Bristol-Myers
Squibb Company (NYSE:BMY) and Pfizer
Inc. (NYSE:PFE) today announced that the U.S. Food and Drug
Administration (FDA) has accepted for review a Supplemental New Drug
Application (sNDA) for ELIQUIS® (apixaban) for the
treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and
for the reduction in the risk of recurrent DVT and PE. The Prescription
Drug User Fee Act (PDUFA) goal date for a decision by the FDA is August
25, 2014.
Together, DVT and PE are known as venous thromboembolism (VTE), and
continue to be a major cause of morbidity and mortality, with
approximately 900,000 patients in the U.S. and approximately 1 million
patients in the EU diagnosed every year.
The sNDA submission is supported by results from two Phase 3 trials,
AMPLIFY and AMPLIFY-EXT, which were both originally published in The
New England Journal of Medicine on June 30, 2013, and December 8,
2012, respectively. AMPLIFY, (Apixaban
for the initial Management of PuLmonary
embolIsm and deep vein thrombosis as
First-line therapY), a randomized,
double-blind, multicenter trial, included 5,395 patients with confirmed
symptomatic DVT or PE requiring treatment for six months, and evaluated
ELIQUIS (10 mg twice daily for 7 days followed by 5 mg twice daily
thereafter) compared to current standard of care (initial parenteral
enoxaparin treatment overlapped by warfarin therapy). AMPLIFY-EXT (Apixaban
after the initial Management of PuLmonary
embolIsm and deep vein thrombosis
with First-line therapY-EXTended
Treatment), a randomized, double-blind, multicenter trial, included
2,486 patients with prior VTE who had completed 6 to 12 months of
anticoagulation treatment for DVT or PE. Patients were randomized to
receive either ELIQUIS 2.5 mg or 5 mg, or placebo twice daily for 12
months.
Additionally, in November 2013 the European Medicines Agency accepted
for review an application for ELIQUIS for the treatment of DVT and PE,
and prevention of recurrent DVT and PE.
About Deep Vein Thrombosis and Pulmonary Embolism
Deep vein thrombosis (DVT) is a blood clot in a vein, usually in the
leg, that partially or totally blocks the flow of blood. Pulmonary
embolism (PE) is a blood clot blocking one or more vessels in the lungs.
DVT causes multiple symptoms including pain, swelling and redness and,
more importantly, can progress to PE, which carries the risk of sudden
death. Together, DVT and PE are known as venous thromboembolism (VTE),
and continue to be a major cause of morbidity and mortality, with
approximately 900,000 patients in the US and approximately 1 million
patients in the EU diagnosed every year. Once a VTE has occurred, up to
10 percent of people may have a VTE recurrence, which could potentially
be fatal.
About ELIQUIS
ELIQUIS (apixaban) is an oral direct Factor Xa inhibitor. By inhibiting
Factor Xa, a key blood clotting protein, ELIQUIS prevents thrombin
generation and blood clot formation. ELIQUIS is approved to reduce the
risk of stroke and systemic embolism in patients with nonvalvular atrial
fibrillation in the United States, European Union (which includes 28
member states), Iceland, Norway, Japan and a number of other countries
around the world. ELIQUIS is approved for prevention of venous
thromboembolic events (VTE) in adult patients who have undergone
elective hip or knee replacement surgery in the European Union (which
includes 28 member states), Iceland, Norway and a number of other
countries around the world. ELIQUIS is not approved for this
indication in the U.S. or Japan.
IMPORTANT SAFETY INFORMATION FOR ELIQUIS
BOXED WARNING: DISCONTINUING ELIQUIS IN PATIENTS WITHOUT ADEQUATE
CONTINUOUS ANTICOAGULATION INCREASES RISK OF STROKE.
Discontinuing ELIQUIS places patients at an increased risk of
thrombotic events. An increased rate of stroke was observed
following discontinuation of ELIQUIS in clinical trials in patients with
nonvalvular atrial fibrillation. If anticoagulation with ELIQUIS
must be discontinued for a reason other than pathological bleeding,
coverage with another anticoagulant should be strongly considered.
