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Macugen(R) (pegaptanib sodium injection) Studied in Treatment of
Diabetic Macular Edema (DME) and Other Diabetic Retinopathy Lesions
Improvement in diabetic retinopathy score noted in review of retinal
photographs
NEW YORK, May 5 /PRNewswire-FirstCall/ -- Eyetech Pharmaceuticals, Inc.
(NASDAQ:EYET) announced today that imaging data from a Phase 2 study of
Macugen(R) (pegaptanib sodium injection) in diabetic macular edema (DME) showed
a reversal of capillary microaneurysms, retinal ischemia and neovascularization
-- all important signs of diabetic retinopathy. These new preliminary
observations from the Macugen Phase 2 DME trial were presented today at the
2005 Association for Research in Vision and Ophthalmology annual meeting in
Fort Lauderdale, Fla. Macugen is indicated in the United States for the
treatment of neovascular age-related macular degeneration (neovascular AMD) and
is not approved for the treatment of DME. For full prescribing information
about Macugen, please visit http://www.macugen.com/.
(Logo: http://www.newscom.com/cgi-bin/prnh/20050407/EYETLOGO )
"Researchers reviewed photographs of the retina and noted evidence of
regression of retinal neovascularization and other signs of diabetic
retinopathy in patients treated with Macugen. We also found an improvement on
the diabetic retinopathy severity scale, which suggests that Macugen may have
helped slow or even reverse the progression of the disease," said Larry
Singerman, M.D., Clinical Professor of Ophthalmology at Case University School
of Medicine and President of Retina Associates of Cleveland. "While no final
conclusions can be drawn from these preliminary and limited data as to the
efficacy of Macugen in diabetic retinopathy, we are encouraged by the potential
implication of these findings, which are consistent with our current
understanding of the role of VEGF in diabetic retinopathy. We look forward to
future research to confirm this important hypothesis."
As previously announced, Eyetech and Pfizer plan to conduct a pivotal Phase 2/3
DME clinical trial that will include the diabetic retinopathy score as a
pre-specified secondary endpoint. This trial is expected to begin in the
second half of 2005.
"There is a tremendous unmet medical need for the 5.3 million of people in the
U.S. who suffer from diabetic retinopathy. We are hoping that future trials
may demonstrate that Macugen is effective in treating or preventing the
progression of diabetic retinopathy," said Anthony P. Adamis, M.D., Chief
Scientific Officer of Eyetech. "Eyetech remains focused on diseases affecting
the back of the eye because we believe these represent the largest unmet needs
in ophthalmology. Our clinical development program for Macugen, in partnership
with Pfizer, continues to progress."
Findings in Retrospective Subgroup Analysis of Macugen DME Phase 2 Data
Researchers conducted a retrospective analysis of 69 patients within the
Macugen 0.3 mg and usual care arms who had recognized and gradable diabetic
retinopathy at both baseline and week 36. In these two arms of the trial,
patients treated with Macugen 0.3 mg therapy showed an improvement in the ETDRS
diabetic retinopathy severity scale, a standard for monitoring the progression
of retinopathy. At week 36, 11 of the 39 Macugen 0.3 mg dosed patients (28.2
percent) showed improvement of greater than or equal to 1 step versus four of
30 in the sham group (13.3 percent). In addition, a higher proportion of
Macugen patients (five of 39, 12.8 percent) showed an improvement of > 2 steps
at week 36 compared to sham group (one of 30, 3.3 percent).
Another retrospective analysis from these two arms of the trial included 82
patients for whom assessment of retinal ischemia data was available at both
baseline and week 36 (43 patients receiving 0.3 mg Macugen, 39 patients
receiving usual care). In this analysis, 16 percent of Macugen patients had
less capillary loss, compared to five percent of patients receiving usual care.
In another analysis of all patients treated with Macugen, (0.3 mg, 1 mg, 3 mg
doses), 13 were noted to have retinal neovascularization upon their baseline
examination. Of these 13 patients, regression in retinal neovascularization
was noted at week 36 in eight (62 percent), while no regression of
neovascularization was recognized in sham patients who had neovascularization
at baseline. As well, recurrence of neovascularization followed
discontinuation of Macugen in three of the eight subjects (38%) at week 52.
More About the Phase 2 DME Study
In a Phase 2, double-masked, sham-controlled study of 172 DME patients, 73
percent of patients receiving 0.3 mg Macugen experienced stable or improved
vision at week 36, compared to 51 percent of patients who received sham
(p=0.023). Among Macugen 0.3 mg patients: 59 percent reported vision gain of
at least one line (5 letters) versus 34 percent of sham (p=0.010); 34 percent
reported vision gain of at least two lines (10 letters) versus 10 percent of
sham (p=0.003); and 18 percent reported vision gain of at least three lines (15
letters) versus seven percent of sham (p=0.12). In addition, 42 percent of
patients receiving Macugen 0.3 mg showed a decrease in mean retinal thickness
of at least 100 microns, compared to 16 percent of sham. As well, at the end
of the study, only half as many patients who received Macugen needed additional
laser therapy compared to those receiving usual care (25% vs. 48%).
About Diabetic Retinopathy
Diabetic retinopathy is a disease affecting the blood vessels of the retina,
resulting in multiple abnormalities including retinal thickening or edema,
hemorrhages, impeded blood flow (retinal ischemia), excessive leakage of fluid
from blood vessels and, in the final stages, abnormal blood vessel growth.
Such blood vessel growth (proliferative diabetic retinopathy) can lead to
hemorrhages and severe retinal damage. When the blood vessel leakage causes
swelling within the macula, it is referred to as DME.
According to the American Diabetes Association (ADA), there are at least 18
million people diagnosed with diabetes in the United States. After 10 years of
disease duration, 75 percent of diabetics have developed some form of diabetic
retinopathy. Diabetes is the leading cause of blindness in adults 20 to 74
years of age in the United States, and DME is the leading cause of vision loss
for patients with diabetes. In the United States, there are approximately
500,000 people suffering from DME, with approximately 75,000 new cases each
year. There is a significant unmet medical need for a new therapy for this
disease.
About Macugen
Macugen is indicated in the United States for the treatment of neovascular
age-related macular degeneration (neovascular AMD) and is administered in a 0.3
mg dose once every six weeks by intravitreal injection. Macugen is a pegylated
anti-VEGF aptamer, which binds to vascular endothelial growth factor (VEGF).
VEGF is a protein that plays a critical role in angiogenesis (the formation of
new blood vessels) and increased permeability (leakage from blood vessels), two
pathological processes that contribute to the vision loss associated with
neovascular AMD.
Important Safety Information
Macugen is contraindicated in patients with ocular or periocular infections.
Intravitreal injections including those with Macugen have been associated with
endophthalmitis. Proper aseptic injection technique -- which includes use of
sterile gloves, a sterile drape, and a sterile eyelid speculum (or equivalent)
-- should always be utilized when administering Macugen. In addition, patients
should be monitored during the week following the injection to permit early
treatment, should an infection occur.
Increases in intraocular pressure (IOP) have been seen within 30 minutes of
injection with Macugen. Therefore, IOP as well as the perfusion of the optic
nerve head should be monitored and managed appropriately.
Serious adverse events related to the injection procedure occurring in