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Not intended for U.S. and UK Media: Secondary Prevention of Acute Coronary Syndrome (ACS):
Berlin, Germany, May 23, 2012 - Bayer HealthCare announced today that the U.S.
Food and Drug Administration's (FDA's) Cardiovascular and Renal Drugs Advisory
Committee voted against the approval of the oral anticoagulant Xarelto®
(rivaroxaban) 2.5 mg BID in combination with standard antiplatelet therapy to
reduce the risk of secondary cardiovascular events in patients with Acute
Coronary Syndrome (ACS).
"We appreciate the thoroughness of the Committee and, together with our
cooperation partner Janssen Research & Development, LLC, we will ensure that
the questions raised today are addressed so the FDA may finalize their review,"
said Dr. Kemal Malik, Member of the Bayer HealthCare Executive Committee and
Head of Global Development.
Xarelto® is approved in the U.S. to reduce the risk of blood clots in the legs
and lungs of people who have just had knee or hip replacement surgery, and to
reduce the risk of both hemorrhagic and thrombotic strokes as well as other
blood clots in people with atrial fibrillation not caused by a heart valve
problem.
Data presented at today's Advisory Committee meeting included results from the
pivotal, global Phase III ATLAS ACS 2-TIMI 51 study, which compared oral
rivaroxaban dosed twice daily in addition to standard antiplatelet therapy ?
low-dose aspirin with or without a thienopyridine such as clopidogrel ? with
standard antiplatelet therapy alone in preventing secondary cardiovascular
events (cardiovascular death, myocardial infarction or stroke) in patients with
ACS.
Results from the ATLAS ACS 2-TIMI 51 study, presented at the 2011 American
Heart Association Scientific Sessions and published simultaneously in the New
England Journal of Medicine (10.1056/NEJMoa1112277), showed that the
combination of oral rivaroxaban 2.5 mg BID with standard antiplatelet therapy
significantly reduced the composite primary efficacy endpoint of cardiovascular
death, myocardial infarction or stroke in patients after a recent ACS compared
to those receiving standard antiplatelet therapy alone. In addition,
rivaroxaban 2.5 mg BID in combination with standard therapy significantly
reduced the rate of cardiovascular mortality by 34% and the incidence of
all-cause mortality by 32% over standard therapy alone, with the benefit
established early and maintained through two years.
In patients receiving 2.5 mg BID of rivaroxaban in combination with standard
antiplatelet therapy, the rate of TIMI major bleeding events not associated
with coronary artery bypass graft (CABG) surgery were low overall, yet
increased versus those treated with standard therapy alone. Importantly, these
differences were not associated with an increase in the risk of fatal bleeding
or fatal intracranial haemorrhage (ICH).
The FDA assigned a Priority Review designation to the supplemental New Drug
Application (sNDA) filed by Bayer's cooperation partner Janssen Research &
Development, LLC on December 29, 2011 for rivaroxaban in patients with ACS.
Recommendations from the Advisory Committee will be considered by the FDA in
its review of the sNDA for rivaroxaban in this indication, but the FDA is not
bound to follow them. If approved by the FDA, Janssen Pharmaceuticals, Inc. (a
Johnson & Johnson Company) will commercialize rivaroxaban for this additional
indication in the U.S.
About ACS
ACS is a complication of coronary heart disease, which is the leading cause of
death in the U.S. and one of the most prevalent non-communicable diseases in
the world. ACS occurs when a blood clot blocks a coronary artery, reducing
blood supply to the heart. This disruption of blood flow can be the direct
cause of a myocardial infarction, or cause unstable angina indicating that a
myocardial infarction may soon occur.
About ATLAS ACS 2-TIMI 51
The ATLAS ACS 2-TIMI 51 (Anti-Xa Therapy to Lower cardiovascular events in A
ddition to aspirin with/without thienopyridine therapy in Subjects with Acute C
oronary Syndrome) study was designed to test the efficacy of rivaroxaban, in
combination with standard antiplatelet therapy, compared to placebo in
preventing cardiovascular death, myocardial infarction or stroke in patients
with ACS. Patients were given standard antiplatelet therapy plus rivaroxaban
dosed at 2.5 mg or 5 mg BID, or a placebo. Of the 15,526 patients randomized
into the study, 93% received aspirin and thienopyridine in addition to
rivaroxaban or placebo, and the balance were treated with aspirin plus
rivaroxaban or placebo.
