Daiichi Sankyo, Inc. Files Supplemental New Drug Application for AZOR(R) as Initial Therapy for High Blood Pressure
17 September 2008 - 2:00PM
PR Newswire (US)
PARSIPPANY, N.J., Sept. 17 /PRNewswire/ -- Daiichi Sankyo, Inc.
today announced the filing of a supplemental New Drug Application
(sNDA) with the United States Food and Drug Administration (FDA)
for the combination treatment AZOR(R) (amlodipine and olmesartan
medoxomil) as initial therapy in patients likely to need multiple
antihypertensive agents to achieve their blood pressure goal. AZOR
is indicated for the treatment of hypertension, alone or with other
antihypertensive agents. Presently, AZOR is not indicated for the
initial therapy of hypertension. AZOR may be substituted for its
individually titrated components. AZOR may also be used to provide
additional blood pressure lowering for patients not adequately
controlled with any calcium channel blocker (CCB) or any
angiotensin receptor blocker (ARB) alone. The sNDA filing was based
upon data from the pivotal registrational trial, which provided
estimates of the probability of patients attaining blood pressure
goals with AZOR compared to amlodipine or olmesartan medoxomil
alone. "Research suggests that more than two-thirds of patients
often require multiple medications to help achieve blood pressure
goals," said Matthew R. Weir, MD, University of Maryland School of
Medicine, Department of Nephrology. "If approved, this filing would
support JNC-7 guideline recommendations to start patients likely to
need multiple antihypertensive agents to reach their blood pressure
goal on combination drugs as initial therapy." High blood pressure
can cause permanent changes to blood vessels and the heart that may
create serious problems elsewhere in the body.(1) Hypertension is
one of the most prevalent conditions in the United States affecting
approximately one in three American adults (about 73 million people
age 20 and older) and approximately one billion people
worldwide.(2,3) It is often difficult to control, and of those with
high blood pressure, approximately 65 percent do not have the
condition under control.(4) The number of people with high blood
pressure is expected to reach about 1.6 billion worldwide by
2025.(5) "Given the prevalence of patients with high blood
pressure, the approval of AZOR as initial therapy would give
physicians a valuable treatment option to help more patients reach
their blood pressure goal," said William R. Sigmund II, MD, Daiichi
Sankyo Vice President of Medical Affairs. "Research and innovation
in cardiovascular care is a therapeutic focus for Daiichi Sankyo,
and expansion of AZOR's label is in line with our vision to
contribute to the health of people in the United States." About
AZOR AZOR is a convenient, once daily, single tablet combination of
amlodipine, the most prescribed CCB on the market(6), which
inhibits the entrance of calcium into the blood vessel walls, with
olmesartan medoxomil, the active ingredient in Benicar(R), which
blocks angiotensin II receptors. Angiotensin II is a hormone that
causes blood vessels to tighten and narrow. Together the two
medicines relax the blood vessels so that blood can flow more
easily. Benicar (olmesartan medoxomil), Daiichi Sankyo's flagship
ARB product, is the fastest growing medication in the fastest
growing class of blood pressure-lowering drugs.(7) The U.S. Food
and Drug Administration (FDA) granted marketing approval for AZOR
in September 2007. AZOR is indicated for the treatment of
hypertension, alone or with other antihypertensive agents.
Presently, AZOR is not indicated for the initial therapy of
hypertension. AZOR may be substituted for its individually titrated
components. AZOR may also be used to provide additional blood
pressure lowering for patients not adequately controlled with any
calcium channel blocker or any angiotensin receptor blocker alone.
In the pivotal registrational trial, AZOR demonstrated that eight
weeks of double-blind treatment with combination therapy resulted
in larger mean reductions in seated blood pressure and brought more
patients to goal in comparison to the corresponding monotherapies.
IMPORTANT SAFETY INFORMATION ABOUT AZOR USE IN PREGNANCY When used
in pregnancy during the second and third trimesters, drugs that act
directly on the renin-angiotensin system can cause injury and even
death to the developing fetus. When pregnancy is detected, AZOR
should be discontinued as soon as possible. See WARNINGS AND
PRECAUTIONS, Fetal/Neonatal Morbidity and Mortality. Hypotension in
Volume- or Salt-Depleted Patients In patients with an activated
renin-angiotensin system, such as volume- and/or salt-depleted
patients, symptomatic hypotension due particularly to the
olmesartan component may occur after initiation of treatment with
AZOR. Treatment should start under close medical supervision.
