Phase IIa Study Assessing Safety and Tolerability of Dapagliflozin after 14 Days as Add-on to Insulin in Adult Patients with Type 1 Diabetes Presented at the 2013 American Diabetes Association Scientific Sessions®
AstraZeneca (NYSE:
AZN) and Bristol-Myers
Squibb Company (NYSE: BMY) today announced results from a two-week
Phase IIa pilot study evaluating dapagliflozin added to insulin in 70
adult patients with sub-optimally controlled type 1 diabetes. Results
from this study showed that in patients treated with dapagliflozin, no
subjects discontinued due to lack of glycemic control, few genital and
urinary tract infections were reported and hypoglycemia was observed in
all treatment groups. In addition, mean daily blood glucose derived from
7-point glucose measurements trended downward in all treatment groups
through day seven and reductions in total daily insulin dosing at day
seven were observed with dapagliflozin. These findings will be presented
Sunday, June 23, in a late-breaking poster session at the 73rd
Scientific Sessions® of the American Diabetes
Association in Chicago.
In this study, there was one case of major hypoglycemia in the
dapagliflozin 10 mg group that led to discontinuation. The proportion of
adverse events (excluding hypoglycemia events) was 61.5% for the placebo
group and 38.5%, 46.7%, 50.0% and 40.0% for the dapagliflozin 1, 2.5, 5
and 10 mg groups added on to background insulin, respectively. The
proportion of hypoglycemia events was 61.5% for the placebo group and
92.3%, 60.0%, 78.6% and 66.7% for the dapagliflozin 1, 2.5, 5 and 10 mg
groups added on to background insulin, respectively. There were two
cases of urinary tract infection reported (one in the placebo group and
one in the dapagliflozin 2.5 mg group) and two cases of genital
infections (one in the dapagliflozin 1 mg group and one in the
dapagliflozin 5 mg group). One serious adverse event was reported
(gastroparesis) in the dapagliflozin 5 mg group, which was not
considered treatment-related, and was the only adverse event that led to
discontinuation.
“Many people with type 1 diabetes may benefit from other treatment
options in addition to insulin,” said Robert Henry, M.D., director,
Center for Metabolic Research VA San Diego Healthcare System and primary
study investigator. “These preliminary data with dapagliflozin added on
to insulin are encouraging and support the need for further studies.”
Results of the study’s exploratory objectives showed a dose-dependent
increase in urine glucose excretion with dapagliflozin at day seven
based on mean change from baseline (41.9, 48.5, 72.4 and 88.8 grams/24
hours for the 1, 2.5, 5 and 10 mg doses, respectively) compared with a
decrease for placebo (-21.6 grams). Continuous glucose monitoring (CGM)
data suggested a dose-dependent potential for reduced glycemic levels
based on mean change from baseline in average daily glucose (-15.7,
-13.9, -29.5 and -41.3 mg/dL for the 1, 2.5, 5 and 10 mg doses,
respectively; -20.4 mg/dL for placebo). In addition, reductions in total
daily insulin dosing at day seven were reported for the higher
dapagliflozin doses (-19.31% for 5 mg and -16.17% for 10 mg compared to
1.66% for placebo). The investigator notes that the small population
size limits the ability to interpret the data from this study.
Dapagliflozin, an investigational oral compound, is a selective and
reversible inhibitor of sodium-glucose cotransporter 2 (SGLT2), which
works independently of insulin. Dapagliflozin is currently approved for
the treatment of type 2 diabetes in the European Union, Australia, New
Zealand and Mexico. In January 2012, the U.S. Food and Drug
Administration (FDA) issued a complete response letter regarding the New
Drug Application (NDA) for dapagliflozin for the treatment of adults
with type 2 diabetes, requesting additional clinical data to allow a
better assessment of the benefit-risk profile for dapagliflozin.
“We are excited to have the opportunity to explore the potential of
dapagliflozin in patients with type 1 diabetes,” said Briggs Morrison,
executive vice president Global Medicines Development and Chief Medical
Officer, AstraZeneca. “The AstraZeneca/Bristol-Myers Squibb Diabetes
Alliance is dedicated to addressing the global burden of diabetes by
advancing individualized patient care and these study results, while
preliminary, align with this commitment.”
