Merck KGaA, Darmstadt, Germany, to Showcase New Data across MS Portfolio at EAN 2019

Merck KGaA, Darmstadt, Germany, today announced that data from across its multiple sclerosis (MS) portfolio will be presented at the 5th Congress of the European Academy, 29 June – 2 July 2019 in Oslo, Norway.

24 Jun 2019 | Darmstadt, Germany
  • Company to present 16 abstracts on MAVENCLAD® (cladribine) tablets, Rebif® (interferon beta-1a) and investigational evobrutinib at the 5th Congress of the European Academy of Neurology
  • Presentations include new data on the long-term efficacy and safety of MAVENCLAD®, new safety data for Rebif® and the 48-week analysis from the Phase 2 clinical study with evobrutinib 

Merck KGaA, Darmstadt, Germany, a leading science and technology company, today announced that data from across its multiple sclerosis (MS) portfolio will be presented at the 5th Congress of the European Academy of Neurology (EAN), 29 June – 2 July 2019 in Oslo, Norway. The company will present a total of 16 abstracts (12 posters and 4 presentations) on MAVENCLAD® (cladribine) tablets, Rebif® (interferon beta-1a) and the investigational therapy evobrutinib (an oral, highly selective Bruton’s Tyrosine Kinase [BTK] inhibitor).

The wealth of new data that we are presenting at EAN 2019, from both our approved medicines and our pipeline in MS, highlight our commitment to making further advances for people living with this chronic disease,” said Luciano Rossetti, Head of Global Research & Development for the Biopharma business of Merck KGaA, Darmstadt, Germany.

Key MAVENCLAD® data will include:

  • Post-hoc analysis of the CLARITY Extension study to examine the long-term efficacy in high-disease activity patients treated with cladribine tablets 3.5 mg/kg
  • Updated safety analysis of cladribine tablets 3.5 mg/kg in patients with relapsing multiple sclerosis (RMS)

Key Rebif® data will include:

  • Results from the Nordic registry regarding the risk of spontaneous abortion and ectopic pregnancy in patients using interferons
  • Results from the UK Multiple Sclerosis Risk Sharing Scheme on treatment with subcutaneous interferon beta-1a 

Key evobrutinib data will include:

  • Results of analysis of the efficacy and safety of evobrutinib in patients with RMS over 48 Weeks: a randomized, placebo-controlled, phase 2 study 

Below is a selection of abstracts that have been accepted for presentation at EAN 2019:

MAVENCLAD® (cladribine tablets)

Title

Lead Author

Poster

Presentation / Session

NEDA-3 durability in CLARITY Extension in patients with relapsing multiple sclerosis receiving Cladribine Tablets

Giovannoni G

EPO1244

Session: “MS and related disorders 3”

Date: Saturday, 29 June 2019

Time: 12:30 to 13:15

Location: Screen B12

 

Variations of uric acid levels and their clinical correlates during cladribine treatment

Moccia M

EPO2218

Session: “MS and related disorders 5”

Date: Sunday 30 June 2019

Time: 12:30 to 13:15

Location: Screen B11

 

CLARITY Extension: Sustained efficacy in relapsing remitting multiple sclerosis following switch from Cladribine Tablets to placebo in patients with high disease activity at baseline

Vermersch P

EPO3211

Session: “MS and related disorders 8”

Date: Monday, 01 July 2019

Time: 12:30 to 13:15

Location: Screen B11

 

Rationale, design and feasibility assessment of the phase IV CLASSIC-MS study evaluating long-term efficacy outcomes for patients with multiple sclerosis treated with Cladribine Tablets

Boyko A

POD026

Session: Poster on Display                                      Date: Saturday 29 June-Monday 1 July

 

Incidence and risk of any malignancies in multiple sclerosis (MS) from the Netherlands (NL) and Denmark (DK)

Kuiper J

EPO2202

Session: “MS and Related Disorders 4”

Date: Sunday 30 June 2019

Time: 12:30 to 13:15

Location: Screen B10

 

Incidence and risk of malignancies by type, in multiple sclerosis (MS) patients, compared from the Netherlands (NL) and Denmark (DK)

Nørgaard M

EPO2226

Session: “MS and related disorders 6”

Date: Sunday, 30 June 2019

Time: 12:30 -13:15

Location:

