QLT announces positive results from the evaluation of Visudyne(R) combination therapy
02 Junio 2009 - 6:00AM
PR Newswire (US)
VANCOUVER, June 2 /PRNewswire-FirstCall/ -- QLT Inc. (NASDAQ: QLTI;
TSX: QLT) today announced positive twelve-month primary analysis
results from the Phase II RADICAL study (Reduced Fluence Visudyne
Anti-VEGF-Dexamethasone In Combination for AMD Lesions) in patients
with wet age-related macular degeneration ("wet AMD"). The purpose
of the study is to determine if Visudyne combined with Lucentis
reduces retreatment rates compared with Lucentis monotherapy, while
maintaining similar vision outcomes and an acceptable safety
profile. Three Visudyne-Lucentis combination therapies were
evaluated against Lucentis monotherapy. The overall results showed
that fewer retreatment visits were required with the combination
therapies than with Lucentis monotherapy, and the differences were
statistically significant: 1. Triple therapy with quarter-fluence
Visudyne followed by Lucentis and then dexamethsone (P=.04) 2.
Triple therapy with half-fluence Visudyne followed by Lucentis and
then dexamethsone (P less than .001) 3. Double therapy with
half-fluence Visudyne followed by Lucentis (P=.04) While the mean
visual acuity (VA) may appear to have improved similarly across all
treatment groups, the confidence intervals were wide. There were no
unexpected safety findings, and adverse event incidence was similar
across treatment groups. Of the four treatment groups, the triple
therapy half-fluence group demonstrated the best results, with the
fewest retreatment visits and mean VA improvement most similar to
Lucentis monotherapy through 12 months. Patients in the triple
therapy half-fluence group had a mean of 3.0 retreatment visits
compared with 5.4 for patients who received Lucentis monotherapy (P
less than .001). At the month 12 examination, mean VA in the triple
therapy half-fluence group improved 6.8 letters from baseline
compared with 6.5 letters in the Lucentis monotherapy group
(P=.94). While all combination groups had significantly fewer
retreatment visits than the Lucentis monotherapy group, the better
results (both in VA change and retreatment visits) in the triple
therapy half-fluence group compared with the other combination
groups was a trend and was not statistically different. Mean
retreatment visits and VA improvement for each treatment group are
presented in the table below. All results presented are based on
ITT analyses; per-protocol analyses yielded similar results.
Patients were evaluated for VA and safety, and to assess if
retreatment was needed, at visits every month over 12 months of
study follow-up. Overall, 10 patients discontinued the study by 12
months for reasons unrelated to Visudyne or Lucentis. Primary
Outcomes from RADICAL Study at 12 Months
-------------------------------------------------------------------------
Triple therapy Double ------------------------------ therapy
Lucentis Quarter-fluence Half-fluence Half-fluence monotherapy
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ITT N equals 39 N equals 39 N equals 43 N equals 41 Mean
retreatment 4.0 3.0 (P less 4.0 visits (P equals .04) than .001) (P
equals .04) 5.4 Mean VA improvement from baseline 3.6 6.8 5.0
(letters) (P equals .38) (P equals .94) (P equals .63) 6.5
Difference from Lucentis group -2.9 0.3 -1.6 (95% CI) (-9.5, 3.6)
(-6.2, 6.7) (-8.0, 4.9) - Per-protocol N equals 37 N equals 34 N
equals 33 N equals 32 Mean retreatment 3.9 3.0 (P less 4.3 visits
(P equals .01) than .001) (P equals .047) 5.9 Mean VA improvement
from baseline 3.6 7.6 4.1 (letters) (P equals .38) (P equals .84)
(P equals .46) 6.8
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P values are from comparison with Lucentis monotherapy CI:
confidence interval "The ability of Visudyne-Lucentis triple
therapy to decrease the number of retreatment visits for patients
while showing vision improvement and an acceptable safety profile
is very encouraging," said Allen C. Ho, M.D., Retina Diagnostic
& Treatment Assoc., LLC, and one of the two lead investigators
for the study. "The RADICAL study has validated our therapeutic
approach to wet AMD," said Henry Hudson, M.D., Retina Centers, PC,
