MALVERN, PA USA (Press Release) - November 7, 2012 - Auxilium Pharmaceuticals, Inc. (NASDAQ: AUXL), a specialty biopharmaceutical company, today announced that it has submitted a supplemental Biologics License Application (sBLA) to the U.S. Food and Drug Administration (FDA) for XIAFLEX® (collagenase clostridium histolyticum or CCH), a novel, in-office, first-in-class biologic therapy for the potential treatment of Peyronie’s disease (PD).
XIAFLEX for the treatment of PD was granted orphan designation in the U.S. by the FDA in January 1996 and, if approved by the FDA, is expected to be the first and only biologic therapy indicated for the treatment of PD. XIAFLEX is currently approved in the U.S., EU and Canada for the treatment of adult Dupuytren’s contracture patients with a palpable cord.
“This submission is a significant regulatory milestone for XIAFLEX and the company and further demonstrates our strong commitment to addressing unmet needs by providing patients with potentially the only FDA-approved biologic therapy to treat this devastating disease,” said Adrian Adams, Chief Executive Officer and President of Auxilium. “PD can have a significant impact on affected men and their partners and we believe that, if approved by the FDA for the treatment of Peyronie’s disease, XIAFLEX has the clinical profile to become a potential breakthrough option in a therapeutic area that currently has limited treatment options. We look forward to working with the FDA as the agency reviews the application.”
Auxilium has requested Priority Review designation for this sBLA submission and the Company expects to hear back from the FDA on Priority Review designation within approximately 60 days from the filing date. If granted, the FDA’s goal for completing a Priority Review, per Prescription Drug User Fee Act guidelines, is six months from receipt date. Priority Review may be granted to drugs that offer major advances in treatment, or provide a treatment where none exists.
The sBLA submission is based on data from the clinical studies known by the acronym IMPRESS – The Investigation for Maximal Peyronie’s ReductionEfficacy and Safety Studies – and other controlled and uncontrolled clinical studies, in which over 1,000 Peyronie’s disease patients were enrolled and received over 7,400 injections of XIAFLEX.
In the two phase III double-blind placebo-controlled IMPRESS studies XIAFLEX demonstrated statistically significant improvement in the co-primary endpoints of penile curvature deformity and patient-reported bother versus placebo. . In IMPRESS I at 52 weeks, the co-primary endpoints met statistical significance with a 37.6% mean reduction in penile curvature deformity for XIAFLEX subjects (p=0.0005) and a 3.3 point improvement in the Peyronie’s Disease Questionnaire (PDQ) bother domain for XIAFLEX subjects (p=0.0451). In IMPRESS II at 52 weeks, the co-primary endpoints met statistical significance with a 30.5% mean improvement in penile curvature deformity for XIAFLEX subjects (p=0.0059) and a 2.4 point improvement in the PDQ bother domain for XIAFLEX subjects (p=0.0496). XIAFLEX was generally well-tolerated. The most common treatment related adverse events reported in the phase III studies were local to the treatment site and consistent with adverse events reported in previous PD trials with XIAFLEX, which included injection site hematoma, pain and swelling. Serious adverse events included corporal rupture (penile fracture) in 3 subjects in the placebo controlled studies.
About Peyronie's Disease
PD is the development of collagen plaque, or scar tissue, on the shaft of the penis that may harden and reduce flexibility, causing the penis to deform in a bend or arc during erection. In addition to difficulty with sexual intercourse, PD is commonly associated with significant disease bother, emotional distress, loss of self-esteem, and depression. PD is a heterogeneous disease with an initial inflammatory component. This inflammatory phase is poorly understood with a somewhat variable disease course and occasional spontaneous resolutions of not greater than 13%. After 12-18 months of disease, the disease is reported to often develop into a more chronic, stable phase. The estimated prevalence in adult men of PD has been reported to be approximately 5%; however the disease is thought to be underdiagnosed and undertreated. Based on U.S. historical medical claims data, it is estimated that between 65,000 and 120,000 PD patients are diagnosed every year, but only 5,000 to 6,500 PD patients are treated with injectables or surgery annually.