Study Design
This was a two-week randomized, double-blind, placebo-controlled, Phase
IIa pilot study which evaluated dapagliflozin added to insulin in
patients with sub-optimally controlled type 1 diabetes. Seventy adult
patients on stable insulin with HbA1c 7-10% (baseline mean 8.5%) were
randomized to receive dapagliflozin (1 mg, 2.5 mg, 5 mg or 10 mg) or
placebo once daily for 14 days. The primary objective of the study was
to assess safety and tolerability of dapagliflozin after 14 days as
add-on to insulin in adult patients with type 1 diabetes. Secondary
objectives included change from baseline at seven days in 7-point
glucose monitoring profiles and pharmacokinetics. Exploratory objectives
included change from baseline at seven days in CGM profiles and 24-hour
urine glucose output.
About SGLT2 Inhibition
The kidney plays an important role in glucose balance, normally
filtering ~180 g of glucose each day from circulation into urine, with
virtually all of the filtered glucose subsequently being reabsorbed back
into circulation by the kidney. SGLT2 is a glucose transporter found in
the kidney which plays a critical role in glucose reabsorption.
Selective inhibition of SGLT2 blocks reabsorption of glucose from the
urine, facilitating its removal in an insulin-independent manner.
About Diabetes
In 2012, diabetes was estimated to affect more than 370 million people
worldwide. The prevalence of diabetes is projected to reach more than
550 million by 2030. While type 2 diabetes accounts for approximately
90% to 95% of all cases of diagnosed diabetes in adults,type
1 diabetes is more often diagnosed in children and young adults and
occurs when the body does not produce insulin.
AstraZeneca/Bristol-Myers Squibb Diabetes Alliance
Dedicated to addressing the global burden of diabetes by advancing
individualized patient care, AstraZeneca and Bristol-Myers Squibb are
working in collaboration to research, develop and commercialize a
versatile portfolio of innovative treatment options for diabetes and
related metabolic disorders that aim to provide treatment effects beyond
glucose control. Find out more about the Alliance and our commitment to
meeting the needs of health care professionals and people with diabetes
at www.astrazeneca.com
or www.bms.com.
About AstraZeneca
AstraZeneca is a global, innovation-driven biopharmaceutical business
that focuses on the discovery, development and commercialization of
prescription medicines, primarily for the treatment of cardiovascular,
metabolic, respiratory, inflammation, autoimmune, oncology, infection
and neuroscience diseases. AstraZeneca operates in over 100 countries
and its innovative medicines are used by millions of patients worldwide.
For more information please visit: www.astrazeneca.com.
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to discover, develop and deliver innovative medicines that help
patients prevail over serious diseases. For more information about
Bristol-Myers Squibb, visit www.bms.com
or follow us on Twitter at http://twitter.com/bmsnews.
AstraZeneca Cautionary Statement Regarding Forward-Looking Statements
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providing the following cautionary statement: This press release
contains certain forward-looking statements with respect to the
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we believe our expectations are based on reasonable assumptions, any
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that regulatory approval processes for biosimilars could have an adverse
effect on future commercial prospects; and the impact of increasing
implementation and enforcement of more stringent anti-bribery and
anti-corruption legislation. Nothing in this press release should be
construed as a profit forecast.
Bristol-Myers Squibb Forward-Looking Statement
This press release contains "forward-looking statements" as that term
is defined in the Private Securities Litigation Reform Act of 1995
regarding product development. Such forward-looking statements are based
on current expectations and involve inherent risks and uncertainties,
including factors that could delay, divert or change any of them, and
could cause actual outcomes and results to differ materially from
current expectations. No forward-looking statement can be guaranteed.
Among other risks, there can be no guarantee that dapagliflozin will
receive regulatory approval in the U.S. or, if approved, that it will
become commercially successful. There is also no guarantee that the
additional studies of the currently-approved product described in this
release will lead to additional approved indications for the product.
Forward-looking statements in this press release should be evaluated
together with the many uncertainties that affect Bristol-Myers Squibb's
business, particularly those identified in the cautionary factors
discussion in Bristol-Myers Squibb's Annual Report on Form 10-K for the
year ended December 31, 2012, in our Quarterly Reports on Form 10-Q and
our Current Reports on Form 8-K. Bristol-Myers Squibb undertakes no
obligation to publicly update any forward-looking statement, whether as
a result of new information, future events or otherwise.
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