US Phase II Trial Results For PVAC
Genesis, Corixa And Medicis Announce US Phase II Trial Results For PVAC™
Evidence Of Clinical Benefit And Safety At 15-Microgram Dose
Auckland, NZ, Seattle, WA, and Scottsdale, AZ, Feb. 15, 2001 — Biotechnology company, Genesis Research and Development Corporation (NZSE/ASX: GEN), together with its U.S. partners, Corixa Corporation and Medicis Pharmaceutical Corporation today announced preliminary U.S. Phase II clinical trial results on their immunotherapeutic psoriasis treatment, PVAC™. Analysis of the results of a four-arm, randomised, double-blinded, controlled study in the United States, suggests that PVAC therapy at a dose of 15 micrograms per injection provides appreciable clinical benefit in patients with moderate to severe psoriasis.
Enrollment of 241 patients in the Phase II PVAC treatment study in the USA was completed in August 2000. In this four-arm study, patients with moderate to severe psoriasis were randomised to one of four groups. Individual groups (approximately 60 patients) were then treated with either control (CANDIN, a local irritant which produces a hypersensitivity reaction in most patients) or one of three different dosages of PVAC treatment (2, 15 or 50 micrograms). Efficacy endpoints – improvements in disease severity as assessed by decrease in psoriasis area and severity index (PASI) score – were measured every three weeks for twelve weeks following the first administration of study treatment. In this Phase II trial, PVAC or control were given via intradermal injection on day 0 and day 21 of the study. This was the same route of administration and dosing schedule that was used in early Phase I PVAC studies conducted in the Philippines.
Evidence of Clinical
Benefit
The Phase II study, conducted in a randomised and
controlled setting, was designed to provide safety data and
to determine an optimal dose for future efficacy studies.
However, clinical efficacy assessed in the middle dose group
(15 micrograms), as compared to the CANDIN control group,
approached statistical significance (p=.08) when the
efficacy endpoint was at least a 50 percent reduction in
PASI score. The companies have concluded that patients
receiving the 15-microgram dose had more impressive results
than patients receiving other doses. Among the 60 patients
in the 15-microgram-dose group, 23 percent had a 50 percent
or greater reduction in PASI score at 12 weeks.
Of the 21 patients in this dose group who had not been treated previously with any form of ultraviolet light, methotrexate or cyclosporin, 43 percent had a 50 percent or greater reduction in PASI score at 12 weeks. Methotrexate, cyclosporin and ultraviolet light therapies are modalities reserved for the most serious cases of psoriasis and likely affect the immune system for long time periods and perhaps permanently. The vast majority of psoriasis patients are not treated with these agents, according to a survey of physicians conducted by Market Measures, Inc. The 15-microgram dose was the same dose administered in Phase I PVAC treatment trials conducted in the Philippines that had previously suggested clinical benefit.
Moreover, further analysis indicates that the percentage of responders in the 15-microgram-dose group achieving either a 50 percent or 75 percent reduction in PASI score continued to increase with time and reached their highest levels at the 12 week observation point. The companies believe this observed increase in efficacy over time suggests that more patients might have been found to reach either a 50 percent or 75 percent improvement in disease severity had the observation point been later than 12 weeks from the first dose of PVAC. A later observation point was not measured because of the Phase II study design. Subsequent studies will likely include measurement points beyond 12 weeks.
Detailed analyses of patient responses at the 15-microgram dose confirmed the clinical efficacy of PVAC. For example, when a comparison was made of the best response (decrease in PASI score) observed at any observation point for patients in the 15-microgram-dose group was compared to the best response in the CANDIN control group, a statistically significant difference was observed favouring the 15-microgram dose group (p= 0.04).
In addition, the moderate and severe psoriasis patients treated in the U.S. Phase II trial had a significantly longer prior history of disease (median of 18 or more years) than did patients treated in the initial Phase I Philippines study (median of three years prior disease history). Moreover, the U.S. patient population studied in the Phase II trial had significant prior exposure to a variety of therapies for a duration that might interfere with or delay responses to an immunoregulatory product such as PVAC, including repetitive exposure to immunosuppressive therapies such as ultraviolet light irradiation, methotrexate and cylcosporin. As such, the U.S. Phase II study provided an extremely rigorous test in which to assess the clinical performance of PVAC.
