THOUSAND OAKS, Calif., March 15, 2019 /PRNewswire/ -- Amgen (NASDAQ:AMGN) today announced plans to conduct VESALIUS-CV, a multinational clinical outcomes study for Repatha® (evolocumab) which will involve at least 13,000 patients worldwide at high risk of experiencing a first cardiovascular (CV) event, despite optimized treatment with lipid-lowering therapy.1 The study will be the first to investigate long-term outcomes in this population with Repatha for a minimum of four years.1
Conducted in collaboration with the Brigham and Women's Hospital Thrombolysis in Myocardial Infarction (TIMI) Study Group, patient enrollment for VESALIUS-CV is due to begin in the second quarter of 2019. The multicenter, double-blind, randomized, placebo-controlled, parallel-group outcomes study will include high-risk patients who have not yet had a heart attack or stroke, but have coronary, cerebrovascular or peripheral arterial disease, who may have had interventions, such as a coronary arterial bypass graft (CABG) or stents, or who may have diabetes with indicators of increased CVD risk.1
"High cholesterol is the most important risk factor in coronary heart and vascular disease, but we know that recommended levels of LDL-C or 'bad' cholesterol are frequently not reached in very high-risk patients," said Robert Giugliano, M.D., principal investigator and a senior investigator at the TIMI Study Group at Brigham and Women's Hospital and Harvard Medical School. "The VESALIUS-CV study will explore the impact of evolocumab on major cardiovascular events, such as heart attack or stroke, in patients who are already receiving treatment for lipid lowering and cardiovascular disease, but remain at high-risk, allowing us to better understand the benefits of significant LDL-C lowering in multiple patient types."
Amgen and TIMI previously collaborated on the Repatha cardiovascular outcomes study (FOURIER), which demonstrated Repatha's efficacy in reducing low-density lipoprotein cholesterol (LDL-C) levels, as well as the relative risk for major CV events in high-risk patients with a history of heart attack or stroke.2 VESALIUS-CV will build on these findings by exploring the potential benefit of Repatha in preventing a first heart attack or stroke in patients with some of the most significant risk factors for a first CV event.1
VESALIUS-CV is part of Amgen's PROFICIO (Program to Reduce LDL-C and cardiovascular Outcomes Following Inhibition of PCSK9 In different pOpulations) program. This program of clinical studies investigates the impact of Repatha on CVD across multiple populations. To date, the PROFICIO program consists of 36 trials including more than 38,000 patients worldwide.3
"PROFICIO represents our commitment to advancing the science of cardiovascular disease and improving the care of patients worldwide, and VESALIUS-CV is an important addition to this growing program," said David M. Reese, M.D., executive vice president of Research and Development at Amgen. "By continuing to invest in new scientific discovery through PROFICIO, we can help address some of the most significant unmet needs in patients at risk of life-changing cardiovascular events."
VESALIUS-CV is a Phase 3, multicenter, double-blind, randomized, placebo-controlled, parallel-group outcomes study. At least 13,000 patients will be enrolled in the study globally, with at least 6,500 patients per treatment arm. Repatha (140 mg) or placebo will be self-administered subcutaneously every two weeks for a minimum of four years. Follow-up of all randomized patients is planned to continue for a minimum of four years and until a sufficient number of patients have experienced the composite endpoints. Two primary endpoints include time to coronary heart disease (CHD) death, myocardial infarction (MI), ischemic stroke (triple component); and time to CHD death, MI, ischemic stroke or any ischemia-driven arterial revascularization, whichever occurs first (quadruple component).
About Repatha® (evolocumab)
Repatha is a human monoclonal antibody that inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9). Repatha binds to PCSK9 and inhibits circulating PCSK9 from binding to the low-density lipoprotein (LDL) receptor (LDLR), preventing PCSK9-mediated LDLR degradation and permitting LDLR to recycle back to the liver cell surface. By inhibiting the binding of PCSK9 to LDLR, Repatha increases the number of LDLRs available to clear LDL from the blood, thereby lowering LDL-C levels.4
Repatha is approved in more than 60 countries, including the U.S., Japan, Canada and in all 28 countries that are members of the European Union. Applications in other countries are pending.
Important U.S. Product Information
Repatha is a PCSK9 (proprotein convertase subtilisin kexin type 9) inhibitor antibody indicated:
- to reduce the risk of myocardial infarction, stroke, and coronary revascularization in adults with established cardiovascular disease.
- as an adjunct to diet, alone or in combination with other lipid-lowering therapies (e.g., statins, ezetimibe), for treatment of adults with primary hyperlipidemia (including heterozygous familial hypercholesterolemia [HeFH]) to reduce low-density lipoprotein cholesterol (LDL-C).