the other lead investigator for the study. "Wet AMD is an ocular
disease that afflicts people of advanced age, and doctor visits can
be onerous to the patient and the patient's caregiver," said Bob
Butchofsky, Chief Executive Officer of QLT Inc. "We are very
pleased that the RADICAL study demonstrated that Visudyne
combination therapy with Lucentis with or without dexamethasone has
the potential to significantly decrease patient burden by reducing
the number of doctor visits. We have showed combination therapy
with Visudyne significantly reduces the need for retreatment visits
through 12 months, which we believe is a great outcome. In addition
to reducing retreatment visits, we also believe that Visudyne
combination therapy is a potential cost effective way to treat
patients with wet AMD." The results for secondary VA endpoints in
the RADICAL study (percentage of patients with VA improvement equal
to or greater than 15 letters, VA change equal to or greater than
zero letters, and VA loss less than 15 letters) were consistent
with the primary VA endpoint. Ocular adverse events considered
associated with treatment were reported for 33% of patients in the
combination therapy groups, compared with 27% of patients in the
Lucentis monotherapy group. The higher incidence of these events
with combination therapy is primarily due to vision disturbance
events (abnormal vision 5 to 10% and decreased vision 5 to 8%),
which are transient and known to be associated with Visudyne
therapy. The full results of the 12-month primary analysis of the
study are expected to be presented at a scientific meeting in the
fall. About RADICAL Phase II Study (Reduced Fluence Visudyne
Anti-VEGF-Dexamethasone In Combination for AMD Lesions) The RADICAL
study is a Phase II, multicenter, randomized, single-masked study
comparing reduced-fluence Visudyne-Lucentis combination therapies
(with or without dexamethasone) to Lucentis monotherapy in 162
subjects with choroidal neovascularization (CNV) secondary to wet
age-related macular degeneration (wet AMD). Subjects were randomly
assigned to one of four treatment groups: Quarter-fluence Visudyne
(180 mW/cm2 for 83 seconds to deliver 15 J/cm2) followed within two
hours by intravitreal Lucentis (0.5 mg) and then intravitreal
dexamethasone (0.5 mg); Half-fluence Visudyne (300mW/cm2 for 83
seconds to deliver 25 J/cm2) followed within two hours by
intravitreal Lucentis (0.5 mg) and then intravitreal dexamethasone
(0.5 mg); Half-fluence Visudyne (300 mW/cm2 for 83 seconds to
deliver 25 J/cm2) followed within two hours by intravitreal
Lucentis (0.5 mg); or Lucentis monotherapy (0.5 mg). Initial
treatment in the combination therapy groups was mandatory. The
Lucentis monotherapy group receieved mandatory injections for
initial treatment and the first two months. After mandatory
treatment, all treatments in all groups were PRN. The treatments
received in all groups were experimental: reduced-fluence Visudyne
and as-needed Lucentis are not standard regimens, while
dexamethasone and combination therapies for AMD are not approved
for marketing by regulatory agencies. The study duration is 24
months with a planned primary analysis when all subjects completed
12 months of follow-up. At baseline, mean best corrected visual
acuity letter scores ranged from 58 to 53 across treatment groups.
About Visudyne Visudyne therapy is a two-step procedure involving
the intravenous administration of the drug into the patient's arm.
A non-thermal laser light is then shone into the patient's eye to
activate the drug. This produces a reaction that closes the
abnormal leaky vessels, resulting in a stabilization of the
corresponding vision loss. Visudyne is approved worldwide for the
treatment of a form of wet AMD, the leading cause of legal
blindness in people over the age of 50, and has been used in more
than two million treatments worldwide. Visudyne is commercially
available in more than 80 countries for the treatment of
predominantly classic subfoveal CNV. In addition, over 60 countries
have approved Visudyne to treat other macular neovascular
conditions such as minimally classic and occult with no classic AMD
lesions, pathologic myopia and presumed ocular histoplasmosis.