Evidence of
Safety
The benign safety profile of PVAC observed in
Phase I investigation was again confirmed in the U.S. Phase
II clinical trial. There were no moderate or severe systemic
adverse reactions to PVAC administration, nor were there any
differences in frequency of other systemic adverse events
observed between any PVAC dose group, or between any PVAC
dose group and the control group. The only adverse event
with an increased incidence over the control group was the
percentage of patients with injection site reactions in the
15- and 50-microgram dose groups compared to the site
reactions induced by CANDIN. The majority of injection site
reactions were mild to moderate.
“Based on the preliminary data disclosed today, we are quite encouraged that PVAC treatment continues to demonstrate clinical benefit in a controlled setting,” said Steven Gillis, Ph.D., chairman and chief executive officer of Corixa. “The U.S. Phase II study has demonstrated clinical activity at the same dose of 15 micrograms per injection that was evaluated in the Philippines. Corixa and its partners, Medicis, Genesis Research and Development, and Zenyaku Kogyo, are developing plans for the next major clinical study of PVAC. Such a trial will likely be a randomized, blinded and controlled study in which different groups of patients would receive 15 micrograms of PVAC in possibly two or three different dosing schedules. Based on the results to date, clinical benefit may be assessed at multiple time points following administration for a longer period of time. Studies may also compare patients with different prior exposure to immunosuppressive therapy.
Gillis added, “Given the speed with which the current study was accrued and completed, we are hoping to construct a statistical plan very shortly for the next study that the FDA may consider supportive for product registration. In the interim, we will gather additional data from an on-going 180 patient, randomized study in Brazil. In this trial of moderate and severe psoriasis patients, patients are being randomized to two-dose therapy with either saline, or 15 or 50 micrograms of PVAC treatment.”
Jonah Shacknai, chairman and chief executive officer of Medicis added, “We are very encouraged by the results of this Phase II study. We have improved greatly our understanding of PVAC’s appropriate dosing regimen, the objective of this phase of development. We believe PVAC demonstrated an impressive effect on some of the toughest psoriasis cases, with a clear reinforcement of the agent’s attractive safety profile. If further trials continue to show strong efficacy and safety results, we believe that we that will have an excellent commercial platform for PVAC.”
“We are heartened by the consistent safety profile displayed by PVAC treatment and the strong parallels in the dose regimen and efficacy that have come from the Philippines and U.S. Phase II studies,” said Jim Watson, chief executive of Genesis. “If our ongoing and further studies continue to show strong efficacy results, we believe PVAC has every prospect of being an excellent first-line therapeutic for psoriasis.”
On August 19, 1999, Genesis and Corixa announced a multi-year license, research and development agreement with Zenyaku Kogyo Co. Ltd., providing the company with exclusive rights to PVAC in Japan. On August 15, 2000, Genesis and Corixa announced a multi-year development, commercialisation and license agreement with Medicis for the commercialisation of PVAC in the United States and Canada. PVAC treatment is a derivative of Mycobacterium vaccae (M.vaccae) developed by Genesis in collaboration with Corixa.
Psoriasis Market
Information
According to the US National Psoriasis
Foundation, psoriasis is a chronic skin disease affecting
more than seven million Americans, or about 2.6 percent of
the U.S. population. Psoriasis occurs when new skin cells
grow too rapidly, resulting in inflamed, scaly skin lesions.
It is estimated that approximately 30 percent of the patient
population suffer from a moderate to severe form of the
disease. About 150,000 to 260,000 new cases of psoriasis
are diagnosed each year. Annual outpatient costs for
treating psoriasis are currently estimated at approximately
US$1.6 to US$3.2 billion. Although the cause of psoriasis
is unknown, researchers believe the increased activation,
adhesion and passage of T-cells to the skin contributes to
the inflammation and abnormal skin cell proliferation. Most
current psoriasis therapies are palliative in nature and
provide temporary patient benefit, or have significant side
effects.
About Genesis
Genesis is a New Zealand-based
biotechnology committed to the building of a broad genomic
platform for the development of innovative products for
human health and agriculture. Genesis uses partnerships with
industry leaders to target products that have global market
potential through the gene mining of its extensive microbe,
plant and mammalian EST databases. In addition to its
collaboration with Corixa in the development of PVAC,
Genesis has two other programs in human clinical
development, five additional programs in pre-clinical
development and two programs in plant biotechnology. Genesis
was founded in 1994 in Auckland, New Zealand. For more
information, please visit the Genesis website at
www.genesis.co.nz.