- as an adjunct to diet and other LDL-lowering therapies (e.g., statins, ezetimibe, LDL apheresis) in patients with homozygous familial hypercholesterolemia (HoFH) who require additional lowering of LDL-C.
The safety and effectiveness of Repatha have not been established in pediatric patients with HoFH who are younger than 13 years old or in pediatric patients with primary hyperlipidemia or HeFH.
Important U.S. Safety Information
Contraindication: Repatha is contraindicated in patients with a history of a serious hypersensitivity reaction to Repatha. Serious hypersensitivity reactions including angioedema have occurred in patients treated with Repatha.
Allergic reactions: Hypersensitivity reactions (e.g. angioedema, rash, urticaria) have been reported in patients treated with Repatha, including some that led to discontinuation of therapy. If signs or symptoms of serious allergic reactions occur, discontinue treatment with Repatha, treat according to the standard of care, and monitor until signs and symptoms resolve.
Adverse reactions: The most common adverse reactions (>5% of patients treated with Repatha and occurring more frequently than placebo) were: nasopharyngitis, upper respiratory tract infection, influenza, back pain, and injection site reactions.
From a pool of the 52-week trial and seven 12-week trials: Local injection site reactions occurred in 3.2% and 3.0% of Repatha-treated and placebo-treated patients, respectively. The most common injection site reactions were erythema, pain, and bruising.
Allergic reactions occurred in 5.1% and 4.7% of Repatha-treated and placebo-treated patients, respectively. The most common allergic reactions were rash (1.0% versus 0.5% for Repatha and placebo, respectively), eczema (0.4% versus 0.2%), erythema (0.4% versus 0.2%), and urticaria (0.4% versus 0.1%).
The most common adverse reactions in the Cardiovascular Outcomes Trial (>5% of patients treated with Repatha and occurring more frequently than placebo) were: diabetes mellitus (8.8% Repatha, 8.2% placebo), nasopharyngitis (7.8% Repatha, 7.4% placebo), and upper respiratory tract infection (5.1% Repatha, 4.8% placebo).
Among the 16,676 patients without diabetes mellitus at baseline, the incidence of new-onset diabetes mellitus during the trial was 8.1% in patients assigned to Repatha compared with 7.7% in those assigned to placebo.
Homozygous Familial Hypercholesterolemia (HoFH): The adverse reactions that occurred in at least two patients treated with Repatha and more frequently than placebo were: upper respiratory tract infection, influenza, gastroenteritis, and nasopharyngitis.
Immunogenicity: Repatha is a human monoclonal antibody. As with all therapeutic proteins, there is a potential for immunogenicity with Repatha.
Please contact Amgen Medinfo at 800-77-AMGEN (800-772-6436) or 844-REPATHA (844-737-2842) regarding Repatha® availability or find more information, including full Prescribing Information, at www.amgen.com and www.Repatha.com.
About Amgen in the Cardiovascular Therapeutic Area
Building on more than three decades of experience in developing biotechnology medicines for patients with serious illnesses, Amgen is dedicated to addressing important scientific questions to advance care and improve the lives of patients with cardiovascular disease, the leading cause of morbidity and mortality worldwide.5 Amgen's research into cardiovascular disease, and potential treatment options, is part of a growing competency at Amgen that utilizes human genetics to identify and validate certain drug targets. Through its own research and development efforts, as well as partnerships, Amgen is building a robust cardiovascular portfolio consisting of several approved and investigational molecules in an effort to address a number of today's important unmet patient needs, such as high cholesterol and heart failure.
Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. This approach begins by using tools like advanced human genetics to unravel the complexities of disease and understand the fundamentals of human biology.
Amgen focuses on areas of high unmet medical need and leverages its biologics manufacturing expertise to strive for solutions that improve health outcomes and dramatically improve people's lives. A biotechnology pioneer since 1980, Amgen has grown to be the world's largest independent biotechnology company, has reached millions of patients around the world and is developing a pipeline of medicines with breakaway potential.
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CONTACT: Amgen, Thousand Oaks
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- DOF, 20170625. A Double-blind, Randomized, Placebo-controlled, Multicenter Study to Evaluate the Impact of Evolocumab on Major Cardiovascular Events in Patients at High Cardiovascular Risk Without Prior Myocardial Infarction or Stroke. (December 2018)
- Sabatine, M.S., et al. Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. N Engl J Med 376, 1713-1722 (2017).
- Data on File, Amgen; 2018.
- Repatha Prescribing Information (Amgen Thousand Oaks, CA, 2018).
- WHO, W.H.O. Cardiovascular diseases (CVDs) fact sheet.