Novartis to request re-examination of serelaxin (RLX030) in acute heart failure (AHF) for conditional marketing authorization in EU
Novartis International AG /
Novartis to request re-examination of serelaxin (RLX030) in acute heart failure
(AHF) for conditional marketing authorization in EU
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* Novartis to submit revised filing package for re-examination with request
for conditional approval following CHMP negative opinion
* RLX030 is currently the only drug for which a reduction in mortality has
been observed in patients with AHF in a major study; data shows RLX030 is
generally well tolerated[1]
* Second phase III study RELAX-AHF-2 started enrolment in September 2013 with
goal to replicate the key findings of RELAX-AHF[1]
* On February 13(th) Novartis will present RLX030 efficacy and safety data at
the FDA's Cardiovascular and Renal Drugs Advisory Committee meeting to
discuss potential US approval
Basel, January 24, 2014 - Novartis announced today it will shortly submit a
revised filing package, including new data analyses, for re-examination for
conditional approval of RLX030 (serelaxin) for acute heart failure by the
Committee for Medicinal Products for Human Use (CHMP) following a negative
opinion issued today. In accordance with CHMP process a revised opinion could be
granted in Q2 2014.
The file for regulatory approval is continuing review by the Food and Drug
Administration (FDA) in the United States where RLX030 was granted Breakthrough
Therapy designation status in June 2013[2]. Reviews are also underway with
health authorities in 16 countries around the world.
"With the results from RELAX-AHF showing significant mortality benefits with
RLX030 in patients with AHF and recognizing that there had been no treatment
breakthroughs in this area for 20 years, Novartis took a decision to file for
regulatory approval," said David Epstein, Division Head of Novartis
Pharmaceuticals. "It has become apparent through the review process and in
accordance with advice we've received that the current evidence package may be
more compatible with an application for conditional approval in the EU. We look
forward to providing a revised package for review to the CHMP shortly."
In September 2013 the second phase III study RELAX-AHF-2 started recruitment of
the over 6000 patients who are expected to be enrolled. The goal is to replicate
the key findings of RELAX-AHF and the study will assess cardiovascular mortality
as the primary endpoint. This would be one of the largest and most robust
programs undertaken by a company for an AHF drug.
RLX030, a relaxin receptor agonist[3], is a form of a naturally occurring
hormone (human relaxin 2) present in both men and women which rises in women
during pregnancy to help the body cope with the additional cardiovascular
demands[4],[5]. RLX030 is thought to have multiple effects including relaxing
the blood vessels, reducing fluid buildup and protecting the heart and vital
organs from the cascade of damage that occurs during an AHF
episode[3],[6],[7],[8],[9]. More than 1.5 million AHF episodes happen every year
in Europe alone[10],[11], with 1 in 5 patients not surviving a year
afterwards[12],[13],[14],[15],[16],[17].
About RELAX-AHF
RLX030 was studied in the phase III RELAX-AHF trial, which showed it had both
short and longer-term effects, relieving symptoms and reducing the rate of heart
failure worsening[1]. In the trial patients who received RLX030 also had a 37%
reduction in mortality at 6 months after an AHF episode compared to those who
received conventional treatment[1]. Data from clinical trials has shown that
RLX030 was generally well tolerated[1],[18].
About acute heart failure
Heart failure is a debilitating and potentially life-threatening condition where
the heart cannot pump enough blood around the body. More than 15 million people
suffer from heart failure globally and this number is increasing[10],[19]. The
condition is often fatal when patients have one or repeated acute heart failure
episodes[19]. As an AHF episode approaches, patients become severely breathless
and rapidly gain weight due to fluid build-up in the lungs and around the body.
This is often compared to the sensation of drowning[20].
Patients experiencing an AHF episode need to be rushed to the emergency room for
urgent treatment, making AHF the most common cause of hospitalization in
patients over 65 years[10],[21]. Currently 20 to 30% of patients die within 1
year after experiencing an AHF episode, and 3-4% do not survive the initial
episode[12],[13],[14],[15],[16],[17]. This means AHF causes more deaths than
some advanced cancers, including breast and bowel cancer[22].
Disclaimer
The foregoing release contains forward-looking statements that can be identified
by words such as "to request," "to submit," "goal," "will," "potential,"
"could," "continuing review," "expected," "would," or similar terms, or by
express or implied discussions regarding potential marketing approvals for
RLX030 or the timing of any such approvals, or regarding potential future
revenues from RLX030. You should not place undue reliance on these statements.