CONTRAINDICATIONS
- Active pathological bleeding
- Severe hypersensitivity reaction to ELIQUIS (apixaban) (i.e.,
anaphylactic reactions)
WARNINGS AND PRECAUTIONS
Increased Risk of Stroke with Discontinuation of ELIQUIS: Discontinuing
ELIQUIS in the absence of adequate alternative anticoagulation increases
the risk of thrombotic events. An increased rate of stroke was observed
during the transition from ELIQUIS to warfarin in clinical trials in
patients with nonvalvular atrial fibrillation. If ELIQUIS must be
discontinued for a reason other than pathological bleeding, consider
coverage with another anticoagulant.
Bleeding Risk: ELIQUIS increases the risk of bleeding and can
cause serious, potentially fatal bleeding. Concomitant use of drugs
affecting hemostasis increases the risk of bleeding including aspirin
and other anti-platelet agents, other anticoagulants, heparin,
thrombolytic agents, SSRIs, SNRIs, and NSAIDs. Patients should be made
aware of signs or symptoms of blood loss and instructed to immediately
report to an emergency room. Discontinue ELIQUIS in patients with active
pathological hemorrhage. There is no established way to reverse the
anticoagulant effect of apixaban, which can be expected to persist for
about 24 hours after the last dose (i.e., about two half-lives). A
specific antidote for ELIQUIS is not available. Because of high plasma
protein binding, apixaban is not expected to be dialyzable. Protamine
sulfate and vitamin K would not be expected to affect the anticoagulant
activity of apixaban. There is no experience with antifibrinolytic
agents (tranexamic acid, aminocaproic acid) in individuals receiving
apixaban. There is neither scientific rationale for reversal nor
experience with systemic hemostatics (desmopressin and aprotinin) in
individuals receiving apixaban. Use of procoagulant reversal agents such
as prothrombin complex concentrate, activated prothrombin complex
concentrate, or recombinant factor VIIa may be considered but has not
been evaluated in clinical studies. Activated charcoal reduces
absorption of apixaban thereby lowering apixaban plasma concentrations.
Prosthetic Heart Valves: The safety and efficacy of ELIQUIS has
not been studied in patients with prosthetic heart valves and is not
recommended in these patients.
ADVERSE REACTIONS
The most common and most serious adverse reactions reported with ELIQUIS
(apixaban) were related to bleeding.
DISCONTINUATIONS FOR SURGERY AND OTHER INTERVENTIONS
ELIQUIS should be discontinued at least 48 hours prior to elective
surgery or invasive procedures with a moderate or high risk of
unacceptable or clinically significant bleeding. ELIQUIS should be
discontinued at least 24 hours prior to elective surgery or invasive
procedures with a low risk of bleeding or where the bleeding would be
noncritical in location and easily controlled.
DRUG INTERACTIONS
Strong Dual Inhibitors of CYP3A4 and P-gp: Inhibitors of CYP3A4
and P-gp increase exposure to apixaban and increase the risk of
bleeding. Decrease the dose of ELIQUIS to 2.5 mg twice daily when
coadministered with drugs that are strong dual inhibitors of CYP3A4 and
P-gp, (e.g., ketoconazole, itraconazole, ritonavir, or clarithromycin).
In patients already taking ELIQUIS at a dose of 2.5 mg twice daily,
avoid coadministration with strong dual inhibitors of CYP3A4 and P-gp.
Strong Dual Inducers of CYP3A4 and P-gp: Inducers of CYP3A4 and
P-gp decrease exposure to apixaban and increase the risk of stroke.
Avoid concomitant use of ELIQUIS with strong dual inducers of CYP3A4 and
P-gp (e.g., rifampin, carbamazepine, phenytoin, St. John’s wort) because
such drugs will decrease exposure to apixaban.
Anticoagulants and Antiplatelet Agents: Coadministration of
antiplatelet agents, fibrinolytics, heparin, aspirin, and chronic NSAID
use increases the risk of bleeding. APPRAISE-2, a placebo-controlled
clinical trial of apixaban in high-risk post-acute coronary syndrome
patients treated with aspirin or the combination of aspirin and
clopidogrel, was terminated early due to a higher rate of bleeding with
apixaban compared to placebo.
PREGNANCY CATEGORY B
There are no adequate and well-controlled studies of ELIQUIS in pregnant
women. Treatment is likely to increase the risk of hemorrhage during
pregnancy and delivery. ELIQUIS should be used during pregnancy only if
the potential benefit outweighs the potential risk to the mother and
fetus.
