Salix Pharmaceuticals, Ltd. SLXP today announced that the FDA has
granted tentative approval for UCERIS(R) (budesonide) rectal foam for the
induction of remission in patients with active mild-to-moderate distal
ulcerative colitis (UC) extending up to 40cm from the anal verge. The foam
is a rectally administered corticosteroid that overcomes treatment
limitations associated with currently approved therapies which are often
ineffective due to insufficient distribution of active drug to the distal
colon.
The FDA's tentative approval of this product means that Salix's product
meets all of the FDA's manufacturing quality and clinical safety and
efficacy standards and will be granted final approval upon the resolution of
patent issues. Salix anticipates resolution of patent issues early in the
fourth quarter of 2014 and the launch of UCERIS rectal foam during the first
quarter of 2015.
"Distal ulcerative colitis can be challenging for patients to live with and
gastroenterologists to treat. Our goal is to put the disease into remission
so that patients can get on with their lives," said Bill Forbes, Executive
Vice President, Medical and Research and Development and Chief Development
Officer, Salix. "The unique delivery system of UCERIS rectal foam can help
overcome current treatment limitations by reaching the affected area of the
distal colon and keeping the medication there long enough to be effective.
People suffering from distal UC now have another option to consider when
facing this disease."
Two identically designed, randomized, double-blind, placebo-controlled Phase
III studies found that a significantly greater percentage of patients
receiving UCERIS 2mg rectal foam achieved remission of distal ulcerative
colitis at six weeks compared with placebo (41.2% vs 24.0%). Significantly
more patients treated with UCERIS rectal foam also achieved key secondary
outcome measures compared with placebo at six weeks, including a Modified
Mayo Disease Activity Index (MMDAI) endoscopy score of 0 or 1 in 55.6%
versus 43.2% in the first trial and 56.0% vs 36.7% in the second trial.
A significantly greater percentage of patients treated with UCERIS rectal
foam experienced improvement in rectal bleeding within the first two weeks
of treatment (twice daily dosing); this percentage increased and was
maintained after an additional two and four weeks of treatment once a day.
At week six, the percentage of patients achieving MMDAI rectal bleeding
score of 0 was 46.6% vs 28.0% in the first trial and 50.0% vs 28.6% in the
second trial.
"These trials definitively demonstrated that UCERIS rectal foam is an
efficacious and well-tolerated rectal therapy for the induction of remission
in patients with mild-to-moderate distal UC. Treatment with UCERIS rectal
foam also led to a rapid response for rectal bleeding that was sustained
through the sixth week of the trial," said William Sandborn, MD, Chief,
Division of Gastroenterology and Director, UCSD IBD Center, University of
California San Diego and UC San Diego Health System, and principle
investigator of the trials. "This unique treatment modality allows the
medication to reach the target area and stay there long enough to work.
UCERIS rectal foam is a welcome addition to the treatment options available
to gastroenterologists and their patients coping with this complex disease."
UC is a chronic disease of the large intestine, also known as the colon, in
which the lining of the colon becomes inflamed and develops tiny open sores,
or ulcers, that produce pus and mucous. The combination of inflammation and
ulceration can cause abdominal discomfort and frequent emptying of the
colon. Distal ulcerative colitis is characterized as either ulcerative
proctitis (inflammation localized to the rectum) or ulcerative
proctosigmoiditis (inflammation localized to the distal colon and rectum).
The Crohn's and Colitis Foundation of America (CCFA) estimates that UC may
affect as many as 700,000 Americans. While most people are diagnosed in
their mid-30's, the disease can occur at any age and equally affects men and
women. An estimated 46% of people with UC have a diagnosis of distal UC.
About half of all patients with ulcerative colitis experience at least mild
symptoms including persistent diarrhea accompanied by abdominal pain and
blood in the stool and more urgent bowel movements. CCFA also notes that
people suffering from UC often experience loss of appetite and may lose
weight as a result. A feeling of low energy and fatigue is also common.
Rectal therapy is recommended for the induction of remission in patients
with mild-to-moderate ulcerative proctitis, and recommended alone or in
combination with oral aminosalicyclic acid (ASA) for mild-to-moderate distal
UC. However, currently available rectal therapies have limitations,
including difficulty of administration and retention (enemas) and limited
proximal spread (suppositories).
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