About Corixa
Corixa is a research-
and development-based biotechnology company committed to
treating and preventing autoimmune diseases, cancer and
infectious diseases by understanding and directing the
immune system. Corixa is focused on immunotherapeutic
products and has a broad technology platform enabling both
fully integrated vaccine design and the use of its separate,
proprietary vaccine components on a standalone basis. Corixa
currently has 16 programs in clinical development and 22
programs in preclinical development, including its most
advanced product candidate, Bexxar™, a monoclonal antibody
conjugated to a radioisotope.
The company partners with numerous developers and marketers of pharmaceuticals and diagnostics, targeting products that are Powered by Corixa™ technology with the goal of making its potential products available to patients around the world. Corixa was founded in 1994 and is headquartered in Seattle, Wash., with additional operations in Hamilton, Mont. and Redwood City, Calif. and South San Francisco, Calif. For more information, please visit Corixa's website at www.corixa.com or call the company's investor relations information line at 1.877.4CORIXA or 1.877.426.7492.
About Medicis
Medicis
is the leading independent pharmaceutical company in the
United States focusing primarily on the treatment of
dermatological conditions. Medicis develops and markets
leading products for major segments within dermatology
including acne, fungal infections, psoriasis, eczema,
rosacea, seborrheic dermatitis, head lice and cosmesis
(improvement in the texture and appearance of skin).
Primary products include the prescription brands DYNACIN®
(minocycline HCl), TRIAZ® (benzoyl peroxide), LUSTRA®
(hydroquinone), LOPROX® (ciclopirox), OVIDE® (malathion),
PLEXION™ (sodium sulfacetamide/sulfur), LIDEX®
(fluocinonide), SYNALAR® (fluocinolone acetonide), TOPICORT®
(desoximetasone), NOVACET® (sodium sulfacetamide/sulfur) and
A/T/S® (erythromycin); the over-the-counter brand
ESOTERICA®; and BUPHENYL™ (sodium phenylbutyrate), a
prescription product indicated in the treatment of Urea
Cycle Disorder. Full prescribing information for any Medicis
prescription product is available by contacting the
Company.
NOTE: CANDIN is a Candida albicans skin test
antigen manufactured by Allermed Laboratories Inc., San
Diego, CA.
GENESIS, CORIXA AND MEDICIS ANNOUNCE US PHASE
II TRIAL RESULTS FOR PVAC™
Editorial Summary
A MEDIA
CONFERENCE WILL BE HELD AT 1.00PM TODAY AT TO DISCUSS THE
RESULT GENESIS’ OFFICES AT 1 FOX STREET, PARNELL
AUCKLAND.
1. Genesis Research and Development Corporation
and its US partners, Corixa Corporation and Medicis
Pharmaceutical Corporation have provided preliminary results
from U.S. clinical trials of their PVAC™ treatment for
psoriasis.
2. 241 patients with moderate to severe
psoriasis were treated with either a control or one of three
different dosages of PVAC (2, 15 or 50 micrograms)
3. The
results suggest that PVAC therapy at a dose of 15 micrograms
per injection provides appreciable clinical benefit in
patients with moderate to severe psoriasis.
4. PVAC’s
safety is outstanding. There were no moderate or severe
systemic adverse reactions to administration of the
treatment.
5. The research profile follows the response
pattern seen in Phase I trials of PVAC conducted earlier in
the Philippines
6. The effective dosage is low (15
micrograms) and falls within a narrow band
7. Patients
that respond best are those with moderate to severe
symptoms
8. After participating in the trial for 12 weeks
all patients became eligible to receive two more injections
of openly labelled PVAC at the 50 microgram dose.
9.
Efficacy continued to increase over the 12 week period of
the study
10. This suggests that more patients might
improved had the trials been continued for longer than 12
weeks.
11. Patients who had not previously been on
immunosuppressive treatments (such as methotrexate or
cyclosporin) responded best to the treatment.
12. Genesis
and its partners are developing plans for the next major
clinical study of PVAC which is likely to involve
administering a 15 miocrogram dose on different schedules
and assessing clinical benefits over a longer period.
13. Psoriasis is a flaky skin disease that affects 2% -
3% of the population worldwide
Editors please note: for a more complete discussion of the preliminary results, please read the full media release that accompanies this summary