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- 14 abstracts to be presented, further characterizing the complementary profiles of Mavenclad (cladribine tablets) and Rebif (interferon beta-1a)
DARMSTADT, Germany, June 14, 2018 /PRNewswire/ -- Merck, a leading science and technology company, will present data from its neurology and immunology portfolio at the 4th Congress of the European Academy of Neurology (EAN), taking place from June 16-19, in Lisbon, Portugal. Merck will present a total of 14 abstracts in the area of relapsing multiple sclerosis (RMS), including a post-hoc analysis of the Phase III CLARITY study, investigating whether the beneficial clinical and magnetic resonance imaging (MRI) effects of MAVENCLAD® are consistent in older (>50 years) and younger (≤50) adult patients with relapsing remitting MS (RRMS). Data presented at the congress will also provide further insights into the benefit-risk profile of MAVENCLAD® in patients with relapsing MS with high disease activity, using Multi-Criteria Decision Analysis, an EMA-recommended methodology used to indirectly compare the benefit-risk profile between treatments. A separate post hoc analysis of patients in the ONWARD study evaluates the efficacy of MAVENCLAD® as add-on to interferon beta-1a in patients with secondary progressive MS (SPMS) with relapses, compared to patients with RRMS from the same study.
Additionally, data presentations on Rebif® (interferon beta-1a) include analysis of MRI in MS (MAGNIMS) score[1] to predict long-term clinical disease activity (CDA)-free status and disability progression following treatment with Rebif®.
In line with Merck's MS Inside Out campaign aiming to better understand patients with MS, results of the Merck-sponsored 'MS in the 21st Century International Unmet Needs Survey' show that MS patients have substantially different perceptions of the current unmet needs in MS compared to healthcare professionals (HCPs). Identification and understanding of these differences could lead to an improved dialogue between HCPs and patients, which is integral to finding appropriate individualised treatment approaches for each patient.
Attendees can learn more about Merck's programs, pipeline and activities in neurology and immunology by visiting the company`s medical booth A07
The following abstracts have been accepted for presentation at EAN Congress 2018:
MAVENCLAD® (Cladribine Tablets) Presentations |
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Title |
Authors |
Abstract No. |
Presentation Date/Time/Session |
Infections during periods of grade 3 or 4 lymphopenia in patients taking cladribine tablets 3.5 mg/kg: data from an integrated safety analysis |
Cook S, Leist T, Comi G, Montalban X, Sylvester E, Hicking C, Dangond F |
748 |
ePoster 16-18 Jun 2018 Time:12:30-14:15 |
Effects of cladribine tablets on CD4+ T cell subsets in the ORACLE-MS study: Results from an analysis of lymphocyte surface markers |
Stuve O, Soelberg-Sorensen P, Leist T, Hyvert Y, Damian D, Boschert U |
762 |
ePoster 16-18 Jun 2018 Time:12:30-14:15 |
Innate Immune Cell Counts in Patients with Relapsing-Remitting Multiple Sclerosis (RRMS) Treated with Cladribine Tablets 3.5 mg/kg in CLARITY and CLARITY Extension |
Soelberg-Sorensen P, Dangond F, Hicking C, Giovannoni G |
749 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
Cladribine tablets produce selective and discontinuous reduction of B and T lymphocytes and natural killer cells in patients with early and relapsing multiple sclerosis (ORACLE-MS, CLARITY and CLARITY Extension) |
Stuve O, Soelberg-Sorensen P, Giovannoni G, Leist T, Hyvert Y, Damian D, Boschert U |
746 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
An analysis of malignancy risk in the clinical development programme of cladribine tablets in patients with relapsing multiple sclerosis (RMS) |
Galazka A, Nolting A, Cook S, Leist T, Comi G, Montalban X, Hicking C, Dangond F |
757 |
ePoster 16-18 Jun 2018 Time:12:30-14:15 |
Pregnancy outcomes during the clinical development programme of cladribine in multiple sclerosis (MS): an integrated analysis of safety for all exposed patients |
Galazka A, Nolting A, Cook S, Leist T, Comi G, Montalban X, Hicking C, Dangond F |
765 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
A benefit-risk assessment of cladribine tablets using Multi-Criteria Decision Analysis for patients with relapsing multiple sclerosis demonstrating high disease activity |
Vermersch P, Martinelli V, Pfleger C, Rieckmann P, Galazka A, Dangond F, Phillips L |
