Oral Presentations at the 2018 Annual Meeting of the Association of Academic
Physiatrists (AAP) Provide Additional Data on the Safety and Efficacy of Dysport®
in Adults with Upper and Lower Limb Spasticity and Children with Lower Limb Spasticity
BASKING RIDGE, N.J., February 15, 2018 – Ipsen Biopharmaceuticals, Inc., an affiliate of
Ipsen (Euronext: IPN; ADR: IPSEY) (Ipsen), announced Dysport® (abobotulinumtoxinA) data will be presented today in two oral presentations at the annual meeting of the Association of Academic Physiatrists (AAP) being held in Atlanta, February 13-17, 2018. The oral presentations provide the outcomes of multiple Phase 3 studies that evaluated time to retreatment, as well as long-term treatment with Dysport®.
“The data being presented at this year’s AAP meeting indicate that Dysport® provides sustained spasticity relief for both adult and pediatric patients,” said David Cox, Vice President, US Medical Affairs, HEOR & Commercial Regulatory Affairs, Ipsen. “Improved outcomes from long-term therapy along with longer time between injections can be important factors in the management of these conditions, and we’re pleased to share these data to help inform physician and patient treatment decisions.”
In the first oral presentation, results from three randomized, placebo-controlled, double-blind
Phase 3 studies of Dysport® evaluating time to retreatment in three patient groups showed that 37 percent of hemiparetic (post-stroke/traumatic brain injury) patients with adult upper limb spasticity (AULS), 20 percent of hemiparetic patients with adult lower limb spasticity (ALLS) and 74 percent of patients with pediatric (at least two years of age) lower limb spasticity (PLLS) due to cerebral palsy did not require reinjection until week 16 or later (Abstract #361196).
Separately, results will also be presented from a randomized, placebo-controlled, double-blind
Phase 3 study followed by an open-label extension, assessing the long-term efficacy and safety (up to 18 months) of Dysport® (at 1000 units or 1500 units) in treating ALLS in hemiparetic patients that had impaired walking ability. Improvements in muscle tone based on Modified Ashworth Scale were demonstrated after a single injection of Dysport® and sustained over subsequent treatment (Abstract #361236). Physician Global Assessment, as well as comfortable barefoot walking speed, also showed progressive improvement across cycles.
In both analyses, safety results were consistent with previous findings with Dysport®. Safety signals and frequencies are reflected in the integrated safety information below.
Dysport® (abobotulinumtoxinA) and all botulinum toxin products have a Boxed Warning in the
US which states that the effects of the botulinum toxin may spread from the area of injection to
other areas of the body, causing symptoms similar to those of botulism. Those symptoms include swallowing and breathing difficulties that can be life-threatening. Dysport® is contraindicated in patients with known hypersensitivity to any botulinum toxin preparation or to any of the components; or in the presence of infection at the proposed injection site(s); or in patients known to be allergic to cow’s milk protein. The potency Units of Dysport® are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products. Please scroll below for additional Important Safety Information.
Two poster presentations will also be featured at the meeting, including:
Importance of walking speed assessment as an indicator of functional improvement in
adults with spastic hemiparesis after repeated administrations of abobotulinumtoxA
- Poster #432
Time to retreatment with botulinum toxin A in upper limb spasticity management: initial data from the Upper Limb International Spasticity (ULIS)-III study
- Poster #430
Spasticity is a condition in which there is an abnormal increase in muscle tone or stiffness in one or more muscles, which might interfere with movement.1 Spasticity is usually caused by damage to nerve pathways in the brain or spinal cord that control muscle movement, and may occur in association with cerebral palsy, spinal cord injury, multiple sclerosis (MS), stroke and brain or head trauma.1 In adults, approximately one in three stroke patients, one in three patients with spinal cord injury, one in six patients with traumatic brain injury, and two in three patients with MS will develop lower limb spasticity.2,3
Lower limb spasticity commonly involves spasticity in the gastrocnemius and soleus muscle complex located in the calf.4,5 These calf muscles, during walking, work to raise the heel from the ground.4 Symptoms of spasticity may include increased muscle tone, rapid muscle contractions, exaggerated deep tendon reflexes, and/or muscle spasms.1 The degree of spasticity can vary from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms.1
About Dysport®(abobotulinumtoxinA) for Injection
Dysport® is an injectable form of botulinum toxin type A (BoNT-A), which is isolated and purified
from Clostridium bacteria producing BoNT-A. It is supplied as a lyophilized powder. Dysport®
has approved indications in the United States for the treatment of adults with Cervical Dystonia (CD) and for the treatment of spasticity in adult patients. Dysport® is also the first and only FDA-approved botulinum toxin for the treatment of lower limb spasticity in pediatric patients two years of age and older.
