52-Week Study Finds ONGLYZA(TM) (saxagliptin) When Added To Metformin Was Non-Inferior To Titrated Glipizide When Added To Metformin In Reducing Glycosylated Hemoglobin (HbA1c) In Adults With Type 2 D
Geschrieben am 26-06-2010 |   
 
    Orlando, Florida, June 26, 2010 (ots/PRNewswire) - Bristol-Myers Squibb 
Company   and AstraZeneca  today announced results from a 52-week 
Phase 3b  study in adults with type 2 diabetes who had inadequate 
glycemic control on  metformin therapy plus diet and exercise. This 
study found that the addition  of ONGLYZA(TM) (saxagliptin) 5 mg to 
existing metformin therapy achieved the  primary objective of 
demonstrating non-inferiority compared to the addition  of titrated 
glipizide (sulfonylurea) to existing metformin therapy in  reducing 
glycosylated hemoglobin levels (HbA1c). Glipizide 5 mg was titrated 
as required to 20 mg (mean dose 14.7 mg). The final dose in 
two-thirds of glipizide-treated patients was 15 mg or greater, 
requiring two or more dosage titrations. Additionally, the study 
found that treatment with ONGLYZA 5 mg plus metformin resulted in a 
statistically significant lower proportion of subjects reporting 
hypoglycemic events and statistically significant weight loss 
compared to titrated glipizide plus metformin. ONGLYZA 5 mg plus 
metformin also resulted in a significantly smaller rise per week in 
HbA1c from week 24 to week 52 compared to titrated glipizide plus 
metformin. Overall adverse events excluding hypoglycemia were 
reported at a similar rate between the two treatment groups. Results 
were presented at the 70th American Diabetes Association (ADA) Annual 
Scientific Sessions. 
 
   "Many adult patients with type 2 diabetes need more than one 
therapy to help improve glycemic control, and the data presented 
today adds to the body of evidence for ONGLYZA," said Burkhard Göke, 
MD, Professor of Internal Medicine, University Hospital Munich, 
Germany. 
 
   ONGLYZA has been submitted for regulatory review in more than 58 
countries and is approved in 43 countries, including the United 
States, Canada, Mexico, 30 EU countries, Chile, India, Brazil, 
Argentina and Switzerland. ONGLYZA was approved by the FDA in July 
2009 and is indicated as an adjunct to diet and exercise to improve 
blood sugar (glycemic) control in adults for the treatment of type 2 
diabetes mellitus. ONGLYZA once daily can be used in combination with 
commonly prescribed oral anti-diabetic medications - metformin, 
glyburide (a sulfonylurea) or a thiazolidinedione (TZD) (pioglitazone 
or rosiglitazone), - or as a monotherapy to significantly reduce 
HbA1c levels. ONGLYZA (saxagliptin) should not be used for the 
treatment of type 1 diabetes or for the treatment of diabetic 
ketoacidosis (high levels of certain acids, known as ketones, in the 
blood or urine). ONGLYZA has not been studied in combination with 
insulin. 
 
   About The Study: Saxagliptin Added to Metformin vs. Titrated 
Glipizide Added to Metformin 
 
   The study was a 52-week, international, multicenter, randomized, 
parallel-group, double-blind, active-controlled Phase 3b study of 858 
patients with type 2 diabetes (aged greater than or equal to 18) 
whose HbA1c  was greater than 6.5% and less than or equal to 10% at 
baseline. The study  was designed to assess the efficacy and safety 
of ONGLYZA 5 mg per day  compared to glipizide 5 mg, titrated as 
required to 20 mg as added to a  stable dose of metformin (greater 
than or equal to 1,500 mg per day) in adult  patients with type 2 
diabetes who did not achieve adequate glycemic control  with 
metformin alone. Individuals were randomized to one of two treatment 
groups: ONGLYZA 5 mg once daily plus metformin (n=428) or glipizide 5 
mg  (titrated as required to 20 mg) plus metformin (n=430). 
 
   The primary endpoint of the study was to assess whether the 
change from baseline in HbA1c achieved with ONGLYZA 5 mg was 
non-inferior to titrated glipizide (defined in the study protocol as 
a treatment group numerical difference in the HbA1c reduction of less 
than 0.35% for the upper limit of the two-sided 95% confidence 
interval [CI]) when both were added to a stable dose of metformin. 
Key secondary endpoints included the proportion of patients reporting 
at least one episode of a hypoglycemic event at week 52, change from 
baseline in body weight at week 52 and durability of HbA1c effect 
based on change per week in HbA1c from week 24 to week 52. 
 
