- 14 abstracts to be presented, further characterizing the complementary profiles of Mavenclad (cladribine tablets)and Rebif (interferon beta-1a)
Merck, a leading science and technology company, will present data from its neurology and immunology portfolio at the 4th Congress of the European Academy of Neurology (EAN), taking place from June 16-19, in Lisbon, Portugal. Merck will present a total of 14 abstracts in the area of relapsing multiple sclerosis (RMS), including a post-hoc analysis of the Phase III CLARITY study, investigating whether the beneficial clinical and magnetic resonance imaging (MRI) effects of MAVENCLAD® are consistent in older (>50 years) and younger (<=50) adult patients with relapsing remitting MS (RRMS). Data presented at the congress will also provide further insights into the benefit-risk profile of MAVENCLAD® in patients with relapsing MS with high disease activity, using Multi-Criteria Decision Analysis, an EMA-recommended methodology used to indirectly compare the benefit-risk profile between treatments. A separate post hoc analysis of patients in the ONWARD study evaluates the efficacy of MAVENCLAD® as add-on to interferon beta-1a in patients with secondary progressive MS (SPMS) with relapses, compared to patients with RRMS from the same study.
Additionally, data presentations on Rebif® (interferon beta-1a) include analysis of MRI in MS (MAGNIMS) score to predict long-term clinical disease activity (CDA)-free status and disability progression following treatment with Rebif®.
In line with Merck's MS Inside Out campaign aiming to better understand patients with MS, results of the Merck-sponsored 'MS in the 21st Century International Unmet Needs Survey' show that MS patients have substantially different perceptions of the current unmet needs in MS compared to healthcare professionals (HCPs). Identification and understanding of these differences could lead to an improved dialogue between HCPs and patients, which is integral to finding appropriate individualised treatment approaches for each patient.
Attendees can learn more about Merck's programs, pipeline and activities in neurology and immunology by visiting the company's medical booth A07
The following abstracts have been accepted for presentation at EAN Congress 2018:
MAVENCLAD(R) (Cladribine Tablets) Presentations
Presentation Title Authors Abstract No. Date/Time/Session
Infections during periods of grade 3 or 4 lymphopenia in patients taking Cook S, Leist T, cladribine tablets 3.5 Comi G, Montalban mg/kg: data from an X, Sylvester E, ePoster integrated safety Hicking C, Dangond 16-18 Jun 2018 analysis F 748 Time:12:30-14:15
Effects of cladribine tablets on CD4+ T cell subsets in the Stuve O, ORACLE-MS study: Soelberg-Sorensen Results from an P, Leist T, Hyvert ePoster analysis of lymphocyte Y, Damian D, 16-18 Jun 2018 surface markers Boschert U 762 Time:12:30-14:15
Innate Immune Cell Counts in Patients with Relapsing-Remitting Multiple Sclerosis (RRMS) Treated with Soelberg-Sorensen Cladribine Tablets 3.5 P, Dangond F, ePresentation mg/kg in CLARITY and Hicking C, 16-18 Jun 2018 CLARITY Extension Giovannoni G 749 Time:12:30-14:15
Cladribine tablets produce selective and discontinuous reduction of B and T lymphocytes and natural killer cells Stuve O, in patients with early Soelberg-Sorensen and relapsing multiple P, Giovannoni G, sclerosis (ORACLE-MS, Leist T, Hyvert Y, ePresentation CLARITY and CLARITY Damian D, Boschert 16-18 Jun 2018 Extension) U 746 Time:12:30-14:15
An analysis of malignancy risk in the clinical development programme of Galazka A, Nolting cladribine tablets in A, Cook S, Leist T, patients with Comi G, Montalban ePoster relapsing multiple X, Hicking C, 16-18 Jun 2018 sclerosis (RMS) Dangond F 757 Time:12:30-14:15
