BYFAVO™ werd op 2 juli 2020 goedgekeurd door de FDA (Food and Drug Administration) van de Verenigde Staten voor de inductie en het onderhoud van procedurele sedatie bij volwassenen die een medische ingreep ondergaan die 30 minuten of minder duurt. Op 6 oktober 2020 werd het product toegewezen aan Schema IV van de Drug Enforcement Administration (DEA) van de Verenigde Staten, waarmee het goedkeuringsproces werd gefinaliseerd en de weg werd geëffend voor de verpakking en levering van het product naar de VS.
De voorbije twee jaar heeft Acacia Pharma de benodigde teams voor verkoop, marketing, medische educatie en operationele ondersteuning uitgebouwd, waardoor de Onderneming in staat is om zowel BYFAVO™ als BARHEMSYS® rechtstreeks met de eigen verkoopkanalen te commercialiseren in de Verenigde Staten. Het ervaren commercieel team van Acacia Pharma legt de focus op het benutten van de gecombineerde grote marktopportuniteiten die in VS bestaan op de hospitaalmarkt voor procedurele sedatie en voor de behandeling van misselijkheid en braken na een chirurgische operatie – de indicaties waarop BYFAVO™ en BARHEMSYS® zich respectievelijk richten.
Het commercieel team zal gedurende het eerste jaar van de lancering van beide producten de focus in eerste instantie leggen op de opname van beide producten in de formularia van de ziekenhuizen. Daarbij zal er op worden gewezen dat beide producten beantwoorden aan noden waarvoor tot voor kort geen afdoende oplossing bestond. Ook de gezondheidseconomische voordelen die beide producten kunnen opleveren, worden daarbij toegelicht.
“We zijn blij dat we BYFAVO™ beschikbaar kunnen maken voor de zorgprofessionals die instaan voor anesthesie en voor de miljoen patiënten in de VS die elk jaar medische ingrepen ondergaan waarvoor milde sedatie is vereist,” zegt Mike Bollinder, de CEO van Acacia Pharma. “BYFAVO™ en BARHEMSYS® bieden een duidelijke, gemeenschappelijke waarde die gericht is om patiënten na dergelijke ingrepen veilig en snel opnieuw te mobiliseren, hetgeen ook gunstig is voor de inkomsten van ziekenhuizen en chirurgische centra in de VS. Beide marktintroducties vallen in een periode waarin Covid-19 een wezenlijke impact op dergelijke centra had. In vele centra heeft Covid-19 geleid tot een aanzienlijke achterstand in de medische ingrepen voor patiënten, hetgeen ook gevolgen had voor de inkomsten van deze centra. Wij geloven dat onze producten kunnen helpen om de doorstroming van patiënten te verbeteren, wat in de huidige omstandigheden relevanter dan ooit is voor zorgverstrekkers en hun patiënten. We geloven dat Acacia Pharma bij deze marktintroducties in een sterke positie staat, omdat we enerzijds in staat zijn om de huidige achterstand in electieve ingrepen kunnen helpen aanpakken, en anderzijds omdat er momenteel een blijvend tekort aan bestaande geneesmiddelen in deze therapeutische domeinen is.”
BYFAVO™ kan nu in de VS worden besteld bij de belangrijkste groothandelaars en geselecteerde distributeurs van farmaceutische specialiteiten, waaronder Cardinal Health, Amerisource Bergen, Besse, McKesson, McKesson Medsurg, Morris and Dickson, en Curascript.
Contacts
Acacia Pharma Group plc
Mike Bolinder, CEO
Gary Gemignani, CFO
+44 1223 919760 / +1 317 505 1280
IR@acaciapharma.com
Internationale Media
Mark Swallow, Frazer Hall, David Dible
Citigate Dewe Rogerson
+44 20 7638 9571
acaciapharma@citigatedewerogerson.com
Media in België en Nederland
Chris Van Raemdonck
+32 499 58 55 31
chrisvanraemdonck@telenet.be
Investeerders in de VS
LifeSci Advisors
Irina Koffler
+1 917-734-7387
ikoffler@lifesciadvisors.com
Over Acacia Pharma
Acacia Pharma is een onderneming die farmaceutische producten voor hospitaalgebruik ontwikkelt en commercialiseert, gericht op een verbetering van de zorg voor patiënten die ernstige medische behandelingen zoals chirurgische ingrepen, invasieve procedures of chemotherapie ondergaan. De Onderneming heeft op deze domeinen belangrijke en commercieel attractieve onvervulde noden geïdentificeerd waarvoor ze met haar productgamma een antwoord wil bieden.
Het eerste product van Acacia Pharma is BARHEMSYS® (amisulpride injectie), dat in de VS beschikbaar is voor de behandeling van postoperatieve misselijkheid en braken (Post-Operative Nausea & Vomiting, afgekort PONV).