Screen B12

Severity and frequency of relapses in patients with relapsing-remitting MS treated with Cladribine Tablets in CLARITY and placebo in CLARITY Extension

Schippling S

EPO3196

Session: “MS and related disorders 7”

Date: Monday, 01 July 2019

Time: 12:30 to 13:15

Location: Screen B10  

 

CLARITY/CLARITY Extension: Lymphopenia rates are consistent in patients with and without high disease activity at baseline

Cook S

POD049

Session: Poster on Display                                      Date: Saturday 29 June-Monday 1 July

 

Treatment of patients with Multiple Sclerosis: An updated safety analysis of Cladribine Tablets

Cook S

POD050

Session: Poster on Display                                      Date: Saturday 29 June-Monday 1 July

 

Efficacy of Cladribine Tablets 3.5 mg/kg in Patients with Relapsing Multiple Sclerosis

Aged Above and Below 45 Years; CLARITY and CLARITY Extension

Giovannoni G

EPO1243

Session: “MS and related disorders 3”

Date: Saturday, 29 June 2019

Time: 12:30 to 13:15

Location: Screen B12

 

Evobrutinib

Bruton’s Tyrosine Kinase Inhibitor Evobrutinib (M2951) in Patients with Relapsing Multiple Sclerosis: a Randomised, Placebo-Controlled, Phase 2 Study

Montalban X

Oral presentation - O1205

Session: “MS and related disorders”

Date: Saturday, 29 June 2019

Time: 17:30

 

Rebif® (interferon beta-1a)

No increased risk of spontaneous abortion and ectopic pregnancy after exposure to interferon-beta prior to or during pregnancy: Results from register-based Nordic study among women with MS

Juuti R

EPR2074

Session: ePresentation

Date: Sunday, June 30

Time: 13:30 to 14:15

Screen A6

 

Subcutaneous Interferon β-1a: 10 years of the UK Multiple Sclerosis Risk Sharing Scheme

Harty G

EPR1089

Session: ePresentation

Date: Saturday 29 June

Time: 13:30 to 14:15

Screen A7

 

A systematic review of relapse rates in patients with relapsing multiple sclerosis during pregnancy and breastfeeding

Sabidó M

EPO3194

Session: ePoster

Date: Monday 1 July

Time: 12:30 to 13:15

Screen B10

 

Rapid reduction of lesion accumulation in specific white matter tracts as assessed by lesion mapping in RR-MS patients treated with IFN beta-1a

De Stefano N

EPR1086

Session: ePresentation

Date: Saturday 29 June

Time: 13:30 to 14:15

Screen A7

Dynamics of Pseudo-Atrophy in RRMS Patients Treated with Interferon beta-1a as Assessed by Monthly Brain MRI       

De Stefano N

EPO1234

Session: ePoster

Date: Saturday 29 June

Time: 12:30 to 13:15

Screen B11

 

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About MAVENCLAD®

MAVENCLAD, approved by the U.S. Food and Drug Administration (FDA) on March 29, 2019, is the first and only short-course oral therapy for the treatment of adults with relapsing-remitting disease (RRMS) and active secondary progressive disease (SPMS). Because of its safety profile, use of MAVENCLAD is generally recommended for patients who have had an inadequate response to, or are unable to tolerate, an alternate drug indicated for the treatment of multiple sclerosis (MS), and MAVENCLAD is not recommended for use in patients with clinically isolated syndrome (CIS). Patients should follow healthcare provider instructions including cancer screening, contraception and blood tests. The approved dose of MAVENCLAD is 3.5 mg per kg body weight over two years, administered as one treatment course of 1.75 mg per kg per year, each consisting of two treatment weeks. The mechanism by which cladribine exerts its therapeutic effects in patients with multiple sclerosis has not been fully elucidated but is thought to involve cytotoxic effects on B and T lymphocytes through impairment of DNA synthesis, resulting in depletion of lymphocytes. MAVENCLAD causes a dose-dependent reduction in lymphocyte counts followed by recovery.

Because cladribine is cytotoxic, special handling and disposal instructions should be followed.

MAVENCLAD has been approved in over 50 countries, including the European Union (EU), Canada, Australia and Switzerland, for various relapsing MS indications. Visit www.MAVENCLAD.com for more information.