- L.A. Levine Peyronie’s Disease: A Guide to Clinical Management. Humana Press: 10-17, 2007.
- Bella A. Peyronie’s Disease J Sex Med 2007;4:1527–1538
- SDI and data on file, Auxilium
About the IMPRESS Clinical Program
Auxilium’s late stage global development plan for XIAFLEX consists of four clinical studies and is known by the acronym IMPRESS – The Investigation for Maximal Peyronie’s Reduction Efficacy and Safety Studies. There are two randomized, double-blind, placebo-controlled phase III studies, which enrolled over 800 patients combined at 64 sites in the U.S. and Australia in less than five months, with a 2:1 ratio of XIAFLEX to placebo. There is also one open label study, which enrolled at least 250 patients, at approximately 30 sites in the U.S., EU and New Zealand, and one pharmacokinetic study, which enrolled approximately 20 patients who were then enrolled into the open label study. XIAFLEX was administered two times a week every six weeks for up to four treatment cycles (2 x 4). Each treatment cycle was followed by a penile modeling procedure. Patients were followed for 52 weeks post-first injection in the double-blind studies and were followed for 36 weeks in the open label and pharmacokinetic trials.
The trials’ co-primary endpoints are percent improvement from baseline in penile curvature deformity compared to placebo and the change from baseline (improvement) in the PD bother domain of the PDQ compared to placebo. The PDQ also has two additional domains as secondary endpoints, which include severity of psychological and physical symptoms of PD, and penile pain. Safety measurements include adverse event monitoring and clinical labs. Immunogenicity testing was also performed.
About the IMPRESS PDQ
The PDQ is a 15-question assessment of the impact of PD on a subject using 3 domains: PD bother, psychological and physical symptoms of PD, and penile pain (administered at screening, week 24, and week 52). The PDQ is a proprietary questionnaire that Auxilium developed with the FDA since 2004 and following its phase IIb PD studies as a valid tool for measuring PD bother.
XIAFLEX (collagenase clostridium histolyticum; CCH) is a biologic approved in the U.S., EU and Canada for the treatment of adult Dupuytren's contracture (DC) patients with a palpable cord. XIAFLEX is a minimally invasive treatment for this condition and consists of a highly purified combination of two subtypes of collagenase, derived from Clostridium histolyticum, in specific proportion. Together, the collagenase sub-types work synergistically to break the bonds of the triple helix collagen structure more effectively than human collagenase. A sBLA for XIAFLEX for the treatment of Peyronie’s disease has been submitted to the FDA. Additionally, CCH is in phase IIa of development for the treatment of Frozen Shoulder syndrome (adhesive capsulitis) and in phase Ib of development for the treatment of Cellulite (edematous fibrosclerotic panniculopathy). XIAFLEX has been granted Orphan status in the U.S. by the FDA for DC and PD. Auxilium also has rights to pursue additional indications for CCH.
Auxilium Pharmaceuticals, Inc. is a specialty biopharmaceutical company with a focus on developing and marketing products to predominantly specialist audiences. Auxilium markets Testim® 1% (testosterone gel) for the topical treatment of hypogonadism and XIAFLEX® (collagenase clostridium histolyticum) for the treatment of adult Dupuytren’s contracture patients with a palpable cord in the U.S. GSK co-promotes Testim with Auxilium in the U.S. Ferring International Center S.A. markets Testim in certain countries of the EU and Paladin Labs Inc. markets Testim in Canada. Pfizer has marketing rights for XIAPEX® (the EU tradename for collagenase clostridium histolyticum) in 46 countries in Eurasia through April 24, 2013; Asahi Kasei Pharma Corporation has development and commercial rights for XIAFLEX in Japan; and Actelion Pharmaceuticals Ltd has development and commercial rights for XIAFLEX in Canada, Australia, Brazil and Mexico. For additional information, visit www.auxilium.com.
James E. Fickenscher
Chief Financial Officer
Auxilium Pharmaceuticals, Inc. +1-484-321-5900
William Q. Sargent Jr.
Vice-President, Investor Relations and Corporate Communications
[ PRESS RELEASE ]