759 |
ePoster 16-18 Jun 2018 Time:12:30-14:15 |
Efficacy of cladribine tablets 3.5 mg/kg added to interferon-beta in patients with secondary progressive multiple sclerosis (SPMS) or relapsing-remitting multiple sclerosis (RRMS): a post-hoc analysis from ONWARD |
Montalban X, Cohen B, Leist T, Moses H, Hicking C, Dangond F |
766 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
A pooled analysis of the efficacy of cladribine tablets 3.5 mg/kg in patients with EDSS ≥3.5 or ≤3.0 at baseline in the CLARITY and ONWARD studies |
Giovannoni G, Montalban X, Hicking C, Dangond F |
747 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
Efficacy of cladribine tablets 3.5 mg/kg in patients with highly active relapsing multiple sclerosis (RMS): Pooled analysis of the double-blind cohort from CLARITY and ONWARD |
Giovannoni G, Montalban X, Damian D, Dangond F |
1345 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
Efficacy of cladribine tablets 3.5 mg/kg in patients ≤50 and >50 years of age with relapsing-remitting multiple sclerosis (RRMS): a post hoc analysis from CLARITY |
Giovannoni G, Rammohan K, Cook S, Comi G, Rieckmann P, Soelberg-Sørensen P, Vermersch P, Dangond F, Damian D |
1341 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
Rebif® (interferon beta-1a) Presentations |
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Disease activity as assessed by the MAGNIMS score predicts long-term clinical disease activity free status and disability progression in patients treated with subcutaneous interferon beta-1a |
Sormani MP, Freedman MS, Aldridge J, Marhardt K, De Stefano N |
743 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
Evolution of new lesions and its temporal patterns in patients with clinically isolated syndrome treated with subcutaneous interferon beta-1a |
Vrenken H, de Vos ML, Battaglini M, Nagtegaal GJ, de Almeida Teixeira BC, Marhardt K, De Stefano N, Barkhof F |
444 |
ePresentation 16-18 Jun 2018 Time:12:30-14:15 |
Additional Merck-sponsored Presentations |
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Patient involvement in treatment decision-making: a sub-analysis of the 'MS in the 21st Century international unmet needs survey' comparing patient and healthcare professional perspectives |
Rieckmann P, Langdon D on behalf of MS in the 21st Century Steering Group, and Contango EV |
1340 |
Poster on Display |
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About MAVENCLAD®
MAVENCLAD® (cladribine tablets) is a short-course oral therapy that selectively and periodically targets lymphocytes thought to be integral to the pathological process of multiple sclerosis (MS). In August 2017, the European Commission (EC) granted marketing authorization for MAVENCLAD® for the treatment of relapsing forms of MS (RMS) in the 28 countries of the European Union (EU) in addition to Norway, Liechtenstein and Iceland. MAVENCLAD® is now available in over 10 countries in Europe, plus Australia, Argentina and the United Arab Emirates. MAVENCLAD® is not yet approved for any use in the United States.
The clinical development program of MAVENCLAD® in MS comprises more than 10,000 patient years of data with over 2,700 patients included in the clinical trial program, and up to 10 years of observation in some patients. These clinical trials include the Phase III CLARITY, CLARITY extension and ORACLE MS trials, the Phase II ONWARD trial and the PREMIERE Long-term Safety Registry.
EU Indication
MAVENCLAD® (cladribine tablets) is indicated for the treatment of adult patients with highly active relapsing multiple sclerosis (RMS) as defined by clinical or imaging features.
Important EU Safety Information
Contraindications:
MAVENCLAD® is contraindicated in patients with hypersensitivity to the active substance, human immunodeficiency virus (HIV), active chronic infection (tuberculosis or hepatitis), active malignancy, moderate to severe renal impairment (creatinine clearance <60 mL/min), and those who are pregnant and breast-feeding. MAVENCLAD® is also contraindicated in immunocompromised patients, including patients currently receiving immunosuppressive or myelosuppressive therapy.
Special warnings and precautions for use:
The most clinically relevant adverse reactions were lymphopenia and herpes zoster.
Haematology
Decreases in neutrophil count, red blood cell count, haematocrit, haemoglobin or platelet count compared to baseline values have been observed in clinical studies, although these parameters usually remain within normal limits.
