Date: 2014-05-09
Type of information:
phase: 3
Announcement: results
Company: Amgen (USA) AstraZeneca (UK)
Product: brodalumab (AMG 827)
Action
mechanism: Brodalumab is a highly-selective human monoclonal antibody that binds to and blocks signaling via the interleukin-17 (IL-17) receptor. The IL-17 pathway plays an important role in inducing and promoting inflammatory disease processes. Blocking inflammatory signaling at the IL-17 receptor may be beneficial in the treatment of moderate to severe plaque psoriasis, psoriatic arthritis, and potentially other immune-mediated diseases.
In April 2012, Amgen and AstraZeneca have announced an agreement to jointly develop and commercialize five monoclonal antibodies from Amgen\'s clinical inflammation portfolio (AMG 139, AMG 157, AMG 181, AMG 557 and brodalumab - AMG 827). With oversight from joint governing bodies, Amgen leads clinical development and commercialization for brodalumab (Phase 3 for moderate-to-severe plaque psoriasis and psoriatic arthritis, Phase 2 for asthma) and AMG 557/MEDI5872 (Phase 1b for autoimmune diseases such as systemic lupus erythematosus). AstraZeneca , through its biologics arm MedImmune, leads clinical development and commercialization for MEDI7183/AMG 181 (Phase 2 for ulcerative colitis and Crohn\'s disease), MEDI2070/AMG 139 (Phase 2 for Crohn\'s disease) and MEDI9929/AMG 157 (Phase 2 for asthma).
Disease: psoriasis
Therapeutic area: Autoimmune diseases - Dermatological diseases
Country:
Trial
details: AMAGINE-1 is a phase 3 study designed to assess the safety and efficacy of brodalumab given every two weeks via subcutaneous injection at two doses (140 mg or 210 mg) compared to placebo in patients with moderate-to-severe plaque psoriasis. Another purpose of the study was to assess safety and efficacy when patients treated with brodalumab, who responded to treatment, began receiving placebo compared to the patients who continued receiving brodalumab. AMAGINE-1 is one of three Phase 3 studies designed to assess the efficacy and safety of brodalumab in patients with moderate-to-severe plaque psoriasis. AMAGINE-2 and AMAGINE-3 are designed to evaluate the efficacy and safety of induction and maintenance regimens of brodalumab at different dose schedules in patients with moderate-to-severe plaque psoriasis compared to ustekinumab and placebo.
The Phase 3 study began with a 12-week, double-blind, placebo-controlled induction phase. During this phase, patients were randomized in a 1:1:1 ratio to receive 210 mg of brodalumab, 140 mg of brodalumab or placebo every two weeks.
At week 12, patients originally randomized to receive treatment with brodalumab who achieved clear or almost clear skin according to their sPGA (0 or 1) were rerandomized 1:1 to receive placebo or continued treatment with brodalumab at the current dose. Rerandomized patients losing disease control were treated with their original brodalumab dose. All patients originally randomized to placebo and any patient not qualifying for rerandomization (sPGA > 1) received 210 mg of brodalumab every two weeks.
sPGA is a physician\'s rating of psoriasis severity at a given point in time based on plaque, scaling and redness. A physician can rate a patient\'s psoriasis as clear (0), almost clear (1), mild (2), moderate (3), severe (4) or very severe (5).
Latest
news: * On May 9, 2014,Amgen and AstraZeneca have announced that the Phase 3 AMAGINE-1TM study evaluating brodalumab in patients with moderate-to-severe plaque psoriasis met all primary and secondary endpoints for both evaluated doses. Brodalumab is the only investigational treatment in development that binds to the interleukin-17 (IL-17) receptor and inhibits inflammatory signaling by blocking the binding of several IL-17 ligands to the receptor. Primary endpoints were patients achieving at least a 75 percent improvement from baseline in disease severity at week 12, as measured by the Psoriasis Area Severity Index (PASI 75), and patients achieving clear or almost clear skin at week 12 according to the static Physician Global Assessment (sPGA 0 or 1). A significantly higher proportion of patients treated with brodalumab achieved a PASI 75 response (primary endpoint), as well as PASI 90 and PASI 100 responses at week 12 (secondary endpoints) compared to placebo. Results showed that 83.3 percent of patients in the 210 mg group and 60.3 percent of patients in the 140 mg group achieved PASI 75 responses compared to placebo (2.7 percent). Results also showed that 70.3 percent of patients in the 210 mg group and 42.5 percent of patients in the 140 mg group achieved PASI 90 responses compared to placebo (0.9 percent). Further, 41.9 percent of patients in the 210 mg group and 23.3 percent of patients in the 140 mg group achieved PASI 100 responses compared to placebo (0.5 percent). Of the 661 patients enrolled in this study, 46 percent reported prior biologic use and 28.7 percent weighed more than 100 kilograms (kg) at baseline (mean weight for the study population was 90.8 kg). The most common adverse events that occurred during the placebo-controlled period in the brodalumab group (more than 5 percent of participants) were nasopharyngitis, upper respiratory tract infection and headache. Serious adverse events occurred in 1.8 percent of patients in the 210 mg group and 2.7 percent of patients in the 140 mg group compared to 1.4 percent for placebo during the placebo-controlled period.