   Study Results   
 
   The mean dose of titrated glipizide was 14.7 mg and the median 
dose 20 mg. Using the per-protocol analysis, after 52 weeks, 
individuals taking ONGLYZA 5 mg plus metformin achieved an adjusted 
mean change from baseline in HbA1c of -0.74%, compared to -0.80% for 
titrated glipizide plus metformin. Results of the study demonstrated 
that therapy with ONGLYZA 5 mg was non-inferior to titrated glipizide 
when added to existing metformin therapy (difference in adjusted mean 
change from baseline vs. titrated glipizide as added to existing 
metformin therapy was 0.06%, 95% CI -0.05 to 0.16). Non-inferiority 
of ONGLYZA (saxagliptin) 5 mg to titrated glipizide was also 
demonstrated in a confirmatory analysis of all individuals receiving 
study treatment for whom HbA1c data were available. 
 
   The number of individuals with any hypoglycemic event was 
significantly lower for patients treated with ONGLYZA 5 mg plus 
metformin as compared to those treated with titrated glipizide plus 
metformin (3% for ONGLYZA plus metformin vs. 36.3% for titrated 
glipizide plus metformin; p-value less than 0.0001) at week 52. 
 
   The study also demonstrated that patients treated with ONGLYZA 5 
mg plus metformin experienced a statistically significant weight 
decrease when compared to those treated with titrated glipizide plus 
metformin (-1.1 kg for ONGLYZA 5 mg plus metformin vs. +1.1 kg for 
titrated glipizide plus metformin; p-value less than 0.0001) at week 
52. 
 
   While both treatment groups exhibited slight increases in HbA1c 
from week 24 to week 52, the study demonstrated that patients treated 
with ONGLYZA had a smaller rise per week in HbA1c compared to those 
treated with titrated glipizide (0.001% for ONGLYZA plus metformin 
vs. 0.004% for titrated glipizide plus metformin; p-value equal to 
0.04) at week 52. 
 
   The number of individuals experiencing adverse events or serious 
adverse events after 52 weeks between the two treatment groups were 
as follows (excluding hypoglycemia): adverse events: 60.0% for 
ONGLYZA 5 mg plus metformin, 56.7% for titrated glipizide plus 
metformin; serious adverse events: 9.1% for ONGLYZA 5 mg plus 
metformin, 7.4% for titrated glipizide plus metformin. The most 
common adverse events (greater than or equal to 5% and observed more 
frequently in the ONGLYZA 5 mg treatment group compared to the 
titrated glipizide treatment group) were nasopharyngitis (9.6% vs. 
8.6%, respectively) and diarrhea (5.1% vs. 3.7%, respectively). 
Discontinuations due to adverse events were 4.2% for ONGLYZA 5 mg 
plus metformin groups vs. 4.4% for titrated glipizide plus metformin. 
 
   IMPORTANT INFORMATION ABOUT ONGLYZA   
 
   Indication and Important Limitations of Use   
 
   ONGLYZA (saxagliptin) is indicated as an adjunct to diet and 
exercise to improve glycemic control in adults with type 2 diabetes 
mellitus. 
 
   ONGLYZA should not be used for the treatment of type 1 diabetes 
mellitus or diabetic ketoacidosis. 
 
   ONGLYZA has not been studied in combination with insulin.   
 
   Important Safety Information  
 
 
    - Use with Medications Known to Cause Hypoglycemia: Insulin 
      secretagogues, such as sulfonylureas, cause hypoglycemia. Therefore, a 
      lower dose of the insulin secretagogue may be required to reduce the 
      risk of hypoglycemia when used in combination with ONGLYZA. 
    - Macrovascular Outcomes: There have been no clinical studies 
      establishing conclusive evidence of macrovascular risk reduction with 
      ONGLYZA or any other antidiabetic drug. 
 