Such forward-looking statements are based on the current beliefs and
expectations of management regarding future events, and are subject to
significant known and unknown risks and uncertainties. Should one or more of
these risks or uncertainties materialize, or should underlying assumptions prove
incorrect, actual results may vary materially from those set forth in the
forward-looking statements. There can be no guarantee that RLX030 will be
approved for sale in any market, or at any particular time. Nor can there be any
guarantee that RLX030 will be commercially successful in the future. In
particular, management's expectations regarding RLX030 could be affected by,
among other things, the uncertainties inherent in research and development,
including unexpected regulatory actions or delays or government regulation
generally; unexpected clinical trial results and additional analysis of existing
clinical data; the company's ability to obtain or maintain proprietary
intellectual property protection; general economic and industry conditions;
global trends toward health care cost containment, including ongoing pricing
pressures; unexpected manufacturing issues, and other risks and factors referred
to in Novartis AG's current Form 20-F on file with the US Securities and
Exchange Commission. Novartis is providing the information in this press release
as of this date and does not undertake any obligation to update any forward-
looking statements contained in this press release as a result of new
information, future events or otherwise.
About Novartis
Novartis provides innovative healthcare solutions that address the evolving
needs of patients and societies. Headquartered in Basel, Switzerland, Novartis
offers a diversified portfolio to best meet these needs: innovative medicines,
eye care, cost-saving generic pharmaceuticals, preventive vaccines and
diagnostic tools, over-the-counter and animal health products. Novartis is the
only global company with leading positions in these areas. In 2012, the Group
achieved net sales of USD 56.7 billion, while R&D throughout the Group amounted
to approximately USD 9.3 billion (USD 9.1 billion excluding impairment and
amortization charges). Novartis Group companies employ approximately 133,000
full-time equivalent associates and operate in more than 140 countries around
the world. For more information, please visit http://www.novartis.com.
Novartis is on Twitter. Sign up to follow @Novartis at
http://twitter.com/novartis.
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[1] Teerlink et al. Serelaxin, recombinant human relaxin-2, for treatment of
acute heart failure (RELAX-AHF): a randomised, placebo-controlled trial. Lancet,
2013;381:29-39
[2] Novartis press release 'FDA grants Breakthrough Therapy designation to
Novartis' serelaxin (RLX030) for acute heart failure' issued on June 21, 2013
[3] Du X., et al. Cardiovascular effects of relaxin: from basic service to
clinical therapy. Nat. Rev. Cardiol. 7, 48-58 (2010);
[4] Teichman S et al. Relaxin, a pleiotropic vasodilator for the treatment of
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[5] Teichman SL et al. Relaxin: Review of biology and potential role in treating
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[7] Shlipak MG, et al. Cystatin C and the risk of death and cardiovascular
events among elderly persons. N Engl J Med 2005;352:2049-60
[8] Metra M, et al. Hemoglobin concentration in acute decompensated heart
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[9] Waikar SS, et al. Can we rely on blood urea nitrogen as a biomarker to
determine when to initiate dialysis. Clin J Am Soc Nephrol 2006;1:903-904
[10] Gheorghiade M, Pang P, Acute heart failure syndromes, Journal of the
American College of Cardiology 2009; 53 (7):557-73
[11] Novartis data on file, approximately 1.6 million in the top 5 EU markets
[12] Mosterd A, Hoes, A, Clinical epidemiology of heart failure, Heart
2007;93:1137-1146
[13] Harrison's 'Principles of Internal Medicine', Seventeenth Edition pages
1442 - 1455
[14] Hunt S et al. Focused update incorporated into the ACC/AHA 2005 Guidelines
for the Diagnosis and Management of Heart Failure in Adults: A Report of the
American College of Cardiology Foundation/American Heart Association Task Force
on Practice Guidelines Developed in Collaboration With the International Society
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[15] Lloyd-Jones et al. Heart disease and stroke statistics--2010 update: a
report from the American Heart Association. Circulation. 2010;121:e46-215
[16] National heart failure audit: April 2010 - March 2011, NICOR and The
British Society for Heart Failure, commissioned by the Healthcare Quality
Improvement Partnership (HQIP)
[17] O'Connor M et al. Causes of death and rehospitalization in patients
hospitalized with worsening heart failure and reduced left ventricular ejection
fraction: Results from efficacy of vasopressin antagonism in heart failure
outcome study with tolvaptan (EVEREST) program, American Heart Journal
2010;159(5): 842-849
[18] Teerlink JR, Metra M, Felker GM, et al. Relaxin for the treatment of
patients with acute heart failure (Pre-RELAX-AHF): a multicentre, randomised,
placebo-controlled, parallel-group, dose-finding phase IIb study. Lancet.
2009;373:1429 -1439
[19] Zannad F. et al, Heart failure burden and therapy, Europace 2009, 11; v1-
v9.
[20] Irish Heart Foundation. Living well with heart failure patient booklet.
http://www.irishheart.ie/media/pub/patient_booklets/living_with_heart_failure.pd
f. Accessed November 2013
[21] Felker et al. Clinical trial of pharmacological therapies in acute heart
failure syndromes, Circ Heart Fail. 2010;3:314-325
[22] Stewart et al. More 'malignant' than cancer? Five-year survival following a
first admission for heart failure Eur J Heart Fail. 2001;3:315322
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