Albiglutide: A New Treatment Option for Type II Diabetes

Transcription

1 Volume 29, Issue 10 July 2014 Albiglutide:ANewTreatmentOption fortypeiidiabetes Bibidh Subedi, PharmD Candidate T P ITI: Albiglutide: A New Treatment Option for Type II Diabetes Zohydro : Extended-release Hydrocodone: A Review 1

2 Table1 CT Table2 Table 1 Pharmacokinetics of albiglutide. 3 Parameter Changes Observed Absorption 2 C max a AUC a Distribution (V d ) Metabolism Elimination Clearance t 1/2 a After a single 30-mg dose. AUC = area under the curve mcg/ml 465 mcg h/ml 11 L Catabolized by proteolytic enzymes in vascular endothelium 67 ml/h 5 days

3 AEP Table3 DA Table 2 Summary of albiglutide clinical trials. 3 Study Treatment Arms Pratley Albiglutide 30 mg/week titrated to 50 mg at week 6 (2014) 5 (n=422) Liraglutide 0.6 mg/day titrated to 1.2 mg at week 1 and 1.8 mg at week 2 (n=419) Rosenstock Albiglutide weekly: (2009) 6 4 mg (n=36) 15 mg (n=35) 30 mg (n=31) Albiglutide every 2 weeks: 15 mg (n=34) 30 mg (n=33) 50 mg (n=35) Albiglutide monthly: 50 mg (n=35) 100 mg (n=35) Exenatide 5 mcg twice daily for 4 weeks titrated to 10 mcg twice daily for 12 weeks (n=35) Placebo (n=52) Primary Endpoint Change in HbA1c from baseline at week 32 Change in HbA1c from baseline at week 16 Results (% change in HbA1c) Albiglutide: -0.78% Liraglutide: -0.99% Albiglutide: 30 mg weekly: -0.87% 50 mg every 2 weeks: -0.79% 100 mg monthly: -0.87% Placebo: -0.17% Exenatide: -0.54% Author s Conclusions Once-daily liraglutide had greater reduction in HbA1c than once-weekly albiglutide Weekly albiglutide significantly improved glycemic control with an adverse effect profile similar to or better than placebo or exenatide Negative sign indicates reduction in HbA1c. 3

4 Table 3 Adverse effects occurring in 5% of patients in albiglutide placebo-controlled trials. 3 Albiglutide (n=923) Placebo (n=468) Adverse Effect Injection site reaction URTI Diarrhea Nausea Cough Back pain Influenza Arthralgia Sinusitis Data represent percent of patients experiencing the adverse event. URTI = upper respiratory tract infection. S R Zohydro :Extendedrelease Hydrocodone:AReview Danielle Cheek, PharmD Candidate C 4

5 , P/P CT Table1 5

6 Table 1 Conversion factor for oral opioids to HC- ER. 7 Prior Oral Opioid Hydrocodone Approximate Oral Conversion Factor Oxycodone 1 Methadone 1 Oxymorphone 2 Hydromorphone 2.67 Morphine 0.67 Codeine 0.10 Note: This table does not indicate equianalgesic dosing and therefore should not be used to convert from HC-ER to other opioids. Table2 AR 1 Table 2 Primary and secondary endpoints in a phase 3 efficacy and safety study of HC-ER. 8 Treatment Group (N) Change in average NRS PI scores (mean ± SD) Achieved 30% Improvement SGAM score Achieved 50% Improvement Increase in Average Pain Intensity Score (mean ± SD) Rescue Medication Use (mean ± SD) Placebo (n=151) 0.96 ± % 0 23% 0.83 ± ± HC-ER (n=151) 0.48 (± 1.56)* 68** 0.8** 48** 1.68 (±2.12)** 6.0 (±3.4) 53.2 Table compares date of screening to Day 85. *p<0.01 for comparison between groups. **p<0.001 for comparison between groups. p<0.05 for comparison between groups. NRS = Numeric Rating Scale; SGAM = Subject Global Assessment of Medication; ODI = Oswestry Disability Inventory; PI = pain intensity. 6 ODI

7 Table 3 Treatment-emergent adverse events (TEAEs) that occurred in 5% of patients. 8,10 Adverse Event During Open- Labeled Titration Period in Phase 3 Study During the Double-Blind Treatment Period in Phase 3 Study Table3 DA Table1 SP During Conversion/Titration Phase in Safety Study Treatment During the Treatment Phase in Safety Study Increase in Average Pain Intensity Score HC-ER (n=510) HC-ER (n=151) Placebo (n=151) HC-ER (n=638) HC-ER (n=424) Constipation 56 (11) 12 (8) 0 (0) 72 (11.3) 53 (12.5) Nausea 50 (10) 11 (7) 5 (3) 68 (10.7) 42 (9.9) Somnolence 24 (5) 1 (1) 0 (0) 49 (7.7) 18 (4.2) Headache 19 (4) 0 (0) 2 (1) 48 (7.5) 29 (6.8) Vomiting 14 (3) 7 (5) 1 (1) 26 (4.1) 41 (9.7) URTI 7 (1) 5 (3) 1 (1) 7 (1.1) 25 (5.9) UTI 4 (1) 8 (5) 3 (2) 6 (0.9) 28 (6.6) Back Pain 4 (1) 6 (4) 5 (3) 9 (1.4) 47 (11.1) Arthralgia NR NR NR 9 (1.4) 33 (7.8) Fall NR NR NR 8 (1.3) 25 (5.9) Nasopharyngitis NR NR NR 11 (1.7) 24 (5.7) Anxiety NR NR NR 8 (1.3) 23 (5.4) Sinusitis NR NR NR 9 (1.4) 23 (5.4) Insomnia NR NR NR 24 (3.8) 21 (5.0) Data represent n (%). NR = data not reported; URI = upper respiratory tract infection; UTI = urinary tract infection C Table4 C 7

8 S R RelievingPaininAmerica,ABlueprint fortransformingprevention,care,education andresearch Pain:CurrentUnderstandingofAssessment,Management,andTreatments AcetaminophenOverdoseandLiverInjury BackgroundandOptionsforReducingInjury FDANewsRelease Table 4 Cost of 30-day retail supply of Zohydro ER. 9 Strength Walgreeens Walmart CVS Mean Range 10 mg $ $ $ $ $ $ mg $ $ $ $ $ $ mg $ $ $ $ $ $ mg $ $ $ $ $ $ mg $ $ $ $ $ $

9 GoodRx. NewYorker BostonGlobe Medscape FedUp!CoalitionSteeringCommittee Clinical Trial Update Nonsteroidal Anti-Inflammatory Drugs and Cardiovascular Outcomes in Women: Results from the Women s Health Initiative (Circ Cardiovasc Qual Outcomes. 2014;7: ) Keyindings: Agent AdjustedHazardRatios_ UPCOMMING ARTICLES: Dalbavancin: A Novel Treatment for Acute Bacterial Skin and Skin-Structure Infections Tedizolid Phosphate: A New Antimicrobial Agent Against MRSA The PharmaNote is Published by: The Department of Pharmacy Services, UF Family Practice Residency Program, Departments of Community Health and Family Medicine and Pharmacotherapy and Translational Research University of Florida John G. Gums, PharmD, FCCP Steve Smith, PharmD, MPH, BCPS R. Whit Curry, MD Nicholas Carris PharmD, BCPS Editor-in-chief Editor Associate Editor Assistant Editor 9