The totality of scientific
data submitted in recent months to the U.S. Food and Drug Administration
(FDA) in preparation for the March 13th Oncologic Drugs Advisory Committee
Meeting (ODAC) reaffirms that erythropoiesis-stimulating agents (ESAs) are
safe and effective when used according to the product label to treat
chemotherapy induced anemia (CIA). ESAs are an important treatment option
for CIA patients as the only proven therapeutic alternative to blood
transfusions.
"ESA use within the label has not been associated with increased risk
of mortality or disease progression," said Craig Tendler, M.D., Vice
President, Medical Affairs, Oncology/Nephrology, Ortho Biotech Products,
L.P. "Ortho Biotech looks forward to Thursday's ODAC meeting, at which we
hope that responsible recommendations will be made based on the totality of
available evidence, including a substantial body of scientific data
submitted to the FDA over the past several months."
At the ODAC meeting, Ortho Biotech will:
-- Present the totality of data requested by the FDA at the May 2007 ODAC
meeting, including follow-up survival data submitted over the last four
months from studies accounting for approximately 50 percent of the
7,444 patients in the company's database;
-- Suggest that vascular thrombotic events (VTEs) are the most plausible
explanation for increased mortality with ESAs in cancer patients seen
in some studies with high hemoglobin targets;
-- Recommend additional research to address outstanding issues; and
-- Propose risk minimization strategies to reduce the risk of VTEs and
ensure safe and appropriate use.
The company has provided to the FDA all available clinical data from
relevant, randomized controlled trials of ESAs to treat CIA. "The known
risks of ESA use are prominently displayed in the current product labeling,
and we will continue to support direction to healthcare professionals to
use the lowest dose of ESAs that will gradually increase the hemoglobin
concentration to a level that will avoid the need for blood transfusion,"
Dr. Tendler said.
In addition to working closely with the FDA, Ortho Biotech, along with
independent investigators and other ESA manufacturers, has provided data to
the independent Cochrane Collaboration to facilitate a patient-level
analysis of all data from appropriately designed and conducted controlled
clinical studies. This project will create a database of more than 15,000
patients, making it the largest combined analysis of ESA safety data ever
undertaken. The company also has proposed unrestricted funding to support
independent research through the National Cancer Institute to evaluate
potential mechanisms that may mediate adverse outcomes when ESAs are used
to treat CIA.
About PROCRIT (Epoetin alfa)
PROCRIT is used for the treatment of anemia in patients with most types
of cancer receiving chemotherapy, with chronic renal failure who are on
dialysis and those who are not on dialysis, who are being treated with
zidovudine for HIV infection, and to reduce the need for transfusion in
anemic patients who are scheduled for elective noncardiac, nonvascular
surgery. Depending on the country in which Epoetin alfa is marketed, these
indications may differ.
Important U.S. Safety Information for PROCRIT
Boxed WARNINGS: INCREASED MORTALITY, SERIOUS CARDIOVASCULAR and
THROMBOEMBOLIC EVENTS, and TUMOR PROGRESSION
Renal failure: Patients experienced greater risks for death and serious
cardiovascular events when administered erythropoiesis-stimulating agents
(ESAs) to target higher versus lower hemoglobin levels (13.5 vs. 11.3 g/dL;
14 vs. 10 g/dL) in two clinical studies. Individualize dosing to achieve
and maintain hemoglobin levels within the range of 10 to 12 g/dL.
Cancer:
-- ESAs shortened overall survival and/or time-to-tumor progression in
clinical studies in patients with breast, non-small cell lung, head and
neck, lymphoid, and cervical cancers when dosed to target a hemoglobin
of greater than or equal to 12 g/dL.
-- The risks of shortened survival and tumor progression have not been
excluded when ESAs are dosed to target a hemoglobin of < 12 g/dL.
-- To minimize these risks, as well as the risk of serious cardio- and
thrombovascular events, use the lowest dose needed to avoid red blood
cell transfusions.
-- Use only for treatment of anemia due to concomitant myelosuppressive
chemotherapy.
-- Discontinue following the completion of a chemotherapy course.
Perisurgery: PROCRIT(R) increased the rate of deep venous thromboses in
patients not receiving prophylactic anticoagulation. Consider deep venous
thrombosis prophylaxis.
