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Positive Phase III Results for Peginterferon in Multiple Sclerosis

Regulatory submission expected this year (Jan. 24)

In a pivotal phase III trial, peginterferon beta-1a (Biogen Idec) has shown promise as a potential treatment dosed every 2 or 4 weeks for relapsing-remitting multiple sclerosis (RRMS). Peginterferon beta-1a is a new molecular entity in which interferon beta-1a is pegylated to extend its half-life and to prolong its exposure in the body, allowing a less frequent dosing schedule. Pegylation is the process of covalent attachment of polyethylene glycol (PEG) polymer chains to another molecule, normally a drug or a therapeutic protein.

The phase III ADVANCE trial was designed to evaluate the efficacy, safety, and tolerability of peginterferon beta-1a 125 mcg compared with placebo in more than 1,500 patients with RRMS. The study’s primary endpoint — the annualized relapse rate (ARR) at 1 year — was met for both the 2-week and 4-week dose regimens. Peginterferon beta-1a also met the secondary endpoints of the risk of 12-week confirmed disability progression, the proportion of patients who relapsed, and magnetic resonance imaging (MRI) assessments for both regimens.

At 1 year, the ARR reduction with the 2-week dosing regimen was 35.6% (P < 0.001) compared with placebo, and the reduction with the 4-week regimen was 27.5% (P < 0.02).

Peginterferon beta-1a also met all of the trial’s secondary endpoints compared with placebo for both dosing regimens:

  • Peginterferon beta-1a reduced the risk of 12-week confirmed disability progression, as measured by the Expanded Disability Status Scale (EDSS), by 38% in both dosing arms (P < 0.04).
  • Peginterferon beta-1a reduced the proportion of patients who relapsed by 39% in the 2-week dosing arm (P < 0.001) and by 26% in the 4-week dosing arm (P < 0.03).
  • Peginterferon beta-1a reduced the number of new or newly enlarging T2-hyperintense lesions on brain MRI scans by 67% in the 2-week dosing arm (P < 0.001) and by 28% in the 4-week dosing arm (P < 0.001).

Regulatory submission in the U.S. is expected this year.

Source: Biogen Idec; January 24, 2013.

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