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Vertex Announces Initiation of Pivotal Phase 3 Program of VX-809 in Combination with Ivacaftor for the Treatment of People with Cystic Fibrosis Who Have Two Copies of the F508del Mutation
CAMBRIDGE, Mass. --(Business Wire)--
Vertex (News - Alert) Pharmaceuticals Incorporated (Nasdaq: VRTX) today announced the
initiation of a global pivotal Phase 3 development program for
fixed-dose combinations of VX-809 (lumacaftor) and ivacaftor in people
with cystic fibrosis (CF) who have two copies (homozygous) of the
F508del mutation in the cystic fibrosis transmembrane conductance
regulator (CFTR) gene. Vertex plans to conduct two 24-week Phase
3 studies to support approval of the combination of VX-809 and ivacaftor
in people with CF ages 12 and older. The studies, TRAFFIC and TRANSPORT,
will each include two treatment groups that will evaluate VX-809 (600mg
QD or 400mg q12h) in combination with ivacaftor (250mg q12h) compared to
a placebo group. Vertex expects to obtain 24-week safety and efficacy
data from both studies and to submit a New Drug Application (NDA) to the
U.S. Food and Drug Administration (FDA) and a Marketing Authorization
Application (MAA) to the European Medicines Agency (EMA (News - Alert)), pending study
results.
Vertex also plans to conduct a pharmacokinetics and safety study to
evaluate VX-809 in combination with ivacaftor in children with CF ages 6
to 11 who have two copies of the F508del mutation. The company expects
to use the data from this study for subsequent registration in children
ages 6 to 11 in the United States and is continuing discussions with
European regulatory agencies for patients in this age group.
Vertex will host a conference call for investors and media today,
February 26, 2013 at 5:15 p.m. EST, to discuss the company's Phase 3
development plan.
"This Phase 3 development program is a significant advance in our
efforts to develop new medicines that treat the underlying cause of
cystic fibrosis for people with the most common type of the disease,"
said Robert Kauffman, M.D., Ph.D., Senior Vice President and Chief
Medical Officer at Vertex. "Importantly, these studies will evaluate two
doses of VX-809 in combination with ivacaftor for 24 weeks, and pending
data, enable submissions to U.S. and European regulatory authorities.
People with CF are in urgent need of new treatments, and we are
committed to advancing this combination through Phase 3 development as
quickly as possible."
Cystic fibrosis is a rare, life-shortening genetic disease for which
there is no cure. Approximately 70,000 people worldwide have CF,
including 30,000 in the United States and 35,000 in Europe. Globally,
nearly half of those with CF have two copies of the F508del mutation.
About the Phase 3 TRAFFIC and TRANSPORT Studies
Vertex plans to conduct two 24-week, randomized, double-blind,
placebo-controlled Phase 3 studies of VX-809 in combination with
ivacaftor. TRAFFIC and TRANSPORT will each enroll approximately 500
people with CF ages 12 and older who have two copies of the F508del
mutation in the CFTR gene, for a total of 1,000 patients. The
studies have the same design and together will be conducted at
approximately 200 clinical trial sites in North America, Europe and
Australia.
The primary endpoint of each study is relative improvement in lung
function (percent predicted FEV1) through 24 weeks of
treatment, compared to placebo. Safety and tolerability will also be
assessed through 24 weeks. Key secondary endpoints through 24 weeks
include absolute improvement in FEV1, change in body mass
index (BMI) or weight gain, number of pulmonary exacerbations and
improvements in patient-reported outcomes as measured by the CF
Questionnaire Revised (CFQ-R), among others.
Each study will include two combination treatment groups and one placebo
group. The treatment groups will evaluate two regimens of VX-809 (600mg
QD or 400mg q12h) in combination with ivacaftor (250mg q12h). Fixed-dose
tablets that contain both VX-809 and ivacaftor, or placebo, will be used
in both studies. Vertex plans to follow the initial 24-week treatment
period with a separate rollover double-blind extension study where all
eligible patients, including those who received placebo, will receive
one of the combination regimens for up to an additional 96 weeks. The
design of the studies is as follows:
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Treatment Group
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24-Week Dosing Regimen
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Group 1 (n=167)
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VX-809 (600mg QD) + ivacaftor (250mg q12h)
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Group 2 (n=167)
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VX-809 (400mg q12h) + ivacaftor (250mg q12h)
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Group 3 (n=167)
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Placebo + Placebo
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About the Study in Patients Ages 6 to 11
Vertex also plans to conduct a study of VX-809 in combination with
ivacaftor in children with CF ages 6 to 11 who have two copies of the
F508del mutation. The study will evaluate the pharmacokinetics and
safety of the combination for up to 24 weeks. Vertex expects to use the
data from this study, along with data from TRAFFIC and TRANSPORT, for
registration of the combination in the United States in children ages 6
to 11, following registration in patients ages 12 and older. In Europe,
the company is in discussions with regulatory agencies regarding
patients in this age group.