Vasodilation Since the vasodilation attributable to amlodipine in
AZOR is gradual in onset, acute hypotension has rarely been
reported after oral administration. Nonetheless, caution, as with
any other peripheral vasodilator, should be exercised when
administering AZOR, particularly in patients with severe aortic
stenosis. Severe Obstructive Coronary Artery Disease Patients,
particularly those with severe obstructive coronary artery disease,
may develop increased frequency, duration, or severity of angina or
acute myocardial infarction on starting calcium channel blocker
therapy or at the time of dosage increase. Congestive Heart Failure
In general, calcium channel blockers should be used with caution in
patients with heart failure. Impaired Renal Function In studies of
ACE inhibitors in patients with unilateral or bilateral renal
artery stenosis, increases in serum creatinine or blood urea
nitrogen (BUN) have been reported. There has been no long-term use
of olmesartan medoxomil in patients with unilateral or bilateral
renal artery stenosis, but similar effects would be expected with
AZOR because of the olmesartan medoxomil component. Hepatic
Impairment Since amlodipine is extensively metabolized by the liver
and the plasma elimination half-life (t1/2) is 56 hours in patients
with severely impaired hepatic function, caution should be
exercised when administering AZOR to patients with severe hepatic
impairment. Laboratory Tests There was a greater decrease in
hemoglobin and hematocrit in the combination product compared to
either component alone. Adverse Reactions The only adverse reaction
that occurred in greater than or equal to 3% of patients treated
with AZOR and more frequently than placebo was edema. The
placebo-subtracted incidence was 5.7% (5/20 mg), 6.2% (5/40 mg),
13.3% (10/20 mg), and 11.2% (10/40 mg). The edema incidence for
placebo was 12.3%. Adverse reactions seen at lower rates but at
about the same or greater incidence as in patients receiving
placebo included hypotension, orthostatic hypotension, rash,
pruritus, palpitation, urinary frequency, and nocturia. In
individual clinical trials of amlodipine and olmesartan medoxomil,
other commonly reported adverse reactions included headache,
dizziness, and flushing. For more information on AZOR, call
877-4-DSPROD (877-437-7763) or go to the web site
http://www.azor.com/. About Daiichi Sankyo, Inc. Daiichi Sankyo,
Inc., headquartered in Parsippany, New Jersey, is the U.S.
subsidiary of Tokyo-based Daiichi Sankyo Co., Ltd. This global
pharma innovator was established in 2005 through the merger of two
leading Japanese pharmaceutical companies. The integration created
a more robust organization that allows for continuous development
of novel drugs that enrich the quality of life for patients around
the world. A central focus of Daiichi Sankyo's research and
development is cardiovascular disease, including therapies for
dyslipidemia, hypertension, diabetes, and acute coronary syndrome.
Equally important to the company is the discovery of new medicines
in the areas of infectious diseases, cancer, bone and joint
diseases, and immune disorders. For more information, visit
http://www.dsus.com/. (1) National Heart, Lung and Blood Institute,
High Blood Pressure Key Points.
http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_Summary.html.
Accessed August 28, 2008 (2) American Heart Association. 2004 High
Blood Pressure Statistics.
http://www.americanheart.org/presenter.jhtml?identifier=4621.
Accessed August 27, 2008 (3) Chobanian AV, Bakris GL, Black HR et
al. The Seventh Report of the Joint National Committee on
Prevention, Detection, Evaluation, and Treatment of High Blood
Pressure. JAMA. 2003;289:2560-2572 (4) American Heart Association.
2004 High Blood Pressure Statistics
http://www.americanheart.org/presenter.jhtml?identifier=4621. Site
accessed August 28, 2008. (5) Kearney PM, et al. Global burden of
hypertension: analysis of worldwide data. Lancet 2005, 365:217-23
(6) http://www.norvasc.com/ -- Last accessed August 28, 2008. (7)
Data are representing May 2002 - February 2006 from IMS Health.
National Prescription Audit, February 2006. DATASOURCE: Daiichi
Sankyo, Inc. CONTACT: Kim Wix,+1-973-695-8338, +1-908-656-5447
(cell), , or Alyssa Dargento, +1-973-630-2913, +1-973-641-1135
(cell), , both of Daiichi Sankyo, Inc. Web Site:
http://www.americanheart.org/presenter.jhtml?identifier=4621
http://www.azor.com/ http://www.dsus.com/
http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_Summary.html
http://www.norvasc.com/
Copyright