Contraindications
PROCRIT is contraindicated in patients with uncontrolled hypertension
or with known hypersensitivity to albumin (human) or mammalian cell-derived
products.
Additional Important Safety Information
-- The dose of PROCRIT should be titrated for each patient to achieve and
maintain the following hemoglobin levels:
-- Chronic renal failure patients - hemoglobin levels between 10 to 12
g/dL. If a patient does not attain hemoglobin levels of 10 to 12
g/dL despite 12 weeks of appropriate PROCRIT therapy, see DOSAGE and
ADMINISTRATION in the PROCRIT Prescribing Information.
-- Cancer or HIV patients - the lowest hemoglobin level sufficient to
avoid transfusion and not to exceed 12 g/dL.
-- Monitor hemoglobin regularly during therapy, more frequently following
a dosage adjustment or until hemoglobin becomes stable.
-- Cases of pure red cell aplasia (PRCA) and of severe anemia, with or
without other cytopenias, associated with neutralizing antibodies to
erythropoietin have been reported in patients with chronic renal
failure receiving PROCRIT by subcutaneous administration. If any
patient develops a sudden loss of response to PROCRIT, accompanied by
severe anemia and low reticulocyte count, and anti-erythropoietin
antibody-associated anemia is suspected, withhold PROCRIT and other
erythropoietic proteins.
-- The safety and efficacy of PROCRIT therapy have not been established in
patients with a known history of a seizure disorder or underlying
hematologic disease (e.g., sickle cell anemia, myelodysplastic
syndromes or hypercoagulable disorders).
-- In some female patients, menses have resumed following PROCRIT therapy;
the possibility of pregnancy should be discussed and the need for
contraception evaluated.
-- Prior to and regularly during PROCRIT therapy monitor iron status;
transferrin saturation should be greater than or equal to 20% and
ferritin should be greater than or equal to 100 ng/mL. During therapy
absolute or functional iron deficiency may develop and all patients
will eventually require supplemental iron to adequately support
erythropoiesis stimulated by PROCRIT.
-- During PROCRIT therapy, blood pressure should be monitored carefully
and aggressively managed, particularly in patients with an underlying
history of hypertension or cardiovascular disease.
-- In studies, the most common side effects included fever (pyrexia),
diarrhea, nausea, vomiting, swelling of hands or feet (edema), lack or
loss of strength or weakness (asthenia, fatigue), shortness of breath,
high blood pressure, headache, joint pain (arthralgias), abnormal skin
sensations (as tingling or tickling or itching or burning;
paresthesia), rash, constipation and upper respiratory infection.
Please visit procrit for the full Prescribing Information,
including the Boxed WARNINGS.
About Ortho Biotech Products, L.P.
Ortho Biotech Products, L.P. is a leading biopharmaceutical company
devoted to helping improve the lives of patients with cancer and with
anemia due to multiple causes, including chronic kidney disease. Since it
was founded in 1990, Ortho Biotech and its worldwide affiliates have earned
a global reputation for researching, manufacturing and marketing innovative
products that enhance patients' health. Located in Bridgewater, N.J., Ortho
Biotech is an established market leader in Epoetin alfa therapy for anemia
management. The company also markets treatments for recurrent ovarian
cancer, rejection of transplanted organs and other serious illnesses. For
more information, visit orthobiotech.
Forward-Looking Statement
This press release contains "forward-looking statements" as defined in
the Private Securities Litigation Reform Act of 1995. These statements are
based on current expectations of future events. If underlying assumptions
prove inaccurate or unknown risks or uncertainties materialize, actual
results could vary materially from Johnson & Johnson's expectations and
projections. Risks and uncertainties include general industry conditions
and competition; economic conditions, such as interest rate and currency
exchange rate fluctuations; technological advances and patents attained by
competitors; challenges inherent in new product development, including
obtaining regulatory approvals; domestic and foreign health care reforms
and governmental laws and regulations; and trends toward health care cost
containment. A further list and description of these risks, uncertainties
and other factors can be found in Exhibit 99 of the Company's Annual Report
on Form 10-K for the fiscal year ended December 30, 2007. Copies of this
Form 10-K, as well as subsequent filings, are available online at
sec, jnj or on request from Johnson & Johnson.
Johnson & Johnson does not undertake to update any forward-looking
statements as a result of new information or future events or developments.
Ortho Biotech Products, L.P.
orthobiotech