Phase 2 Data Supporting Phase 3 Trial Design
The Phase 3 studies announced today are supported by data from a Phase 2
study of VX-809 in combination with ivacaftor. The two combination
dosing regimens selected for evaluation in Phase 3 were evaluated in
Cohorts 2 and 3 of the Phase 2 study.
Cohort 2: As previously reported, the once-daily (QD)
600mg dose of VX-809 in combination with ivacaftor (250mg q12h) was
evaluated in 21 patients in the second part (Cohort 2) of the Phase 2
study and resulted in statistically significant improvements in lung
function (within group and versus placebo) during the combination dosing
period, as noted below:
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Cohort 2
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Mean Absolute and Relative Changes in Percent Predicted FEV1
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Day 0 - 28; VX-809 Alone
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Day 28 - 56; VX-809 + ivacaftor
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Day 0 - 56
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VX-809 (600mg QD) + ivacaftor (250mg q12h)
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Within-Group
Absolute
Relative
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-2.9 (p=0.07)
-3.5 (p=0.13)
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+6.1 (p<0.001)
+9.7 (p<0.001)
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+3.4 (p=0.03)
+5.3 (p=0.02)
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Versus Placebo
Absolute
Relative
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-2.0 (p=0.36)
-3.9 (p=0.21)
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+8.6 (p<0.001)
+12.8 (p<0.001)
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+6.7 (p=0.002)
+9.2 (p=0.004)
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Cohort 3: Vertex also evaluated a 400mg twice-daily (q12h)
dosing regimen of VX-809 in combination with ivacaftor in a third cohort
of patients in the Phase 2 study. Cohort 3 evaluated 11 patients who
received VX-809 (400mg q12h) for 28 days followed by VX-809 (400mg q12h)
in combination with ivacaftor (250mg q12h) for 28 days. This cohort was
designed to evaluate safety and pharmacokinetics of the 400mg q12h dose
of VX-809 to support inclusion of this dose in the Phase 3 program.
Cohort 3 also included the randomization of four patients to placebo to
allow for a blinded safety assessment. Three patients completed
treatment in the placebo group. A pharmacokinetic model suggested that
400mg dosing every 12 hours (q12h) of VX-809 would provide a higher
total exposure (AUC; area under the curve) compared to 600mg QD dosing,
and data from Cohort 3 were consistent with this model.
Safety results from the 400mg (q12h) dose group were similar to that of
the 600mg (QD) dose group. In both dose groups, VX-809 was generally
well-tolerated alone and in combination with ivacaftor. The most common
adverse events in both groups were respiratory in nature. In Cohort 3,
one patient in the treatment group discontinued treatment because of a
pulmonary adverse event.
Together, these pharmacokinetic and safety data support inclusion of
VX-809 400mg (q12h) in combination with ivacaftor 250mg (q12h) in the
Phase 3 program to evaluate the effect that higher exposures of VX-809
have on efficacy and safety.
The pattern of lung function response observed in Cohort 3 was similar
to that observed in the 600mg QD dose group in Cohort 2, with a decline
in FEV1 during the VX-809 monotherapy dosing period followed
by a statistically significant increase in FEV1 during the
VX-809 and ivacaftor combination dosing period. The within-group mean
absolute improvement in FEV1 observed during the
combination-dosing period in Cohort 3 was 6.6 percentage points,
compared to 6.1 percentage points for the 600mg QD dose group in Cohort
2.
Additional lung function results for Cohort 3 are provided below:
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Cohort 3
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Mean Absolute and Relative Changes in Percent Predicted FEV1
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Day 0 - 28; VX-809 Alone
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Day 28 - 56; VX-809 + ivacaftor
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Day 0 - 56
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VX-809 (400mg q12h) + ivacaftor (250mg q12h)
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Within-Group
Absolute
Relative
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-4.3 (p=0.04)
-6.3 (p=0.08)
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+6.6 (p=0.01)
+8.8 (p=0.01)
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+1.9 (p=0.57)
+2.5 (p=0.67)
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Study in People with One Copy of the F508del Mutation
In addition to the Phase 3 studies in people with two copies of the
F508del mutation, Vertex plans to conduct an 8-week exploratory Phase 2
study of VX-809 in combination with ivacaftor in people 12 and older
with one copy (heterozygous) of the F508del mutation on one
allele and a second mutation that is not expected to respond to either
ivacaftor or VX-809 alone. This study is designed to provide additional
safety and lung function data on the combination in heterozygous
patients, and will evaluate the twice daily (q12h) combination of VX-809
(400mg) and ivacaftor (250mg).
VX-809 and ivacaftor were discovered as part of a collaboration with
Cystic Fibrosis Foundation Therapeutics, Inc., the non-profit drug
discovery and development affiliate of the Cystic Fibrosis Foundation.
About Cystic Fibrosis and the Combination of VX-809 and Ivacaftor
Cystic fibrosis is a rare, life-shortening genetic disease affecting
approximately 70,000 people worldwide, including 30,000 people in the
United States and 35,000 in Europe. The median predicted age of survival
for a person with CF born today is between 34 and 47 years, but the
median age of death remains in the mid-20s. The most common cause of
death among people with CF is lung disease, which results from recurring
infections and chronic lung inflammation.