Pregnancy outcomes during the clinical development programme of cladribine in Galazka A, Nolting multiple sclerosis A, Cook S, Leist T, (MS): an integrated Comi G, Montalban ePresentation analysis of safety for X, Hicking C, 16-18 Jun 2018 all exposed patients Dangond F 765 Time:12:30-14:15
A benefit-risk assessment of cladribine tablets using Multi-Criteria Decision Analysis for Vermersch P, patients with Martinelli V, relapsing multiple Pfleger C, sclerosis Rieckmann P, ePoster demonstrating high Galazka A, Dangond 16-18 Jun 2018 disease activity F, Phillips L 759 Time:12:30-14:15
Efficacy of cladribine tablets 3.5 mg/kg added to interferon-beta in patients with secondary progressive multiple sclerosis (SPMS) or relapsing-remitting Montalban X, Cohen multiple sclerosis B, Leist T, Moses ePresentation (RRMS): a post-hoc H, Hicking C, 16-18 Jun 2018 analysis from ONWARD Dangond F 766 Time:12:30-14:15
A pooled analysis of the efficacy of cladribine tablets 3.5 mg/kg in patients with EDSS greater than or equal to3.5 or less than or equal to3.0 at Giovannoni G, baseline in the Montalban X, ePresentation CLARITY and ONWARD Hicking C, Dangond 16-18 Jun 2018 studies F 747 Time:12:30-14:15 Efficacy of cladribine tablets 3.5 mg/kg in patients with highly active relapsing multiple sclerosis (RMS): Pooled analysis of the double-blind Giovannoni G, ePresentation cohort from CLARITY Montalban X, Damian 16-18 Jun 2018 and ONWARD D, Dangond F 1345 Time:12:30-14:15
Efficacy of cladribine tablets 3.5 mg/kg in patients less than or Giovannoni G, equal to50 and >50 Rammohan K, Cook S, years of age with Comi G, Rieckmann relapsing-remitting P, multiple sclerosis Soelberg-Sørensen ePresentation (RRMS): a post hoc P, Vermersch P, 16-18 Jun 2018 analysis from CLARITY Dangond F, Damian D 1341 Time:12:30-14:15
Rebif(R) (interferon beta-1a) Presentations
Disease activity as assessed by the MAGNIMS score predicts long-term clinical disease activity free status and disability Sormani MP, progression in Freedman MS, patients treated with Aldridge J, ePresentation subcutaneous Marhardt K, De 16-18 Jun 2018 interferon beta-1a Stefano N 743 Time:12:30-14:15
Evolution of new lesions and its Vrenken H, de Vos temporal patterns in ML, Battaglini M, patients with Nagtegaal GJ, de clinically isolated Almeida Teixeira syndrome treated with BC, Marhardt K, De ePresentation subcutaneous Stefano N, Barkhof 16-18 Jun 2018 interferon beta-1a F 444 Time:12:30-14:15
Additional Merck-sponsored Presentations
Patient involvement in treatment decision-making: a sub-analysis of the 'MS in the 21st Century international Rieckmann P, unmet needs survey' Langdon D on behalf comparing patient and of MS in the 21st healthcare Century Steering professional Group, and Contango perspectives EV 1340 Poster on Display
1. Magnetic Resonance Imaging in MS
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MAVENCLAD® (cladribine tablets) is a short-course oral therapy that selectively and periodically targets lymphocytes thought to be integral to the pathological process of multiple sclerosis (MS). In August 2017, the European Commission (EC) granted marketing authorization for MAVENCLAD® for the treatment of relapsing forms of MS (RMS) in the 28 countries of the European Union (EU) in addition to Norway, Liechtenstein and Iceland. MAVENCLAD® is now available in over 10 countries in Europe, plus Australia, Argentina and the United Arab Emirates. MAVENCLAD® is not yet approved for any use in the United States.
The clinical development program of MAVENCLAD® in MS comprises more than 10,000 patient years of data with over 2,700 patients included in the clinical trial program, and up to 10 years of observation in some patients. These clinical trials include the Phase III CLARITY, CLARITY extension and ORACLE MS trials, the Phase II ONWARD trial and the PREMIERE Long-term Safety Registry.
MAVENCLAD® (cladribine tablets) is indicated for the treatment of adult patients with highly active relapsing multiple sclerosis (RMS) as defined by clinical or imaging features.