Visudyne is generally well tolerated and has a well established
safety profile. The most commonly reported side effects include
injection site reactions and visual disturbances. In addition, some
patients experienced back pain, usually during the infusion. Using
the approved light dose of 50J/cm(2) between 1% and 5% of patients
experienced a substantial decrease in vision in the first 7 days
with partial recovery in some patients. Recent studies suggest that
halving the light dose/fluence may lower the incidence of visual
disturbances with similar visual outcomes as the standard light
dose which led to lower light doses being used in this study. After
treatment, patients should avoid direct sunlight for five days to
prevent sunburn. People with porphyria should not be treated with
Visudyne. About QLT QLT Inc. is a global biopharmaceutical company
dedicated to the discovery, development and commercialization of
innovative therapies. Our research and development efforts are
focused on pharmaceutical products in the field of ophthalmology.
In addition, we utilize three unique technology platforms,
photodynamic therapy, Atrigel(R) and punctal plugs with drugs, to
create products such as Visudyne(R) and Eligard(R) and future
product opportunities. For more information, visit our website at
http://www.qltinc.com/. Atrigel is a registered trademark of QLT
USA, Inc. Lucentis is a registered trademark of Genentech, Inc.
Visudyne is a registered trademark of Novartis AG. Eligard is a
registered trademark of Sanofi-Synthelabo Inc. QLT Plug Delivery,
Inc. is a wholly-owned subsidiary of QLT Inc. QLT Inc. is listed on
The NASDAQ Stock Market under the trading symbol "QLTI" and on the
Toronto Stock Exchange under the trading symbol "QLT."
Forward-Looking Statements Certain statements in this press release
constitute "forward looking statements" of QLT within the meaning
of the Private Securities Litigation Reform Act of 1995 and
constitute "forward looking information" within the meaning of
applicable Canadian securities laws. Forward looking statements
include, but are not limited to: the results of the Radical Study,
or other clinical studies, may not necessarily result in increased
usage of Visudyne; our expectations for timing to receive and
release further data from the RADICAL study; any future
expectations concerning the reduced-fluence Visudyne-Lucentis
combination therapy; and statements which contain language such as:
"assuming," "prospects," "future," "projects," "believes,"
"expects" and "outlook." Forward-looking statements are predictions
only which involve known and unknown risks, uncertainties and other
factors that may cause actual results to be materially different
from those expressed in such statements. Many such risks,
uncertainties and other factors are taken into account as part of
our assumptions underlying these forward-looking statements and
include, among others, the following: uncertainties relating to the
timing and results of the clinical development and
commercialization of our products and technologies (including
reduced-fluence Visudyne-Lucentis combination therapy and our
punctal plug technology) and the associated costs of these
programs; the timing, expense and uncertainty associated with the
regulatory approval process for products; uncertainties regarding
the impact of competitive products and pricing; risks and
uncertainties associated with the safety and effectiveness of our
technology; risks and uncertainties related to the scope, validity,
and enforceability of our intellectual property rights and the
impact of patents and other intellectual property of third parties;
and general economic conditions and other factors described in
detail in QLT's Annual Report on Form 10-K, Quarterly Reports on
Form 10-Q and other filings with the U.S. Securities and Exchange
Commission and Canadian securities regulatory authorities. Forward
looking statements are based on the current expectations of QLT and
QLT does not assume any obligation to update such information to
reflect later events or developments except as required by law.
DATASOURCE: QLT Inc. CONTACT: QLT Inc.: Vancouver, Canada, Karen
Peterson, Telephone: (604) 707-7000, or 1-800-663-5486, Fax: (604)
707-7001; The Trout Group Investor Relations Contact: New York,
USA, Christine Yang, Telephone: (646) 378-2929; or Marcy Nanus,
Telephone: (646) 378-2927
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