Het tweede geneesmiddel is BYFAVO™, met als actief bestanddeel remimazolam, uit de chemische familie van de benzodiazepines. Dit injecteerbaar product voor snel-startende en kortdurende sedatie is in de VS goedgekeurd en op de markt geïntroduceerd voor gebruik tijdens invasieve medische procedures bij volwassenen die 30 minuten of korter duren, zoals colonoscopie en brochoscopie. BYFAVO wordt door Acacia Pharma voor de VS in licentie genomen van Paion UK Limited.
APD403 (amisulpride voor intraveneuze toediening en orale inname) is een selectieve dopamine-antagonist voor misselijkheid en braken ten gevolge van chemotherapie (Chemotherapy-Induced Nausea & Vomiting, afgekort CINV). Dit product heeft met success een ‘Proof-of-Concept’-studie en een fase 2-studie voor dosisbepaling doorlopen bij patiënten die een sterk emetogene chemotherapie kregen.
Het hoofdkwartier voor de VS van Acacia Pharma bevindt zich in Indianapolis (IN), terwijl de R&D-activiteiten geconcentreerd zijn in Cambridge, VK. De Onderneming is genoteerd op Euronext Brussels onder de ISIN-code GB00BYWF9Y76 en met de ticker ACPH.
www.acaciapharma.com
Aanvullende informatie over BYFAVO™ en BARHEMSYS®, waaronder de indicaties en hun veiligheidsprofiel wordt op de volgende pagina’s in de oorspronkelijke, Engelstalige versie weergegeven.
Ook de informatie over Forward Looking Statements (Toekomstgerichte verklaringen) is opgenomen op de volgende pagina’s.
Beide informaties maken onlosmakelijk deel uit van dit bericht, dat in zijn geheel dient te worden gelezen.
About BYFAVO™
BYFAVO (remimazolam) for injection is a very rapid onset/offset intravenous benzodiazepine sedative for use during invasive medical procedures in adult patients lasting 30 minutes or less, such as during colonoscopy and bronchoscopy. Approximately 25 million such procedures take place annually in the US, of which around 90% use moderate sedation.
Cosmo in-licensed the US rights to BYFAVO from Paion AG in 2016 and together they have progressed the product candidate through to registration. BYFAVO is now approved and launched in the US and is indicated for the induction and maintenance of procedural sedation in adults lasting 30 minutes or less.
Important Safety Information for BYFAVO™ (remimazolam) Injection
Indications
BYFAVO is a benzodiazepine indicated for the induction and maintenance of procedural sedation in adults undergoing procedures lasting 30 minutes or less.
Important Safety Information
WARNING: PERSONNEL AND EQUIPMENT FOR MONITORING AND RESUSCITATION AND RISKS FROM CONCOMITANT USE WITH OPIOID ANALGESICS
Personnel and Equipment for Monitoring and Resuscitation
- Only personnel trained in the administration of procedural sedation, and not involved in the conduct of the diagnostic or therapeutic procedure, should administer BYFAVO.
- Administering personnel must be trained in the detection and management of airway obstruction, hypoventilation, and apnea, including the maintenance of a patent airway, supportive ventilation, and cardiovascular resuscitation.
- BYFAVO has been associated with hypoxia, bradycardia, and hypotension. Continuously monitor vital signs during sedation and during the recovery period.
- Resuscitative drugs, and age- and size-appropriate equipment for bag-valve-mask–assisted ventilation must be immediately available during administration of BYFAVO.
Risks From Concomitant Use With Opioid Analgesics and Other Sedative-Hypnotics
Concomitant use of benzodiazepines, including BYFAVO, and opioid analgesics may result in profound sedation, respiratory depression, coma, and death. The sedative effect of intravenous BYFAVO can be accentuated by concomitantly administered CNS depressant medications, including other benzodiazepines and propofol. Continuously monitor patients for respiratory depression and depth of sedation.
Contraindication
BYFAVO is contraindicated in patients with a history of severe hypersensitivity reaction to dextran 40 or products containing dextran 40.
Personnel and Equipment for Monitoring and Resuscitation
Clinically notable hypoxia, bradycardia, and hypotension were observed in Phase 3 studies of BYFAVO. Continuously monitor vital signs during sedation and through the recovery period. Only personnel trained in the administration of procedural sedation, and not involved in the conduct of the diagnostic or therapeutic procedure, should administer BYFAVO. Administering personnel must be trained in the detection and management of airway obstruction, hypoventilation, and apnea, including the maintenance of a patent airway, supportive ventilation, and cardiovascular resuscitation. Resuscitative drugs, and age- and size-appropriate equipment for bag-valve-mask–assisted ventilation must be immediately available during administration of BYFAVO. Consider the potential for worsened cardiorespiratory depression prior to using BYFAVO concomitantly with other drugs that have the same potential (e.g., opioid analgesics or other sedative-hypnotics). Administer supplemental oxygen to sedated patients through the recovery period. A benzodiazepine reversal agent (flumazenil) should be immediately available during administration of BYFAVO.