Important EU Safety Information
MAVENCLAD® is contraindicated in patients with hypersensitivity to the active substance, human immunodeficiency virus (HIV), active chronic infection (tuberculosis or hepatitis), active malignancy, moderate to severe renal impairment (creatinine clearance <60 mL/min), and those who are pregnant and breast-feeding. MAVENCLAD® is also contraindicated in immunocompromised patients, including patients currently receiving immunosuppressive or myelosuppressive therapy.
Special warnings and precautions for use:
The most clinically relevant adverse reactions were lymphopenia and herpes zoster.
Decreases in neutrophil count, red blood cell count, haematocrit, haemoglobin or platelet count compared to baseline values have been observed in clinical studies, although these parameters usually remain within normal limits.
Additive haematological adverse reactions may be expected if cladribine is administered prior to or concomitantly with other substances that affect the haematological profile
Lymphocyte counts must be determined
- before initiating MAVENCLAD® in year 1, - before initiating MAVENCLAD® in year 2, - 2 and 6 months after start of treatment in each treatment year. If the lymphocyte count is below 500 cells/mm³, it should be actively monitored until values increase again.
Cladribine can reduce the body's immune defence and may increase the likelihood of infections. HIV infection, active tuberculosis and active hepatitis must be excluded before initiation of cladribine.
The incidence of herpes zoster was increased in patients on cladribine. If lymphocyte counts drop below 200 cells/mm³, anti-herpes prophylaxis according to local standard practice should be considered during the time of grade 4 lymphopenia. Interruption or delay of MAVENCLAD® may be considered until proper resolution of the infection.
Cases of progressive multifocal leukoencephalopathy (PML) have been reported for parenteral cladribine in patients treated for hairy cell leukaemia with a different treatment regimen.
In the clinical study data base of cladribine in MS (1,976 patients, 8,650 patient years) no case of PML has been reported. However, a baseline magnetic resonance imaging (MRI) should be performed before initiating MAVENCLAD® (usually within 3 months).
Rebif® (interferon beta-1a) is a disease-modifying drug used to treat relapsing forms of multiple sclerosis (MS) and is similar to the interferon beta protein produced by the human body. The efficacy of Rebif® in chronic progressive MS has not been established. Interferon ß is thought to help reduce inflammation. The exact mechanism is unknown.
Rebif®, which was approved in Europe in 1998 and in the US in 2002, is registered in more than 90 countries worldwide. Rebif® has been proven to delay the progression of disability, reduce the frequency of relapses and reduce MRI lesion activity and area*.
Rebif® can be administrated with the RebiSmart® electronic auto-injection device (not approved in the US), or with the RebiDose® single-use disposable pen, or the manual multidose injection pen RebiSlide. Rebif® can also be administered with the autoinjector Rebiject II® or by manual injection using ready-to-use pre-filled syringes. These injection devices are not approved in all countries.
In January 2012, the European commission approved the extension of the indication of Rebif® in early multiple sclerosis. The extension of the indication of Rebif® has not been submitted in the United States.
Rebif® should be used with caution in patients with a history of depression, liver disease, thyroid abnormalities and seizures. Most commonly reported side effects are flu-like symptoms, injection site disorders, elevation of liver enzymes and blood cell abnormalities. Patients, especially those with depression, seizure disorders, or liver problems, should discuss treatment with Rebif® with their doctors.
*The exact correlation between MRI findings and the current or future clinical status of patients, including disability progression, is unknown.
Rebif® (interferon beta-1a) is approved in the United States for relapsing forms of MS. RebiSmart®, an electronic device for self-injection of Rebif®, is also not approved in the United States.
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 in Multiple Sclerosis
Merck has a long-standing legacy in neurology and immunology, with significant R&D and commercial experience in multiple sclerosis (MS). Merck's current 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 aims to improve the lives of those living with MS, by addressing areas of unmet medical needs.
Merck is a leading science and technology company in healthcare, life science and performance materials. More than 53,000 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 2017, Merck generated sales of EUR 15.3 billion in 66 countries.
Founded in 1668, Merck is the world's oldest pharmaceutical and chemical company. The founding family remains the majority owner of the publicly listed corporate group. Merck holds the global rights to the Merck name and brand. The only exceptions are the United States and Canada, where the company operates as EMD Serono, MilliporeSigma and EMD Performance Materials.
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