Full Press Release Details
R788 Significantly Improves Rheumatoid Arthritis in Phase 2b Clinical Trial
and Manageable Safety Profile Demonstrated in TASKi2
SOUTH SAN FRANCISCO, Calif., July 9,
2009 Rigel Pharmaceuticals, Inc. (Nasdaq: RIGL) today announced that
R788 (fostamatinib disodium) produced significant clinical improvement in
rheumatoid arthritis (RA) patients in the recently completed TASKi2 Phase 2b
clinical trial of 457 patients treated for up to 6 months. The groups treated with 100 mg of R788 bid
(twice a day) and 150 mg qd (once a day) reported higher ACR 20, ACR 50, ACR 70
and DAS28 response rates than the placebo group. The efficacy results for the two dosing
groups were comparable, although the response rates for the 100 mg bid group
was uniformly greater. Consistent with
the previous Phase 2a clinical trial (TASKi1), the onset of effect of R788
occurred within one week after the initiation of therapy and was
maintained. The most frequent adverse
events were expected based on TASKi1 and appear to be manageable. The significant, early and sustained
efficacy, combined with a good safety profile, supports Rigel s plans to
conduct corporate partnership discussions with respect to R788 and initiate a
Phase 3 clinical program with R788 in RA in the first half of 2010 with a
Rigel will host a conference
call today at 8:00am EDT/5:00am PDT to discuss these results (see conference
call details below).
These are impressive
results, said James M. Gower, chairman and chief executive officer of
Rigel. The data from this clinical
trial and the soon to be completed TASKi3 clinical trial, a total of over 670
patients, will guide the design of the Phase 3 trials that we plan to launch
with a corporate partner in the first half of next year, he added.
| Treatment | N of Pts | ACR 20 | ACR 50 | ACR 70 | DAS28<2.6 | ||||||
| Placebo | 153 | 53 (35%) | 29 (19%) | 16 (10%) | 9 (6%) | ||||||
| 150 mg qd | 152 | 87 (57%) p<0.001 | 49 (32%) p=0.007 | 21 (14%) p=0.34 | 26 (17%) p=0.003 | ||||||
| 100 mg bid | 152 | 101 (66%) p<0.001 | 65 (43%) p<0.001 | 43 (28%) p<0.001 | 41 (27%) <0.001 |
p values compared to placebo
Note: At 6 months. All
patients were on stable doses of methotrexate throughout the clinical trial.
* The results presented are
based on an intention to treat analysis that includes all randomized patients,
regardless of how long treatment lasted.
Any patient who dropped out of the study for any reason, or for whom
month 6 data were unavailable, was considered a treatment failure (ACR
non-responder). Disease Activity Scores are based on a 28 joint count and CRP
or an ESR at week 24 (depending on which was the qualifying biomarker).
The most common clinically
meaningful drug-related adverse events noted in TASKi2 were diarrhea and
hypertension. Dose reduction options
were pre-specified in the trial protocol and in cases where doses were reduced,
patients generally completed the clinical trial with minimal safety issues. The
most common adverse events in the trial overall were related to infections,
though these were generally evenly distributed among the placebo and active
The mean increase in blood
pressure from baseline at 6 months, using a last observation carry forward methodology,
was less than 0.5 mmHg for the 150 mg qd dose group and approximately 1 mmHg
for the 100 mg bid dose group.
Approximately 18% and 23% of patients in the 150 mg qd and the 100 mg
bid dose groups, respectively, had blood pressure medication adjusted or in
some cases initiated during the course of the study, compared with 7% of the
placebo patients. The blood pressure was
successfully reduced in these patients, and their blood pressure was generally
well controlled throughout the trial.
The blood pressure medications were standard doses of common blood
pressure medications such as ACE inhibitors or diuretics.
R788 continues to perform
with strong efficacy and good tolerability in the groups of patients with RA
who have failed to respond to methotrexate, said Elliott Grossbard, M.D.,
chief medical officer for Rigel. We now
have a much better understanding of R788 s safety profile and believe that the
observed side effects may be effectively managed, he added.