INDICATIONS AND IMPORTANT SAFETY INFORMATION
Dysport® (abobotulinumtoxinA) for injection is indicated for the treatment of:
- Adults with cervical dystonia
- Spasticity in adult patients
- Lower limb spasticity in pediatric patients 2 years of age and older
IMPORTANT SAFETY INFORMATION
|Warning: Distant Spread of Toxin Effect
Postmarketing reports indicate that the effects of Dysport and all botulinum toxin
products may spread from the area of injection to produce symptoms consistent with
botulinum toxin effects. These may include asthenia, generalized muscle weakness,
diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have underlying conditions that would predispose them to these symptoms. In unapproved uses, including upper limb
spasticity in children, and in approved indications, cases of spread of effect have been
reported at doses comparable to or lower than the maximum recommended total dose.
Dysport is contraindicated in patients with known hypersensitivity to any botulinum toxin
preparation or to any of the components; or in the presence of infection at the proposed
injection site(s); or in patients known to be allergic to cow’s milk protein. Hypersensitivity
reactions including anaphylaxis have been reported.
Warnings and Precautions
Lack of Interchangeability Between Botulinum Toxin Products
The potency Units of Dysport are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products, and, therefore, units of biological activity of Dysport cannot be compared to or converted into units of any other botulinum toxin products assessed with any other specific assay method.
Dysphagia and Breathing Difficulties
Treatment with Dysport and other botulinum toxin products can result in swallowing or breathing
difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or swallowing. When distant side effects occur, additional respiratory muscles may be involved. Deaths as a complication of severe dysphagia have been reported after treatment with botulinum toxin. Dysphagia may persist for several weeks, and require use of a feeding tube to maintain adequate nutrition and hydration. Aspiration may result from severe dysphagia and is a particular risk when treating patients in whom swallowing or respiratory function is already compromised. Patients treated with botulinum toxin may require immediate medical attention should they develop problems with swallowing, speech, or respiratory disorders. These reactions can occur within hours to weeks after injection with botulinum toxin.
Pre-existing Neuromuscular Disorders
Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (e.g., myasthenia gravis or Lambert-Eaton syndrome) should be monitored particularly closely when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including severe dysphagia and respiratory compromise from typical doses of Dysport.
Human Albumin and Transmission of Viral Diseases
This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD, or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.
Intradermal Immune Reaction
The possibility of an immune reaction when injected intradermally is unknown. The safety of Dysport for the treatment of hyperhidrosis has not been established. Dysport is approved only for intramuscular injection.
Most Common Adverse Reactions
Adults with upper limb spasticity (≥2% and greater than placebo): nasopharyngitis, urinary
tract infection, muscular weakness, musculoskeletal pain, dizziness, fall, and depression.
Adults with lower limb spasticity (≥ 5% and greater than placebo): falls, muscular weakness, and pain in extremity.
Adults with cervical dystonia (≥5% and greater than placebo): muscular weakness,
dysphagia, dry mouth, injection site discomfort, fatigue, headache, musculoskeletal pain, dysphonia, injection site pain, and eye disorders.
