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PharmaEssentia
Completes Patient Enrollment for Phase 2b EXCEED-ET Trial in
Essential Thrombocythemia
and Phase 3b ECLIPSE-PV Trial in Polycythemia Vera
2024-06-25
·
BioSpace
Both trials, EXCEED-ET and ECLIPSE-PV, completed enrollment at 142% and 110% of target, respectively, demonstrating high levels of clinical site interest BURLINGTON, Mass.--(BUSINESS WIRE)-- PharmaEssentia USA Corporation, a subsidiary of PharmaEssentia Corporation (TWSE: 6446), a global biopharmaceutical innovator based in Taiwan leveraging deep expertise and proven scientific principles to deliver new biologics in hematology, oncology and immunology, today announced completion of enrollment for two clinical trials evaluating its
ropeginterferon alfa-2b-njft
(
BESREMi
®). The Phase 2b EXCEED-ET trial (NCT05482971), which is evaluating the effectiveness and safety of
ropeginterferon alfa-2b-njft
in adult patients with
essential thrombocythemia (ET)
, has exceeded the enrollment goal of 64 patients to include 91 patients. EXCEED-ET is evaluating people diagnosed with ET who are either treatment naïve or have received previous ET treatment with
hydroxyurea
or
anagrelide
but require a treatment change due to intolerance or because the previous treatment is no longer effective. This trial is being conducted in the United States and Canada and will use the accelerated dosing schedule (250, 350, 500 mcg). This accelerated dosing schedule has been previously assessed in Asian clinical trials. The Phase 3b ECLIPSE-PV trial (NCT05481151), assessing the effectiveness and safety of two dosing regimens of
ropeginterferon alfa-2b-njft
in adult patients with
polycythemia vera (PV)
, has also exceeded the enrollment goal of 100 patients to include 111 patients. ECLIPSE-PV is evaluating two
ropeginterferon alfa-2b-njft
doses, including the accelerated dosing schedule (as described above) in comparison to the current recommended dosing regimen. The ECLIPSE-PV study is being performed in the United States and Canada. "
Myeloproliferative neoplasms
, including ET and PV, are
chronic blood diseases
that can impact patients' quality of life and lead to life-threatening complications, including the development of specific types of
blood cancers
, and PharmaEssentia is committed to developing new therapeutic solutions for these patients,” said Robert B. Geller, M.D., Head of Medical at PharmaEssentia USA. “We are thrilled with the pace at which we have enrolled patients, which we believe reflects a high level of interest in both the EXCEED-ET and ECLIPSE-PV trials. Our goal with each of these programs is to redefine the early treatment paradigm of
myeloproliferative neoplasms
.” Follow PharmaEssentia USA on Twitter and LinkedIn for news and updates. About
Polycythemia Vera (PV)
Polycythemia vera (PV)
is a
cancer
originating from a disease-initiating stem cell in the bone marrow resulting in a chronic increase of red blood cells, white blood cells, and platelets. PV may result in cardiovascular complications such as
thrombosis
and
embolism
, and often transforms to
secondary myelofibrosis
or
leukemia
. While the molecular mechanism underlying PV is still subject of intense research, current results point to a set of acquired mutations, the most important being a mutant form of JAK2.1 About
Essential Thrombocythemia (ET)
Essential thrombocythemia (ET)
is a
myeloproliferative neoplasm (MPN)
characterized by an overproduction of platelets in the blood that results from a genetic mutation; data indicates a
JAK2
gene mutation is present in approximately half of diagnosed patients. ET is estimated to affect up to 57 per 100,000 people in the U.S. The disease is most commonly diagnosed through routine blood work and is most common in people over the age of 50, with women 1.5 more times more likely to be diagnosed than men. As a chronic, progressive disease, ET requires regular monitoring and appropriate treatment. Over time, the disease may progress into more deadly conditions such as
myelofibrosis
or
acute leukemia.2,3
About
BESREMi
® (
ropeginterferon alfa-2b-njft
)
BESREMi
is an innovative monopegylated, long-acting interferon. With its unique pegylation technology,
BESREMi
has a long duration of activity in the body and is aimed to be administered once every two weeks (or every four weeks with hematological stability for at least one year), allowing flexible dosing that helps meet the individual needs of patients.