The double blind, randomized, placebo-controlled study was coordinated by the
TIMI Study Group and Brigham and Women's Hospital and Harvard Medical School,
Boston, U.S., and was funded and led by Bayer HealthCare and Janssen Research &
Development, LLC.
About Venous Arterial Thromboembolism (VAT)
Thrombosis is the formation of a blood clot inside a blood vessel, blocking a
vein (venous thrombosis) or artery (arterial thrombosis). Venous Arterial
Thromboembolism (VAT) is caused when some or all of a clot detaches and is
moved within the blood stream until it obstructs a smaller vessel. This can
result in damage to vital organs, because the tissue beyond the blockage no
longer receives nutrients and oxygen.
VAT is responsible for a number of serious and life threatening conditions:
· Venous Thromboembolism (VTE) occurs when part of a clot formed in a deep
vein, for example in the leg (known as deep vein thrombosis, or DVT), is
carried to the lung, via the heart, preventing the uptake of oxygen. This is
known as a pulmonary embolism (PE), an event which can be rapidly fatal
· Arterial Thromboembolism (ATE) occurs when oxygenated blood flow from the
heart to another part of the body (via an artery) is interrupted by a blood
clot. If this occurs in a vessel supplying blood to the brain, it can lead to a
stroke, an event that can be severely debilitating or fatal. If it occurs in a
coronary artery, it can lead to acute coronary syndrome (ACS), a complication
of coronary heart disease which includes conditions such as myocardial
infarction (heart attack), and unstable angina
VAT is responsible for significant morbidity and mortality, and requires active
or preventative treatment to avoid potentially serious or fatal patient
outcomes.
About Rivaroxaban (Xarelto®)
Rivaroxaban is an oral anticoagulant that was discovered in Bayer HealthCare's
Wuppertal laboratories in Germany, and is being jointly developed by Bayer
HealthCare and Janssen Research & Development, LLC. It has a rapid onset of
action with a predictable dose response and high bioavailability, no
requirement for routine coagulation monitoring, and a limited potential for
food and drug interactions.
Rivaroxaban is marketed under the brand name Xarelto® for VTE prevention in
adult patients following elective hip or knee replacement surgery, and it is
the only oral anticoagulant that has consistently demonstrated superior
efficacy over enoxaparin in this indication. Rivaroxaban is approved in more
than 120 countries worldwide and is marketed outside the U.S. by Bayer
HealthCare in this indication. On December 9, 2011, Xarelto® received further
marketing approval in the EU for the prevention of stroke and systemic embolism
in patients with atrial fibrillation, as well as for the treatment of deep vein
thrombosis (DVT) and the prevention of recurrent DVT and pulmonary embolism
following an acute DVT in adult patients.
In the U.S., where rivaroxaban has been available since July 2011 for VTE
prevention in adult patients following elective hip or knee replacement
surgery, Janssen Pharmaceuticals, Inc. (a Johnson & Johnson Company) holds
marketing rights. The Bayer HealthCare sales force is supporting Janssen
Pharmaceuticals, Inc. in designated hospital accounts. On November 4, 2011,
Xarelto® received further marketing approval in the U.S. to reduce the risk of
stroke and systemic embolism in patients with nonvalvular Atrial Fibrillation.
The extensive clinical trial program supporting rivaroxaban makes it the most
studied and widely published oral, direct Factor Xa inhibitor. The studies
involve over 75,000 patients for the prevention and treatment of venous and
arterial thromboembolic (VAT) disorders across a broad range of acute and
chronic conditions, including VTE prevention in adult patients following
elective hip or knee replacement surgery, stroke prevention in patients with
Atrial Fibrillation, VTE treatment and the prevention of recurrent DVT or PE,
and for secondary prevention after an Acute Coronary Syndrome.
To learn more about thrombosis, please visit www.thrombosisadviser.com.
About Bayer HealthCare
The Bayer Group is a global enterprise with core competencies in the fields of
health care, nutrition and high-tech materials. Bayer HealthCare, a subgroup of
Bayer AG with annual sales of EUR 17.2 billion (2011), is one of the world's
leading, innovative companies in the healthcare and medical products industry
and is based in Leverkusen, Germany. The company combines the global activities
of the Animal Health, Consumer Care, Medical Care and Pharmaceuticals
divisions. Bayer HealthCare's aim is to discover, develop, manufacture and
market products that will improve human and animal health worldwide. Bayer
HealthCare has a global workforce of 55,700 employees (Dec 31, 2011) and is
represented in more than 100 countries. Find more information at
www.bayerhealthcare.com.
Find more information at www.bayerpharma.com.
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