Therefore, IOP as well as the perfusion of
the optic nerve head should be monitored and managed appropriately.
Serious adverse events related to the injection procedure occurring
in
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