Monday, April 22, 2019

MAYZENT: New Drug Trials Snapshot Posted


A new  DRUG TRIALS SNAPSHOT is now available

Drug Trials Snapshots: MAYZENT

HOW TO USE THIS SNAPSHOT
The information provided in Snapshots highlights individuals who participated in the clinical trials that supported the FDA approval of this drug, and whether there were differences among sex, race and age groups. The “MORE INFO” bar shows more detailed, technical content for each section. The Snapshot is intended as one tool for consumers to use when discussing the risks and benefits of the drugs.
LIMITATIONS OF THIS SNAPSHOT:
Do not rely on Snapshots to make decisions regarding medical care. Always speak to your health provider about the risks and benefits of a drug. Refer to the MAYZENT Package Insert for complete information.
MAYZENT (siponimod) 
mā’zĕnt
Novartis Pharmaceuticals Corporation
Approval date: March 26, 2019

DRUG TRIALS SNAPSHOT SUMMARY:

What is the drug for?

MAYZENT is a drug used for the treatment of adults with relapsing forms of multiple sclerosis (RMS) including:
  • clinically isolated syndrome,
  • relapsing-remitting disease, and
  • active secondary progressive disease
In RMS, patients have episodes of worsening function (relapses) followed by recovery periods. Patients can also experience an increase in the underlying disability, particularly as the disease progresses.

How is this drug used?

MAYZENT is taken by mouth once daily. MAYZENT is initially started at a low dose. The dose is gradually increased over 5 to 6 days.

What are the benefits of this drug?

MAYZENT reduced the risk of disability progression. Twenty-six percent of patients that received MAYZENT had confirmed progression of disability that was sustained over a 3-month period compared to 32% of patients that received placebo.

Were there any differences in how well the drug worked in clinical trials among sex, race and age?

  • Sex: MAYZENT worked similarly in men and women.
  • Race: The majority of patients were White. The number of patients in other races was limited; therefore, differences in how well MAYZENT worked among races could not be determined.
  • Age: MAYZENT worked similarly in patients younger and older than 45 years of age.

What are the possible side effects?

MAYZENT may cause serious side effects including infection, build-up of fluid in the back of the eye (macular edema), decreased heart rate, decrease in lung function, liver injury, increased blood pressure, and risk to a fetus.
The most common side effects of MAYZENT are headache, high blood pressure, and increased liver function tests.

Were there any differences in side effects among sex, race and age?

  • Sex: The occurrence of side effects was similar in men and women.
  • Race: The majority of patients were White. The number of patients in other races was limited; therefore, differences in the occurrence of side effects among races could not be determined.
  • Age: The occurrence of side effects was similar in patients younger and older than 45 years of age.

WHO WAS IN THE CLINICAL TRIALS?

Who participated in the clinical trials?

The FDA approved MAYZENT based on evidence primarily from one clinical trial (Trial 1/NCT01665144) of 1651 patients with secondary progressive multiple sclerosis (SPMS). The trial was conducted at 294 centers in Asia, Australia, Canada, Europe, South America, and the United States.
Figure 1 summarizes how many men and women were in the clinical trial.
Figure 1. Demographics by Sex
Pie chart summarizing how many males and females were in the clinical trials. In total, 659 males (40%) and 992 (60%) women participated in the clinical trials.
FDA Review
Figure 2 and Table 1 summarize the percentage of patients by race in the clinical trial.
Figure 2. Demographics by Race
Pie chart summarizing the percentage of patients by race enrolled in the clinical trials. In total, 1563 White (95%), 49 Asian (3%) and 39 Other patients (2%) participated in the clinical trials.
*Includes Black or African American
FDA Review
Table 1. Demographics of Trials by Race
RaceNumber of PatientsPercentage of Patients
White156395%
Black or African American10Less than 1%
Asian493%
Other292%
FDA Review
Figure 3 summarizes the percentage of patients by age group in the clinical trial.
Figure 3. Demographics by Age
Pie charts summarizing how many individuals of certain age groups were enrolled in the clinical trials. In total, 593 patients (36%) were 45 years and younger, and 1058 patients (64%) were older than 45 years
FDA Review

How were the trials designed?

The benefits and side effects of MAYZENT were evaluated in one clinical trial of patients with SPMS who had experienced disability progression in the two years prior to enrollment and no relapses in the three months prior to enrollment. The degree of disability was established by neurologic examination using the Expanded Disability Status Scale (EDSS). The EDSS is used to score disability on a scale from 0 (normal) to 10 (death due to MS). Patients received MAYZENT or placebo tablets by mouth once daily for up to 37 months. Neither the patients nor the health care providers knew which treatment was being given until the trial was completed.
The benefit of MAYZENT was evaluated by comparing the time to disability progression in each group using EDSS scores. To count as progression, the observed disability progression had to last for 3 months.

GLOSSARY

CLINICAL TRIAL: Voluntary research studies conducted in people and designed to answer specific questions about the safety or effectiveness of drugs, vaccines, other therapies, or new ways of using existing treatments.
COMPARATOR: A previously available treatment or placebo used in clinical trials that is compared to the actual drug being tested.
EFFICACY: How well the drug achieves the desired response when it is taken as described in a controlled clinical setting, such as during a clinical trial.
PLACEBO: An inactive substance or “sugar pill” that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.
SUBGROUP: A subset of the population studied in a clinical trial. Demographic subsets include sex, race, and age groups.

PRESCRIBING INFORMATION

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