Additive haematological adverse reactions may be expected if cladribine is administered prior to or concomitantly with other substances that affect the haematological profile
Lymphocyte counts must be determined
- before initiating MAVENCLAD® in year 1,
- before initiating MAVENCLAD® in year 2,
- 2 and 6 months after start of treatment in each treatment year. If the lymphocyte count is below 500 cells/mm³, it should be actively monitored until values increase again.
Infections
Cladribine can reduce the body's immune defence and may increase the likelihood of infections. HIV infection, active tuberculosis and active hepatitis must be excluded before initiation of cladribine.
The incidence of herpes zoster was increased in patients on cladribine. If lymphocyte counts drop below 200 cells/mm³, anti-herpes prophylaxis according to local standard practice should be considered during the time of grade 4 lymphopenia. Interruption or delay of MAVENCLAD® may be considered until proper resolution of the infection.
Cases of progressive multifocal leukoencephalopathy (PML) have been reported for parenteral cladribine in patients treated for hairy cell leukaemia with a different treatment regimen.
In the clinical study data base of cladribine in MS (1,976 patients, 8,650 patient years) no case of PML has been reported. However, a baseline magnetic resonance imaging (MRI) should be performed before initiating MAVENCLAD® (usually within 3 months).
About Rebif®
Rebif® (interferon beta-1a) is a disease-modifying drug used to treat relapsing forms of multiple sclerosis (MS) and is similar to the interferon beta protein produced by the human body. The efficacy of Rebif® in chronic progressive MS has not been established. Interferon ß is thought to help reduce inflammation. The exact mechanism is unknown.
Rebif®, which was approved in Europe in 1998 and in the US in 2002, is registered in more than 90 countries worldwide. Rebif® has been proven to delay the progression of disability, reduce the frequency of relapses and reduce MRI lesion activity and area*.
Rebif® can be administrated with the RebiSmart® electronic auto-injection device (not approved in the US), or with the RebiDose® single-use disposable pen, or the manual multidose injection pen RebiSlide™. Rebif® can also be administered with the autoinjector Rebiject II® or by manual injection using ready-to-use pre-filled syringes. These injection devices are not approved in all countries.
In January 2012, the European commission approved the extension of the indication of Rebif® in early multiple sclerosis. The extension of the indication of Rebif® has not been submitted in the United States.
Rebif® should be used with caution in patients with a history of depression, liver disease, thyroid abnormalities and seizures. Most commonly reported side effects are flu-like symptoms, injection site disorders, elevation of liver enzymes and blood cell abnormalities. Patients, especially those with depression, seizure disorders, or liver problems, should discuss treatment with Rebif® with their doctors.
- The exact correlation between MRI findings and the current or future clinical status of patients, including disability progression, is unknown.
Rebif® (interferon beta-1a) is approved in the United States for relapsing forms of MS. RebiSmart®, an electronic device for self-injection of Rebif®, is also not approved in the United States.
About Multiple Sclerosis
Multiple sclerosis (MS) is a chronic, inflammatory condition of the central nervous system and is the most common, non-traumatic, disabling neurological disease in young adults. It is estimated that approximately 2.3 million people have MS worldwide. While symptoms can vary, the most common symptoms of MS include blurred vision, numbness or tingling in the limbs and problems with strength and coordination. The relapsing forms of MS are the most common.
Merck in Multiple Sclerosis
Merck has a long-standing legacy in neurology and immunology, with significant R&D and commercial experience in multiple sclerosis (MS). Merck's current portfolio includes two products for the treatment of relapsing MS, with a robust pipeline focusing on discovering new therapies that have the potential to modulate key pathogenic mechanisms in MS. Merck aims to improve the lives of those living with MS, by addressing areas of unmet medical needs.
About Merck
Merck is a leading science and technology company in healthcare, life science and performance materials. More than 53,000 employees work to further develop technologies that improve and enhance life – from biopharmaceutical therapies to treat cancer or multiple sclerosis, cutting-edge systems for scientific research and production, to liquid crystals for smartphones and LCD televisions. In 2017, Merck generated sales of € 15.3 billion in 66 countries.
Founded in 1668, Merck is the world's oldest pharmaceutical and chemical company. The founding family remains the majority owner of the publicly listed corporate group. Merck holds the global rights to the Merck name and brand. The only exceptions are the United States and Canada, where the company operates as EMD Serono, MilliporeSigma and EMD Performance Materials.
[1] Magnetic Resonance Imaging in MS
SOURCE Merck KGaA
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