 
   Most common adverse reactions (regardless of investigator 
assessment of causality) reported in greater than or equal to 5% of 
patients treated with ONGLYZA and more commonly than in patients 
treated with control were upper respiratory tract infection (7.7%, 
7.6%), headache (7.5%, 5.2%), nasopharyngitis (6.9%, 4.0%) and 
urinary tract infection (6.8%, 6.1%). When used as add-on combination 
therapy with a thiazolidinedione, the incidence of peripheral edema 
for ONGLYZA 2.5 mg, 5 mg, and placebo was 3.1%, 8.1% and 4.3%, 
respectively. 
 
   Laboratory Tests: There was a dose-related mean decrease in 
absolute lymphocyte count observed with ONGLYZA. 
 
   Drug Interactions: Because ketoconazole, a strong CYP3A4/5 
inhibitor, increased saxagliptin exposure, the dose of ONGLYZA should 
be limited to 2.5 mg when coadministered with a strong CYP3A4/5 
inhibitor (e.g., atazanavir, clarithromycin, indinavir, itraconazole, 
ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and 
telithromycin). 
 
   Patients with Renal Impairment: The dose of ONGLYZA (saxagliptin) 
is 2.5 mg once daily for patients with moderate or severe renal 
impairment, or with end-stage renal disease requiring hemodialysis 
(creatinine clearance [CrCl] less than or equal to 50 mL/min). 
ONGLYZA should be administered following hemodialysis. ONGLYZA has 
not been studied in patients undergoing peritoneal dialysis. 
Assessment of renal function is recommended prior to initiation of 
ONGLYZA and periodically thereafter. 
 
   Pregnant and Nursing Women: There are no adequate and 
well-controlled studies in pregnant women. ONGLYZA, like other 
antidiabetic medications, should be used during pregnancy only if 
clearly needed. It is not known whether saxagliptin is secreted in 
human milk. Because many drugs are secreted in human milk, caution 
should be exercised when ONGLYZA is administered to a nursing woman. 
 
   Pediatric Patients: Safety and effectiveness of ONGLYZA in 
pediatric patients have not been established. 
 
   U.S. Full Prescribing Information is available at 
http://www.bms.com. 
 
   Bristol-Myers Squibb and AstraZeneca Collaboration   
 
   Bristol-Myers Squibb and AstraZeneca entered into a collaboration 
in January 2007 to enable the companies to research, develop and 
commercialize select investigational drugs for type 2 diabetes. The 
Bristol-Myers Squibb/AstraZeneca Diabetes collaboration is dedicated 
to global patient care, improving patient outcomes and creating a new 
vision for the treatment of type 2 diabetes. 
 
   About Bristol-Myers Squibb   
 
   Bristol-Myers Squibb is a global biopharmaceutical company whose 
mission is to discover, develop and deliver innovative medicines that 
help patients prevail over serious diseases. For more information 
about Bristol-Myers Squibb, visit www.bms.com or follow us on Twitter 
at http://twitter.com/bmsnews. 
 
   About AstraZeneca   
 
   AstraZeneca is a global, innovation-driven biopharmaceutical 
business with a primary focus on the discovery, development and 
commercialization of prescription medicines. As a leader in 
gastrointestinal, cardiovascular, neuroscience, respiratory and 
inflammation, oncology and infectious disease medicines, AstraZeneca 
generated global revenues of $32.8 billion in 2009. In the United 
States, AstraZeneca is a $14.8 billion healthcare business. 
 
   For more information about AstraZeneca in the US or our AZ&Me(TM) 
Prescription Savings programs, please visit: 
http://www.astrazeneca-us.com or call +1-800-AZandMe (292-6363). 
 
   ONGLYZA is a trademark of the Bristol-Myers Squibb Company.   
 
ots Originaltext: Bristol-Myers Squibb and AstraZeneca 
Im Internet recherchierbar: http://www.presseportal.de 
 
Contact: 
CONTACT:  Contacts: Media: Ken Dominski, Bristol-Myers  
Squibb,+1-609-252-5251,ken.dominski@bms.com; Corey Windett,  
AstraZeneca, +1-302-885-0034,corey.windett@astrazeneca.com;  
Investors: John Elicker, Bristol-MyersSquibb,  
+1-609-252-4611,john.elicker@bms.com; Karl Hard, AstraZeneca,  
+44-20-7304-5322,karl.j.hard@astrazeneca.com; Clive Morris,  
AstraZeneca, +44-20-7304-5084,clive.morris@astrazeneca.com
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