Pediatric patients with lower limb spasticity (≥10% and greater than placebo): upper respiratory tract infection, nasopharyngitis, influenza, pharyngitis, cough, and pyrexia.
Co-administration of Dysport and aminoglycosides or other agents interfering with neuromuscular transmission (e.g., curare-like agents), or muscle relaxants, should be observed closely because the effect of botulinum toxin may be potentiated. Use of anticholinergic drugs after administration of Dysport may potentiate systemic anticholinergic effects, such as blurred vision. The effect of administering different botulinum neurotoxins at the same time or within several months of each other is unknown. Excessive weakness may be exacerbated by another administration of botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin. Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of Dysport.
Use in Pregnancy
Based on animal data, Dysport may cause fetal harm. There are no adequate and well controlled studies in pregnant women. Dysport should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Pediatric Use Based on animal data Dysport may cause atrophy of injected and adjacent muscles; decreased bone growth, length, and mineral content; delayed sexual maturation; and decreased fertility.
In general, elderly patients should be observed to evaluate their tolerability of Dysport, due to the greater frequency of concomitant disease and other drug therapy. Subjects aged 65 years and over who were treated with Dysport for lower limb spasticity reported a greater percentage of fall and asthenia as compared to those younger (10% vs. 6% and 4% vs. 2%, respectively).
To report SUSPECTED ADVERSE REACTIONS or product complaints, contact Ipsen at 1-855- 463-5127. You may also report SUSPECTED ADVERSE REACTIONS to the FDA at 1-800-
FDA-1088 or www.fda.gov/medwatch.
Please see Full Prescribing Information, including Boxed Warning and Medication Guide.
About Ipsen in North America
Ipsen Biopharmaceuticals, Inc. is a U.S. affiliate of Ipsen (Euronext: IPN; ADR: IPSEY), a global
specialty-driven biopharmaceutical group focused on innovation and specialty care. The U.S.
head office is located in Basking Ridge, New Jersey, and its Canadian office, Ipsen Biopharmaceuticals Canada, Inc., an integrated business unit within North America, is located in Mississauga, Ontario. Additional research and development and manufacturing sites are located in Cambridge, Massachusetts, as part of Ipsen Bioscience, Inc., the Ipsen U.S. research and development center, which is focused on the discovery of potentially highly differentiated and competitive products in Oncology, Neurosciences and Rare Diseases. Ipsen North America employs more than 400 people and is dedicated to providing hope for the patients whose lives are challenged by difficult-to-treat diseases. At Ipsen, we focus our resources, investments and energy on discovering, developing and commercializing new therapeutic options for oncologic, neurologic and rare diseases. For more information on Ipsen in North America, please visit www.ipsenus.com or www.ipsen.ca.
Ipsen is a global specialty-driven biopharmaceutical group focused on innovation and specialty care. The group develops and commercializes innovative medicines in three key therapeutic areas – Oncology, Neurosciences and Rare Diseases. Its commitment to oncology is exemplified through its growing portfolio of key therapies for prostate cancer, neuroendocrine tumors, renal cell carcinoma and pancreatic cancer. Ipsen also has a well-established Consumer Healthcare business. With total sales close to €1.6 billion in 2016, Ipsen sells more than 20 drugs in over 115 countries, with a direct commercial presence in more than 30 countries. Ipsen’s R&D is focused on its innovative and differentiated technological platforms located in the heart of the leading biotechnological and life sciences hubs (Paris-Saclay, France; Oxford, UK; Cambridge, US). The Group has about 5,100 employees worldwide. Ipsen is listed in Paris (Euronext: IPN) and in the United States through a Sponsored Level I American Depositary Receipt program (ADR: IPSEY). For more information on Ipsen, visit www.ipsen.com.