BESREMi
has orphan drug designation for the treatment of
polycythemia vera (PV)
in adults in the United States. The product was approved by the European Medicines Agency (EMA) in 2019, by the US Food and Drug Administration (FDA) in 2021, and has recently received approval in Taiwan and South Korea. The drug candidate was invented by PharmaEssentia and is manufactured in the company’s Taichung plant, which was cGMP certified by TFDA in 2017 and by EMA in January 2018. PharmaEssentia retains full global intellectual property rights for the product in all indications.
BESREMi
was approved with a boxed warning for risk of serious disorders including aggravation of neuropsychiatric, autoimmune, ischemic and infectious disorders. Please see full Prescribing Information, including Boxed Warning. Indication
BESREMi
is indicated for the treatment of adults with
polycythemia vera
. Important Safety Information WARNING: RISK OF SERIOUS DISORDERS Interferon alfa products may cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disorders. Patients should be monitored closely with periodic clinical and laboratory evaluations. Therapy should be withdrawn in patients with persistently severe or worsening signs or symptoms of these conditions. In many, but not all cases, these disorders resolve after stopping therapy. CONTRAINDICATIONS Existence of, or history of severe
psychiatric disorders
, particularly severe
depression
,
suicidal ideation
, or suicide attempt Hypersensitivity to interferons including
interferon alfa-2b
or any of the inactive ingredients of
BESREMi
. Moderate (Child-Pugh B) or severe (Child-Pugh C)
hepatic impairment
History or presence of active serious or untreated
autoimmune disease
Immunosuppressed transplant recipients WARNINGS AND PRECAUTIONS
Depression
and
Suicide
: Life-threatening or fatal neuropsychiatric reactions have occurred in patients receiving
interferon alfa-2b
products, including
BESREMi
. These reactions may occur in patients with and without previous
psychiatric illness
. Other central nervous system effects, including
suicidal ideation
,
attempted suicide
,
aggression
,
bipolar disorder
,
mania
and
confusion
have been observed with other
interferon alfa products
. Closely monitor patients for any symptoms of
psychiatric disorders
and consider psychiatric consultation and treatment if such symptoms emerge. If psychiatric symptoms worsen, it is recommended to discontinue
BESREMi
therapy. Endocrine Toxicity: These toxicities may include worsening
hypothyroidism
and
hyperthyroidism
. Do not use
BESREMi
in patients with active serious or untreated
endocrine disorders
associated with
autoimmune disease
. Evaluate thyroid function in patients who develop symptoms suggestive of
thyroid disease
during
BESREMi
therapy. Discontinue
BESREMi
in patients who develop
endocrine disorders
that cannot be adequately managed during treatment with
BESREMi
. Cardiovascular Toxicity: Toxicities may include
cardiomyopathy
,
myocardial infarction
,
atrial fibrillation
and
coronary artery ischemia
. Patients with a history of
cardiovascular disorders
should be closely monitored for cardiovascular toxicity during
BESREMi
therapy. Avoid use of
BESREMi
in patients with severe or
unstable cardiovascular disease
, (e.g.,
uncontrolled hypertension
,
congestive heart failure
(≥ NYHA class 2), serious
cardiac arrhythmia
,
significant coronary artery stenosis
,
unstable angina
) or
recent stroke
or
myocardial infarction
. Decreased Peripheral Blood Counts: These toxicities may include
thrombocytopenia
(increasing the risk of
bleeding
),
anemia
, and
leukopenia
(increasing the risk of
infection
). Monitor complete blood counts at baseline, during titration and every 3-6 months during the maintenance phase. Monitor patients for signs and symptoms of
infection
or
bleeding
.
Hypersensitivity Reactions
: Toxicities may include serious,
acute hypersensitivity reactions
(e.g.,
urticaria
,
angioedema
, bronchoconstriction,
anaphylaxis
). If such reactions occur, discontinue
BESREMi
and institute appropriate medical therapy immediately. Transient rashes may not necessitate interruption of treatment.
