NicOx Announces Favorable Blood Pressure Data for Naproxcinod in a Large ABPM Study
04 Novembro 2008 - 10:09AM
PR Newswire (US)
SOPHIA ANTIPOLIS, France, November 4 /PRNewswire-FirstCall/ --
NicOx S.A. (Euronext Paris: COX) today announced positive top-line
results from a 118 patient Ambulatory Blood Pressure Monitoring
(ABPM) trial (the 111 study), which compared the 24-hour blood
pressure profile of escalating doses of naproxcinod and naproxen in
osteoarthritis (OA) patients with controlled hypertension. The
primary ABPM parameter was the mean 24-hour ambulatory systolic
blood pressure (SBP) measured by ABPM over the whole study period
and naproxcinod showed a statistically significant decrease in SBP
of 3.8 mmHg (p=0.011) compared to naproxen. Furthermore, in
contrast to naproxen, naproxcinod reduced the mean 24-hour SBP and
diastolic blood pressure (DBP) from baseline at every dose
comparison. Good safety and tolerability were shown by all
naproxcinod doses. NicOx plans to provide further details of the
results at a leading cardiology conference in 2009. Naproxcinod is
the first investigational drug in the new Cyclooxygenase-Inhibiting
Nitric Oxide-Donator (CINOD) class of anti-inflammatory agents,
which is nearing the end of phase 3 clinical development for the
treatment of the signs and symptoms of osteoarthritis, with the
submission of a New Drug Application (NDA) with the US Food and
Drug Administration (FDA) projected for mid-2009. NicOx expects to
have the results of a second large ABPM study in patients with
hypertension and OA (112) before the end of 2008, in addition to
the results of the remaining pivotal phase 3 trial in hip OA (303).
COX-2 inhibitors and traditional non-steroidal anti-inflammatory
drugs (NSAIDs), such as naproxen and ibuprofen, are widely used as
symptomatic treatments for OA. However, they can cause new episodes
of high blood pressure and destabilize previously controlled
hypertensive patients, which is a particular concern in the OA
population where approximately 50% of patients are estimated to be
hypertensive. "These impressive results suggest that naproxcinod
could represent a valuable treatment alternative for osteoarthritis
patients," said Raymond Townsend, Professor of Medicine at the
University of Pennsylvania, who advised NicOx on the design and
analysis of the study. "The hypertensive side effects of COX-2
inhibitors and traditional NSAIDs are a serious medical issue and
there is a clear need for a new drug with no detrimental effect on
blood pressure. These ABPM data have been obtained in a relevant
population of chronically treated osteoarthritis patients with many
cardiovascular risk factors and clearly show a consistent
beneficial effect on blood pressure for naproxcinod across the dose
range, in contrast to naproxen. In addition, the use of the ABPM
technique gives them considerable weight, as it is widely
recognized as the gold standard method for assessing the blood
pressure profile of new drugs." The 111 study design and results In
the study, 118 patients were randomized on a 1:1 basis to receive
naproxcinod or naproxen, with escalating doses every three weeks.
The trial included three doses of naproxcinod (375 mg bid, 750 mg
bid and a supra-therapeutic dose of 1125 mg bid), which were
compared to naproxen (250, 500 and 750 mg bid). 24-hour blood
pressure monitoring was conducted at baseline and at the end of
each three-week dose escalation (i.e. at the end of week 3, 6 and
9), using an FDA validated, ABPM device. The primary objective of
the study was to characterize the 24-hour arterial blood pressure
profile of the three doses of naproxcinod, as measured by ABPM
after each dose, compared to naproxen. At all time points,
naproxcinod showed a decrease in the mean 24-hour SBP and DBP from
baseline in contrast to naproxen. In terms of the overall treatment
effect, as an average over week 3, 6 and 9, naproxen raised SBP by
1.5 mmHg from baseline, while naproxcinod lowered it by 2.3 mmHg,
resulting in a difference between the two treatments of 3.8 mmHg
(p=0.011) in favor of naproxcinod. Michele Garufi, Chairman and CEO
of NicOx, commented: "These excellent results are an important
addition to the consistent data we are accumulating on
naproxcinod's potentially non-detrimental blood pressure profile
and its clear differentiation from naproxen. We are confident that
naproxcinod's potential will be confirmed by the further clinical
results expected in the coming months." The three doses of
naproxcinod showed good general safety and tolerability. In the
naproxcinod arm 32 patients (54.2%) experienced one or more adverse
events, compared to 38 patients (64.4%) in the naproxen arm. There
were no serious adverse events in the naproxcinod arm. Additional
note on study design: The 111 study was a 12-week pharmacodynamic
ABPM trial (with 9 weeks of active treatment), with a double-blind,
parallel group design, in which 118 OA patients with controlled
hypertension were enrolled at 30 clinical sites in the United
States. Eligible patients were 40 years and older and had been
suffering from osteoarthritis for at least three months, with at
least one hip or knee involved. In addition to OA, all patients
were diagnosed with controlled essential hypertension (i.e. SBP