Forward Looking Statements
The forward-looking statements, objectives and targets contained herein are based on the Group’s management strategy, current views and assumptions. Such statements involve known and unknown risks and uncertainties that may cause actual results, performance or events to differ materially from those anticipated herein. All of the above risks could affect the Group’s future ability to achieve its financial targets, which were set assuming reasonable macroeconomic conditions based on the information available today. Use of the words “believes,” “anticipates” and “expects” and similar expressions are intended to identify forwardlooking statements, including the Group’s expectations regarding future events, including regulatory filings and determinations. Moreover, the targets described in this document were prepared without taking into account external growth assumptions and potential future acquisitions, which may alter these parameters. These objectives are based on data and assumptions regarded as reasonable by the Group. These targets depend on conditions or facts likely to happen in the future, and not exclusively on historical data. Actual results may depart significantly from these targets given the occurrence of certain risks and uncertainties, notably the fact that a promising product in early development phase or clinical trial may end up never being launched on the market or reaching its commercial targets, notably for regulatory or competition reasons. The Group must face or might face competition from generic products that might translate into a loss of market share. Furthermore, the Research and Development process involves several stages each of which involves the substantial risk that the Group may fail to achieve its objectives and be forced to abandon its efforts with regards to a product in which it has invested significant sums. Therefore, the Group cannot be certain that favorable results obtained during pre-clinical trials will be confirmed subsequently during clinical trials, or that the results of clinical trials will be sufficient to demonstrate the safe and effective nature of the product concerned. There can be no guarantees a product will receive the necessary regulatory approvals or that the product will prove to be commercially successful. If underlying assumptions prove inaccurate or risks or uncertainties materialize, actual results may differ materially from those set forth in the forward-looking statements. Other risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation; global trends toward health care cost containment; technological advances, new products and patents attained by competitors; challenges inherent in new product development, including obtaining regulatory approval; the Group’s ability to accurately predict future market conditions; manufacturing difficulties or delays; financial instability of international economies and sovereign risk; dependence on the effectiveness of the Group’s patents and other protections for innovative products; and the exposure to litigation, including patent litigation, and/or regulatory actions. The Group also depends on third parties to develop and market some of its products which could potentially generate substantial royalties; these partners could behave in such ways which could cause damage to the Group’s activities and financial results. The Group cannot be certain that its partners will fulfill their obligations. It might be unable to obtain any benefit from those agreements. A default by any of the Group’s partners could generate lower revenues than expected. Such situations could have a negative impact on the Group’s business, financial position or performance. The Group expressly disclaims any obligation or undertaking to update or revise any forward-looking statements, targets or estimates contained in this press release to reflect any change in events, conditions, assumptions or circumstances on which any such statements are based, unless so required by applicable law. The Group’s business is subject to the risk factors outlined in its registration documents filed with the French Autorité des Marchés Financiers.
For further information:
Vice President, North American
Internal & External Communications
Chamberlain Healthcare PR
1. National Institute of Neurological Disorders and Stroke. Spasticity Information Page.
January 31, 2018.
2. Martin A, et al. Epidemiological, humanistic, and economic burden of illness of lower limb
spasticity in adults: a systematic review. Neuropsychiatric Disease and Treatment. 2014; 10
3. Sköld A, et al. Spasticity after traumatic spinal cord injury: nature, severity, and location.
Archives of Physical Medicine and Rehabilitation. 1999; 80 (1548-57).
4. Gray H. Anatomy of the Human Body. “The Muscles and Fasciæ of the Leg.”
http://www.bartleby.com/107/129.html. Accessed January 31, 2018.
5. Delgado M, et al. AbobotulinumtoxinA for equinus foot deformity in cerebral palsy: A
randomized clinical trial. Pediatrics. 2016;137(2).
Dysport®(abobotulinumtoxinA) for injection, for intramuscular use 300- and 500-Unit vials.
DYSPORT is a registered trademark of Ipsen Biopharm Limited.
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© 2018 Ipsen Biopharmaceuticals, Inc.
February 2018 DYS-US-002510