Pancreatitis
:
Pancreatitis
has occurred in 2.2% of patients receiving
BESREMi
. Symptoms may include
nausea
,
vomiting
,
upper abdominal pain
, bloating, and
fever
. Patients may experience elevated
lipase
,
amylase
, white blood cell count, or altered renal/hepatic function. Interrupt
BESREMi
treatment in patients with possible
pancreatitis
and evaluate promptly. Consider discontinuation of
BESREMi
in patients with confirmed
pancreatitis
. Colitis: Fatal and serious ulcerative or hemorrhagic/ischemic colitis have occurred in patients receiving
interferon alfa products
, some cases starting as early as 12 weeks after start of treatment. Symptoms may include
abdominal pain
,
bloody diarrhea
, and
fever
. Discontinue
BESREMi
in patients who develop these signs or symptoms.
Colitis
may resolve within 1 to 3 weeks of stopping treatment. Pulmonary Toxicity: Pulmonary toxicity may manifest as
dyspnea
, pulmonary infiltrates,
pneumonia
,
bronchiolitis obliterans
,
interstitial pneumonitis
,
pulmonary hypertension
, and
sarcoidosis
. Some events have resulted in
respiratory failure
or death. Discontinue
BESREMi
in patients who develop pulmonary infiltrates or
pulmonary function impairment
. Ophthalmologic Toxicity: These toxicities may include severe
eye disorders
such as
retinopathy
,
retinal hemorrhage
,
retinal exudates
,
retinal detachment
and
retinal artery or vein occlusion
which may result in
blindness
. During
BESREMi
therapy, 23% of patients were identified with an
eye disorder
. Eyes disorders ≥5% included
cataract
(6%) and dry eye (5%). Advise patients to have eye examinations before and during
BESREMi
therapy, specifically in those patients with a
retinopathy-associated disease
such as
diabetes mellitus
or
hypertension
. Evaluate eye symptoms promptly. Discontinue
BESREMi
in patients who develop new or worsening
eye disorders
.
Hyperlipidemia
: Elevated triglycerides may result in
pancreatitis
. Monitor serum triglycerides before
BESREMi
treatment and intermittently during therapy and manage when elevated. Consider discontinuation of
BESREMi
in patients with persistently, markedly elevated triglycerides. Hepatotoxicity: These toxicities may include increases in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT) and bilirubin. Liver enzyme elevations have also been reported in patients after long-term
BESREMi
therapy. Monitor liver enzymes and hepatic function at baseline and during
BESREMi
treatment. Discontinue
BESREMi
in patients who develop evidence of hepatic decompensation (characterized by
jaundice
,
ascites
,
hepatic encephalopathy
,
hepatorenal syndrome
or
variceal hemorrhage
) during treatment. Renal Toxicity: Monitor serum creatinine at baseline and during therapy. Avoid use of
BESREMi
in patients with eGFR <30 mL/min. Discontinue
BESREMi
if severe
renal impairment
develops during treatment. Dental and Periodontal Toxicity: These toxicities may include
dental and periodontal disorders
, which may lead to loss of teeth. In addition, dry mouth could have a damaging effect on teeth and mucous membranes of the mouth during long-term treatment with
BESREMi
. Patients should have good oral hygiene and regular dental examinations. Dermatologic Toxicity: These toxicities have included
skin rash
,
pruritus
,
alopecia
,
erythema
,
psoriasis
, xeroderma,
dermatitis acneiform
,
hyperkeratosis
, and
hyperhidrosis
. Consider discontinuation of
BESREMi
if clinically significant dermatologic toxicity occurs. Driving and Operating Machinery: BESREMi may impact the ability to drive and use machinery. Patients should not drive or use heavy machinery until they know how
BESREMi
affects their abilities. Patients who experience
dizziness
,
somnolence
or
hallucination
during BESREMi therapy should avoid driving or using machinery. Embryo-Fetal Toxicity: Based on the mechanism of action,
BESREMi
can cause fetal harm when administered to a pregnant woman. Pregnancy testing is recommended in females of reproductive potential prior to treatment with
BESREMi
. Advise females of reproductive potential to use an effective method of contraception during treatment with
BESREMi
and for at least 8 weeks after the final dose. ADVERSE REACTIONS The most common adverse reactions reported in > 40% of patients in the PEGINVERA study (n=51) were
influenza-like illness
,
arthralgia
,
fatigue
,
pruritis
,
nasopharyngitis
, and
musculoskeletal pain
. In the pooled safety population (n=178), the most common adverse reactions greater than 10%, were liver enzyme elevations (20%),
leukopenia
(20%),