CF is caused by a defective or missing CFTR protein resulting from
mutations in the cystic fibrosis transmembrane conductance regulator (CFTR)
gene. Children must inherit two defective CFTR genes - one from
each parent - to have CF. There are more than 1,800 known mutations in
the CFTR gene. Some of these mutations, which can be determined
by a genetic, or genotyping test, lead to CF by creating non-working or
too few CFTR protein at the cell surface. The absence of working CFTR
protein results in poor flow of salt and water into and out of the cell
in a number of organs, including the lungs.
In people with the most common mutation in the CFTR gene,
F508del, little-to-no CFTR protein reaches the cell surface. As a
result, thick, sticky mucus builds up and blocks the passages in many
organs, leading to a variety of symptoms. In particular, mucus builds up
and clogs the airways in the lungs, causing chronic lung infections and
progressive lung damage. VX-809, known as a CFTR corrector, is believed
to help CFTR protein reach the cell surface. Ivacaftor, known as a CFTR
potentiator, keeps the CFTR protein channels on the cell surface open
longer to increase the flow of salt and water into and out of the cell.
Globally, nearly half of people with CF have two copies of the F508del
mutation and an additional one-third have one copy of the F508del
mutation.
As announced in January 2013, the FDA granted Breakthrough Therapy
Designation to the combination regimen of VX-809 with ivacaftor for
cystic fibrosis.
Collaborative History with Cystic Fibrosis Foundation Therapeutics,
Inc. (CFFT)
Vertex initiated its CF research program in 1998 as part of a
collaboration with CFFT, the non-profit drug discovery and development
affiliate of the Cystic Fibrosis Foundation in the U.S. This
collaboration was expanded to support the accelerated discovery and
development of Vertex's CFTR modulators.
About Vertex
Vertex creates new possibilities in medicine. Our team discovers,
develops and commercializes innovative therapies so people with serious
diseases can lead better lives.
Vertex scientists and our collaborators are working on new medicines to
cure or significantly advance the treatment of hepatitis C, cystic
fibrosis, rheumatoid arthritis and other life-threatening diseases.
Founded more than 20 years ago in Cambridge, Mass., we now have ongoing
worldwide research programs and sites in the U.S., U.K. and Canada.
Today, Vertex has more than 2,000 employees around the world, and for
three years in a row, Science magazine has named Vertex one of
its Top Employers in the life sciences.
Special Note Regarding Forward-Looking Statements
This press release contains forward-looking statements as defined in the
Private Securities Litigation Reform Act of 1995, including, without
limitation, Dr. Kauffman's statements in the fourth paragraph of this
press release and statements regarding (i) the clinical studies the
company plans to conduct to evaluate VX-809 in combination with
ivacaftor, (ii) the design of these studies, including the primary and
secondary endpoints and the anticipated number of patients to be
enrolled, (iii) the company's expectations regarding when data will be
available from these clinical trials, (iv) the potential submission of
the NDA and MAA for the combination therapy and (v) the expectation that
the data from the study in children 6 to 11 will be used for subsequent
registration in the United States and the plan to continue discussions
with European regulatory agencies for this age group. While the Company
believes the forward-looking statements contained in this press release
are accurate, those statements are subject to risks and uncertainties
that could cause actual outcomes to vary materially from the outcomes
referenced in the forward-looking statements. These risks and
uncertainties include, among other things, the risks that efforts to
develop VX-809 in combination with ivacaftor may not be successful
because the results of the clinical trials described in this press
release may not support registration or for technical, scientific or
other reasons, that clinical trials may not proceed as planned due to
drug supply, patient enrollment or other issues, and that an adverse
event profile for VX-809 in combination with ivacaftor could be revealed
in further nonclinical or clinical studies and the other risks listed
under Risk Factors in Vertex's annual report and quarterly reports filed
with the Securities and Exchange Commission and available through the
company's website at www.vrtx.com.
Vertex disclaims any obligation to update the information contained in
this press release as new information becomes available.
Conference Call Information
Vertex will host a conference call and webcast today, February 26, 2013
at 5:15 p.m. ET to review the initiation of the Phase 3 pivotal program
studying the combination regimen of VX-809 and ivacaftor for F508del
homozygous patients. The conference call will be webcast live, and a
link to the webcast may be accessed from the 'Vertex Events' page of
Vertex's website at www.vrtx.com.
To listen to the live call on the telephone, dial 1-866-501-1537 (United
States and Canada) or 1-720-545-0001 (International). To ensure a timely
connection, it is recommended that users register at least 15 minutes
prior to the scheduled webcast.
The conference ID number for the live call and replay is 15208263.
The call will be available for replay via telephone commencing February
26, 2013 at 8:00 p.m. ET running through 5:00 p.m. ET on March 5, 2013.
The replay phone number for the United States and Canada is
1-855-859-2056. The international replay number is 1-404-537-3406.
Following the live webcast, an archived version will be available on
Vertex's website until 5:00 p.m. ET on March 5, 2013. Vertex is also
providing a podcast MP3 file available for download on the Vertex
website at www.vrtx.com.
(VRTX - GEN)

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