IMPORTANT SAFETY INFORMATION

BOXED WARNING: MALIGNANCIES and RISK OF TERATOGENICITY

  • Treatment with MAVENCLAD may increase the risk of malignancy. MAVENCLAD is contraindicated in patients with current malignancy; evaluate the benefits and risks of the use of MAVENCLAD on an individual patient basis for patients with prior or increased risk of malignancy.
  • MAVENCLAD is contraindicated for use in pregnant women and in women and men of reproductive potential who do not plan to use effective contraception because of the potential for fetal harm.

CONTRAINDICATIONS

  • Current malignancy.
  • Pregnancy, and women and men of reproductive potential who do not plan to use effective contraception during MAVENCLAD dosing and for 6 m after the last dose in each treatment course.
  • Human immunodeficiency virus (HIV).
  • Active chronic infections (e.g., hepatitis or tuberculosis).
  • History of hypersensitivity to cladribine.
  • Breastfeeding while taking MAVENCLAD and for 10 days after the last dose.

DOSING CONSIDERATIONS:  After the completion of 2 treatment courses, do not administer additional MAVENCLAD during the next 2 years.  The risk of malignancy with reinitiating MAVENCLAD more than 2 years after completion of 2 treatment courses has not been studied.

ADDITIONAL WARNINGS AND PRECAUTIONS

  • Lymphopenia: In clinical studies, 87% of MAVENCLAD-treated patients experienced lymphopenia. Concomitant use of MAVENCLAD with hematotoxic drugs may increase the risk of adverse reactions because of the additive hematological effects. Monitor lymphocyte counts before and during treatment, periodically thereafter, and when clinically indicated. 
  • Infections: Infections occurred in 49% of MAVENCLAD-treated patients compared to 44% of patients treated with placebo in clinical studies. The most frequent serious infections included herpes zoster and pyelonephritis. Single fatal cases of tuberculosis and fulminant hepatitis B were reported in the clinical program. Administer live-attenuated or live vaccines at least 4 to 6 weeks prior to starting MAVENCLAD. Screen patients for latent infections; consider delaying treatment until infection is fully controlled. Vaccinate patients antibody-negative to varicella zoster virus prior to treatment. Monitor for infections.
  • Hematologic Toxicity: Mild to moderate decreases in neutrophil counts, hemoglobin levels, and platelet counts were observed. Severe decreases in neutrophil counts were observed in 3.6% of MAVENCLAD-treated patients, compared to 2.8% of placebo patients. Obtain complete blood count (CBC) with differential including lymphocyte count before and during treatment, periodically thereafter, and when clinically indicated. 
  • Risk of Graft-versus-Host Disease With Blood Transfusions:  Irradiation of cellular blood components is recommended.
  • Liver Injury:  Obtain liver function tests prior to treatment.  Discontinue MAVENCLAD if significant injury is suspected.
  • Hypersensitivity: In clinical studies, 11% of MAVENCLAD-treated patients had hypersensitivity reactions, compared to 7% of placebo patients. Serious hypersensitivity reactions occurred in 0.5% of MAVENCLAD-treated patients, compared to 0.1% of placebo patients. If a hypersensitivity reaction is suspected, discontinue treatment. Do not use MAVENCLAD in patients with a history of hypersensitivity to cladribine.

Adverse Reactions: The most common adverse reactions with an incidence of >20% for MAVENCLAD are upper respiratory tract infection, headache, and lymphopenia.

Drug Interactions/Concomitant Medication: Concomitant use of MAVENCLAD with immunosuppressive or myelosuppressive drugs and some immunomodulatory drugs (e.g., interferon beta) is not recommended and may increase the risk of adverse reactions.  Avoid concomitant use of certain antiviral and antiretroviral drugs. Avoid concomitant use of BCRP or ENT/CNT inhibitors as they may alter bioavailability of MAVENCLAD. 

Please see the full Prescribing Information, including boxed WARNING for additional information.

About Rebif® (interferon beta-1a) 

Rebif (interferon beta-1a) is used to treat relapsing forms of MS to decrease the frequency of relapses and delay the occurrence of some of the physical disability that is common in people with MS. The efficacy and safety of Rebif in controlled clinical trials beyond 2-years has not been established. 

IMPORTANT SAFETY INFORMATION:

Rebif is contraindicated in patients with a history of hypersensitivity to natural or recombinant interferon beta, human albumin, or any other component of the formulation. 