thrombocytopenia
(19%),
arthralgia
(13%),
fatigue
(12%),
myalgia
(11%), and
influenza-like illness
(11%). DRUG INTERACTIONS Patients on
BESREMi
who are receiving concomitant drugs which are CYP450 substrates with a narrow therapeutic index should be monitored to inform the need for dosage modification for these concomitant drugs. Avoid use with myelosuppressive agents and monitor patients receiving the combination for effects of excessive
myelosuppression
. Avoid use with narcotics, hypnotics or sedatives and monitor patients receiving the combination for effects of excessive CNS toxicity. USE IN SPECIFIC POPULATIONS Pregnancy: Based on mechanism of action and the role of
interferon alfa
in pregnancy and fetal development,
BESREMi
may cause fetal harm and should be assumed to have abortifacient potential when administered to a pregnant woman. There are adverse effects on maternal and fetal outcomes associated with
polycythemia vera
in pregnancy. Advise pregnant women of the potential risk to a fetus. Lactation: There are no data on the presence of
BESREMi
in human or animal milk, the effects on the breastfed child, or the effects on milk production. Because of the potential for serious adverse reactions in breastfed children from BESREMi, advise women not to breastfeed during treatment and for 8 weeks after the final dose. Females of Reproductive Potential:
BESREMi
may cause embryo-fetal harm when administered to a pregnant woman. Pregnancy testing prior to
BESREMi
treatment is recommended for females of reproductive potential. Advise female patients of reproductive potential to use effective contraception during treatment with
BESREMi
and for at least 8 weeks after the final dose. Pediatric Use: Safety and effectiveness in pediatric patients have not been established. Geriatric Use: In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other therapy. About PharmaEssentia PharmaEssentia (TPEx: 6446), headquartered in Taipei, Taiwan, is a global and rapidly growing biopharmaceutical innovator. Leveraging deep expertise and proven scientific principles, PharmaEssentia aims to deliver effective new biologics for challenging diseases in the areas of hematology, oncology, and immunology with one approved product and a diversifying pipeline. Founded in 2003 by a team of Taiwanese-American executives and renowned scientists from U.S. biotechnology and pharmaceutical companies, today PharmaEssentia is expanding its global presence with operations in the U.S., Japan, China, and Korea, along with a world-class biologics production facility in Taichung, Taiwan. For more information about PharmaEssentia USA, visit the website, LinkedIn or Twitter. Forward Looking Statement This press release may contain forward looking statements, including statements regarding the clinical benefits to be derived from
ropeginterferon alfa-2b
, the commercial opportunity and competitive positioning, new indications or labeling for
ropeginterferon alfa-2b
, and business prospects for
ropeginterferon alfa-2b
. For those statements, we claim the protection of the safe harbor for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995 and similar legislation and regulations under Taiwanese law. These forward-looking statements are based on management expectations and assumptions as of the date of this press release, and actual results may differ materially from those in these forward looking statements as a result of various factors. These factors include whether
BESREMi
is successfully commercialized and adopted by physicians and patients, the extent to which reimbursement is available for
BESREMi
, and the ability to receive FDA and other regulatory approvals for additional indications for
BESREMi
. We do not undertake to update any of these forward-looking statements to reflect events or circumstances that occur after the date hereof. © 2024 PharmaEssentia Corporation. All rights reserved. PharmaEssentia, the PharmaEssentia logo, and BESREMi are trademarks or registered trademarks of PharmaEssentia Corporation. 1 Cerquozzi S, Tefferi A. Blast transformation and fibrotic progression in
polycythemia vera
and
essential thrombocythemia
: a literature review of incidence and risk factors. Blood Cancer J. 2015;5, e366; DOI:10.1038/bcj.2015.95 2 Mehta J, Wang H, Iqbal SU, Mesa R. Epidemiology of
myeloproliferative neoplasms
in the United States.
Leuk Lymphoma
. 2014 Mar;55(3):595-600 3 “What is
Essential Thrombocythemia
?” MPN Research Foundation. 2020. Available at:
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