Safety Results Tables
| (N) | Placebo (153) | 150 mg qd (152) | 100 mg bid (152) | ||||||||||
| Dose Reductions | N | % | N | % | N | % | |||||||
| # Had a Dose Reduction | 6 | 4 | % | 21 | 14 | % | 21 | 14 | % | ||||
| Neutropenia (ANC <1500) | 1 | 1 | % | 6 | 4 | % | 1 | 1 | % | ||||
| Diarrhea, nausea, vomiting, dizziness | 1 | 1 | % | 5 | 3 | % | 9 | 6 | % | ||||
| Increase in Blood Pressure | 2 | 1 | % | 4 | 3 | % | 6 | 4 | % | ||||
| ALT or Alkphos Elevation | 2 | 1 | % | 6 | 4 | % | 5 | 3 | % |
| Treatment Emergent Adverse Events | N | % | N | % | N | % | |||||||
| Diarrhea | 5 | 3 | % | 18 | 12 | % | 29 | 19 | % | ||||
| Hypertension | 7 | 5 | % | 18 | 12 | % | 21 | 14 | % | ||||
| Infections | 42 | 27 | % | 37 | 24 | % | 53 | 35 | % |
| Mean Blood Pressure (Systolic/Diastolic in mmHg) | mmHg | mmHg | mmHg | ||||
| Baseline | 125/76 | 125/77 | 125/77 | ||||
| At Month 6 | 123/76 | 125/77 | 125/78 | ||||
| Change from Baseline to Month 6 (LOCF) | -1.8/+0.4 | +0.2/+0.3 | +0.6/+1.4 |
Mean Systolic BP if had
Adjustment or Initiation of BP Medication (mmHg)
| # Had BP Meds Adjusted/Initiated | 11 (7%) | 27 (18%) | 35 (23%) | ||||
| BP Measurement Pre-Adjustment/Initiation | 139 | 149 | 153 | ||||
| At Month 6 | 136 | 128 | 138 | ||||
| Mean Change | -4 | -20 | -16 |
TASKi2 was a 6 month,
multi-center, randomized, double blind, placebo controlled, parallel dose
clinical trial involving 457 RA patients in the U.S., Latin America and Europe
who had failed to respond to methotrexate alone. The patients were randomly assigned to two
cohorts and thus received R788 orally in either 100 mg bid (twice daily) or 150
mg qd (once daily) doses or placebo for a period of 6 months. Within in each cohort, patients were assigned
on a 2:1 basis to R788 or placebo. All
of the patients continued to receive their same stable dose of methotrexate
throughout the clinical trial period.
Efficacy assessments for
each participant were based on the American College of Rheumatology criteria,
which denotes at least a 20% (ACR 20) improvement, at least a 50% (ACR 50)
improvement, or at least a 70% (ACR 70) improvement, from the
baseline assessment at the
end of the 6 month treatment period. The ACR measurement factors include reported
physician and patient global assessment of disease activity, patient reported
pain score, and any change in C-reactive protein (CRP) in the patients
blood. The primary efficacy endpoint for
the study was the percent of patients assigned to the R788 100 mg bid dose who
were ACR 20 responders at the end of 6 months.
Secondary efficacy endpoints included a comparison of response rates for
the R788 100 mg bid and R788 150 mg qd doses at the ACR 20, ACR 50 and ACR 70
scores, as well as Disease Activity Scores (DAS) over the period of 6 months.
RA is a progressive, painful
and potentially debilitating disease, that affects more than 2 million people
in the U.S. It is a chronic inflammatory disease that puts the body s immune
system into overdrive where it ultimately causes inflammation in the joints and
destroys soft tissues, cartilage and bone.
Rigel s R788 is a novel, orally available syk kinase inhibitor designed
to interrupt the cellular signaling at the trigger point of inflammation, thereby