Please see full Prescribing Information including BOXED WARNING and
Medication Guide available at www.bms.com.
About the Bristol-Myers Squibb/Pfizer Collaboration
In 2007, Pfizer and Bristol-Myers Squibb entered into a worldwide
collaboration to develop and commercialize ELIQUIS, an oral
anticoagulant discovered by Bristol-Myers Squibb. This global alliance
combines Bristol-Myers Squibb's long-standing strengths in
cardiovascular drug development and commercialization with Pfizer’s
global scale and expertise in this field.
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to discover, develop and deliver innovative medicines that help
patients prevail over serious diseases. For more information, please
visit http://www.bms.com
or follow us on Twitter at http://twitter.com/bmsnews.
Pfizer Inc.: Working together for a healthier world™
At Pfizer, we apply science and our global resources to bring therapies
to people that extend and significantly improve their lives. We strive
to set the standard for quality, safety and value in the discovery,
development and manufacture of health care products. Our global
portfolio includes medicines and vaccines as well as many of the world's
best-known consumer health care products. Every day, Pfizer colleagues
work across developed and emerging markets to advance wellness,
prevention, treatments and cures that challenge the most feared diseases
of our time. Consistent with our responsibility as one of the world's
premier innovative biopharmaceutical companies, we collaborate with
health care providers, governments and local communities to support and
expand access to reliable, affordable health care around the world. For
more than 150 years, Pfizer has worked to make a difference for all who
rely on us. To learn more, please visit us at www.pfizer.com.
Bristol-Myers Squibb Forward-Looking Statement
This press release contains "forward-looking statements" as that term
is defined in the Private Securities Litigation Reform Act of 1995
regarding product development. Such forward-looking statements are based
on current expectations and involve inherent risks and uncertainties,
including factors that could delay, divert or change any of them, and
could cause actual outcomes and results to differ materially from
current expectations. No forward-looking statement can be guaranteed.
Among other risks, there can be no guarantee that ELIQUIS will be
approved for these additional indications in the U.S., or, if
approved, that these additional indications will lead to increased
commercial success. Forward-looking statements in this press release
should be evaluated together with the many uncertainties that affect
Bristol-Myers Squibb's business, particularly those identified in the
cautionary factors discussion in Bristol-Myers Squibb's Annual Report on
Form 10-K for the year ended December 31, 2012, in our Quarterly Reports
on Form 10-Q and our Current Reports on Form 8-K. Bristol-Myers Squibb
undertakes no obligation to publicly update any forward-looking
statement, whether as a result of new information, future events or
otherwise.
PFIZER DISCLOSURE NOTICE:
The information contained in this release is as of December 19, 2013.
Pfizer assumes no obligation to update forward-looking statements
contained in this release as the result of new information or future
events or developments.
This release contains forward-looking information about ELIQUIS
(apixaban), including its potential benefits, that involves substantial
risks and uncertainties. Such risks and uncertainties include, among
other things, (i) the uncertainties inherent in research and
development; (ii) whether and when ELIQUIS will be approved by the U.S.
Food and Drug Administration (FDA) for the treatment of deep vein
thrombosis (DVT) and pulmonary embolism (PE) and for the reduction in
the risk of recurrent DVT and PE, or by the European Medicines Agency
(EMA) for the treatment of DVT and PE and the prevention of recurrent
DVT and PE, as well as the FDA’s and EMA’s decisions regarding labeling
and other matters that could affect the availability or commercial
potential of those additional indications; (iii) uncertainty regarding
the commercial success of those additional indications if they are
approved by the FDA and the EMA; and (iv) competitive developments.
A further description of risks and uncertainties can be found in
Pfizer’s Annual Report on Form 10-K/A for the fiscal year ended December
31, 2012 and in its reports on Form 10-Q and Form 8-K.

Bristol-Myers SquibbChrissy Trank (Media)609-252-3418christina.trank@bms.comorRanya Dajani (Investors)609-252-5330ranya.dajani@bms.comorRyan Asay (Investors)609-252-5020ryan.asay@bms.comorPfizer Inc.Jennifer Kokell (Media)917-741-4254jennifer.kokell@pfizer.comorRyan Crowe (Investors)212-733-8160ryan.crowe@pfizer.com