Rebif should be used with caution in patients with depression, a condition that is common in people with multiple sclerosis. Depression, suicidal ideation, and suicide attempts have been reported to occur with increased frequency in patients receiving interferon compounds, including Rebif. 

Severe liver injury, including some cases of hepatic failure requiring liver transplantation, has been reported rarely in patients taking Rebif. The potential for liver injury should be considered when used in combination with other products associated with liver injury. Monitor liver function tests and patients for signs and symptoms of hepatic injury. Consider discontinuing Rebif if hepatic injury occurs.

Anaphylaxis and other allergic reactions (some severe) have been reported as a rare complication of Rebif. Discontinue Rebif if anaphylaxis occurs. 

In controlled clinical trials, injection site reactions occurred more frequently in Rebif-treated patients than in placebo-treated and Avonex-treated patients. Injection site reactions including injection site pain, erythema, edema, cellulitis, abscess, and necrosis have been reported in the postmarketing setting. Do not administer Rebif into affected area until fully healed; if multiple lesions occur, discontinue Rebif until skin lesions are healed. 

Decreased peripheral blood counts in all cell lines, including pancytopenia, have been reported in Rebif-treated patients. In controlled clinical trials, leukopenia occurred at a higher frequency in Rebif-treated patients than in placebo and Avonex-treated patients. Thrombocytopenia and anemia occurred more frequently in 44 mcg Rebif-treated patients than in placebo-treated patients. Patients should be monitored for symptoms or signs of decreased blood counts. Monitoring of complete blood and differential white blood cell counts is also recommended. 

Cases of thrombotic microangiopathy (TMA), some fatal, have been reported with interferon beta products, including Rebif, up to several weeks or years after starting therapy. Discontinue Rebif if clinical symptoms and laboratory findings consistent with TMA occur, and manage as clinically indicated.

Caution should be exercised when administering Rebif to patients with pre-existing seizure disorders. Seizures have been temporally associated with the use of beta interferons, including Rebif, in clinical trials and in postmarketing reports. 

The most common side effects with Rebif are injection-site disorders, headaches, influenza-like symptoms, abdominal pain, depression, elevated liver enzymes, and hematologic abnormalities. 

There are no adequate and well-controlled studies in pregnant women. Rebif should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Please see the full Prescribing Information for additional information: http://www.emdserono.com/ms.country.us/en/images/Rebif_PI_tcm115_140051.pdf?Version=

About Evobrutinib

Evobrutinib (M2951) is in clinical development to investigate its potential as a treatment for multiple sclerosis (MS), rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). It is an oral, highly selective inhibitor of Bruton’s tyrosine kinase (BTK) which is important in the development and functioning of various immune cells including B lymphocytes and macrophages. Evobrutinib is designed to inhibit primary B cell responses such as proliferation and antibody and cytokine release, without directly affecting T cells. BTK inhibition is thought to suppress autoantibody-producing cells, which preclinical research suggests may be therapeutically useful in certain autoimmune diseases. Evobrutinib is currently under clinical investigation and not approved for any use anywhere in the world.

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 KGaA, Darmstadt, Germany in Neurology and Immunology

Merck KGaA, Darmstadt, Germany, has a long-standing legacy in neurology and immunology, with significant R&D and commercial experience in multiple sclerosis (MS). The company`s current MS 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 KGaA, Darmstadt, Germany, aims to improve the lives of those living with MS, by addressing areas of unmet medical needs.

The company`s robust immunology pipeline focuses on discovering new therapies that have the potential to modulate key pathogenic mechanisms in chronic diseases such as MS, systemic lupus erythematosus (SLE) and forms of arthritis, including rheumatoid arthritis (RA) and osteoarthritis (OA).

About Merck KGaA, Darmstadt, Germany

Merck KGaA, Darmstadt, Germany, is a leading science and technology company in healthcare, life science and performance materials. Around 52,000 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 2018, Merck KGaA, Darmstadt, Germany, generated sales of € 14.8 billion in 66 countries.

Scientific exploration and responsible entrepreneurship have been key to the company’s technological and scientific advances. This is how Merck KGaA, Darmstadt, Germany, has thrived since its founding in 1668. The founding family remains the majority owner of the publicly listed company. Merck KGaA, Darmstadt, Germany, holds the global rights to the Merck name and brand. The only exceptions are the United States and Canada, where the business sectors of Merck operate as EMD Serono in healthcare, MilliporeSigma in life science, and EMD Performance Materials.

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