NicOx' Naproxcinod Shows Differentiated 24-Hour Blood Pressure Profile After 13 Weeks Treatment
19 Dezembro 2008 - 10:00AM
PR Newswire (US)
The Results of the 112 Ambulatory Blood Pressure Monitoring (ABPM)
Study Complete an Extensive Database in More Than 3,000 Patients
SOPHIA ANTIPOLIS, France, December 19 /PRNewswire-FirstCall/ --
NicOx S.A. (Euronext Paris: COX) today announced positive results
from the 112 clinical pharmacology study in 299 patients with
osteoarthritis (OA) and hypertension, which was designed to
characterize the 24-hour blood pressure profile of naproxcinod in
comparison to the two most widely used non-steroidal
anti-inflammatory drugs (NSAIDs). At week 13, naproxcinod 750 mg
bid showed a reduction in systolic blood pressure (SBP) of 2.7 mmHg
compared to naproxen 500 mg bid and 3.8 mmHg compared to ibuprofen
600 mg tid, in the ABPM compliant population. Naproxcinod 375 mg
bid showed a reduction in SBP of 1.1 mmHg compared to naproxen 250
mg bid and 4.2 mmHg compared to ibuprofen 600 mg tid. Naproxcinod
is the most advanced compound in the new Cyclooxygenase-Inhibiting
Nitric Oxide Donator (CINOD) class. COX-2 inhibitors and
traditional NSAIDs, such as ibuprofen and naproxen, are widely used
as symptomatic treatments for OA. However, there is increasing
concern in the medical community over their tendency to raise blood
pressure and destabilize previously controlled hypertensive
patients. William B. White, MD, Professor of Medicine in the
Cardiology Center at the University of Connecticut School of
Medicine, Farmington, commented: "The risks of developing
hypertension in patients with OA and the potential for
destabilizing blood pressure control in treated hypertensive
patients who receive NSAID therapy are of substantial clinical
concern. A new drug for the treatment of OA which is less likely to
increase blood pressure would be a useful and welcome therapy for
OA patients, particularly those with hypertension." "The results
from the 112 study demonstrate important differential effects of
naproxcinod's 24-hour ABPM profile at 13 weeks, compared to
ibuprofen and naproxen, two of the most commonly used NSAIDs,"
continued Professor White. "Both cardiovascular specialists and
rheumatologists place great importance on the additional level of
detail provided by the ABPM technique, a method which has become a
gold standard in blood pressure measurement in clinical trials and
practice. Furthermore, these new results should provide support to
the findings from the pooled blood pressure data from the phase 3
program." Naproxcinod showed positive efficacy results in a program
of three pivotal phase 3 studies in OA patients (301, 302 and 303).
Moreover, a pre-specified pooled analysis of the Office Blood
Pressure Measurements (OBPMs) collected in 2,734 patients in these
trials showed a significant reduction in SBP and diastolic blood
pressure (DBP) for both doses of naproxcinod (375 and 750 mg bid)
over the whole 13 week period, compared to naproxen 500 mg bid.
NicOx plans to submit a New Drug Application (NDA) for naproxcinod
to the US Food and Drug Administration (FDA) in mid-2009. Both
doses of naproxcinod showed a blood pressure reduction compared to
naproxen and ibuprofen. The 112 study was a 16-week clinical
pharmacology trial, with a double-blind, parallel group design, in
which 299 OA patients with controlled hypertension were enrolled at
60 clinical sites in the United States (see NOTE 1). Patients were
randomized to receive naproxcinod 375 mg bid, naproxcinod 750 mg
bid, naproxen 250 mg bid, naproxen 500 mg bid, or ibuprofen 600 mg
tid (three times daily) for 13 weeks. The study was not designed to
show statistical significance between the treatment arms but rather
aimed to explore the 24-hour blood pressure profile of the two
naproxcinod doses, in comparison to different NSAIDs. No formal
sample size computations were performed in the 112 protocol. The
24-hour blood pressure monitoring was conducted at baseline and at
week 13 using a validated ABPM device. The primary parameter was
the mean 24-hour ambulatory SBP as measured by ABPM at week 13.
Compared to naproxen 500 mg bid, naproxcinod 750 mg bid lowered SBP
by 2.7 mmHg and DBP by 1.4 mmHg, in terms of the mean change from
baseline at week 13. Naproxcinod 375 mg bid decreased SBP by 1.1
mmHg and DBP by 0.8 mmHg compared to naproxen 250 mg bid.
Naproxcinod 750 mg bid showed a 3.8 mmHg decrease in SBP and a 0.7
mmHg decrease in DBP compared to ibuprofen 600 mg tid, in terms of
the mean change from baseline at week 13. Naproxcinod 375 mg bid
showed a reduction in SBP of 4.2 mmHg and a reduction in DBP of 1.7
mmHg, compared to ibuprofen 600 mg tid. Naproxcinod 375 mg bid was
the treatment with the lowest percentage of patients experiencing
at least one adverse event. There were no treatment-related serious
adverse events in the study. Far more patients in the ibuprofen arm
discontinued due to an adverse event compared to the other
treatments. The 112 results were consistent with those of previous
studies and complete an extensive database describing naproxcinod's
differentiated blood pressure profile. The 112 study is the last in
a program of three clinical pharmacology trials using the ABPM
technique in a total of 548 subjects (see NOTE 2 on the 111 and 104
studies) and its results complete a detailed picture of
naproxcinod's 24-hour blood pressure profile. In particular, the
112 results complement and confirm the recently reported data from
the 111 study, as the 112 study tested corresponding doses of
naproxcinod and naproxen in parallel groups, while the 111 study
tested escalating doses of naproxcinod and naproxen. The extensive
blood pressure data from these three ABPM studies suggest an effect
of nitric oxide donation on blood pressure. Further analyses on the
111 and 112 studies will form the basis of presentations at leading
medical conferences and peer reviewed scientific publications
during 2009 and 2010. Pascal Pfister MD, Chief Scientific Officer
and Head of Research and Development at NicOx, said: "With these
results we have successfully finalized our extensive program of
clinical studies specifically designed to characterize the blood
pressure profile of naproxcinod. The 112 results complete a
positive and consistent package of OBPM and ABPM data in over 3,000
patients. We have great confidence in this robust clinical database
which shows naproxcinod's differentiated blood pressure profile
across the dose range and at multiple time points up to 26 weeks."
NOTE 1: In the 112 study, 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. systolic blood pressure (SBP)