Risks From Concomitant Use With Opioid Analgesics and Other Sedative-Hypnotics
Concomitant use of BYFAVO and opioid analgesics may result in profound sedation, respiratory depression, coma, and death. The sedative effect of IV BYFAVO can be accentuated when administered with other CNS depressant medications (eg, other benzodiazepines and propofol). Titrate the dose of BYFAVO when administered with opioid analgesics and sedative-hypnotics to the desired clinical response. Continuously monitor sedated patients for hypotension, airway obstruction, hypoventilation, apnea, and oxygen desaturation. These cardiorespiratory effects may be more likely to occur in patients with obstructive sleep apnea, the elderly, and ASA-PS class III or IV patients.
Hypersensitivity Reactions
BYFAVO contains dextran 40, which can cause hypersensitivity reactions, including rash, urticaria, pruritus, and anaphylaxis. BYFAVO is contraindicated in patients with a history of severe hypersensitivity reaction to dextran 40 or products containing dextran 40.
Neonatal Sedation
Use of benzodiazepines during the later stages of pregnancy can result in sedation (respiratory depression, lethargy, hypotonia) in the neonate. Observe newborns for signs of sedation and manage accordingly.
Pediatric Neurotoxicity
Published animal studies demonstrate that anesthetic and sedation drugs that block NMDA receptors and/or potentiate GABA activity increase neuronal apoptosis in the developing brain and result in long-term cognitive deficits when used for longer than 3 hours. The clinical significance of this is not clear. However, the window of vulnerability to these changes is believed to correlate with exposures in the third trimester of gestation through the first several months of life but may extend out to approximately 3 years of age in humans.
Anesthetic and sedation drugs are a necessary part of the care of children needing surgery, other procedures, or tests that cannot be delayed, and no specific medications have been shown to be safer than any other. Decisions regarding the timing of any elective procedures requiring anesthesia should take into consideration the benefits of the procedure weighed against the potential risks.
Adverse Reactions
The most common adverse reactions reported in >10% of patients (N=630) receiving BYFAVO 5-30 mg (total dose) and undergoing colonoscopy (two studies) or bronchoscopy (one study) were: hypotension, hypertension, diastolic hypertension, systolic hypertension, hypoxia, and diastolic hypotension.
Use in Specific Populations
Pregnancy
There are no data on the specific effects of BYFAVO on pregnancy. Benzodiazepines cross the placenta and may produce respiratory depression and sedation in neonates. Monitor neonates exposed to benzodiazepines during pregnancy and labor for signs of sedation and respiratory depression.
Lactation
Monitor infants exposed to BYFAVO through breast milk for sedation, respiratory depression, and feeding problems. A lactating woman may consider interrupting breastfeeding and pumping and discarding breast milk during treatment and for 5 hours after BYFAVO administration.
Pediatric Use
Safety and effectiveness in pediatric patients have not been established. BYFAVO should not be used in patients less than 18 years of age.
Geriatric Use
No overall differences in safety or effectiveness were observed between these subjects and younger subjects. However, there is a potential for greater sensitivity (eg, faster onset, oversedation, confusion) in some older individuals. Administer supplemental doses of BYFAVO slowly to achieve the level of sedation required and monitor all patients closely for cardiorespiratory complications.
Hepatic Impairment
In patients with severe hepatic impairment, the dose of BYFAVO should be carefully titrated to effect. Depending on the overall status of the patient, lower frequency of supplemental doses may be needed to achieve the level of sedation required for the procedure. All patients should be monitored for sedation-related cardiorespiratory complications.
Abuse and Dependence
BYFAVO is a federally controlled substance (CIV) because it contains remimazolam which has the potential for abuse and physical dependence.
BYF HCP ISI 10/2020
© 2020 Acacia Pharma Group Plc
BYFAVO™ is a trademark owned or licensed by Cosmo Technologies Ltd.
About BARHEMSYS®
BARHEMSYS is a selective dopamine-2 (D2) and dopamine-3 (D3) receptor antagonist, which Acacia Pharma has developed and protected for the management of PONV.
BARHEMSYS is indicated in adults for:
- treatment of PONV in patients who have received antiemetic prophylaxis with an agent of a different class or who have not received prophylaxis
- prevention of PONV, either alone or in combination with an antiemetic of a different class
Important Safety Information for BARHEMSYS® (amisulpride) Injection
Contraindication
BARHEMSYS is contraindicated in patients with known hypersensitivity to amisulpride.
QT Prolongation
BARHEMSYS causes dose- and concentration-dependent prolongation of the QT interval. The recommended dosage is 5 mg or 10 mg as a single intravenous (IV) dose infused over 1 to 2 minutes.
Avoid BARHEMSYS in patients with congenital long QT syndrome and in patients taking droperidol.
Electrocardiogram (ECG) monitoring is recommended in patients with pre-existing arrhythmias/cardiac conduction disorders, electrolyte abnormalities (e.g., hypokalemia or hypomagnesemia), congestive heart failure, and in patients taking other medicinal products (e.g., ondansetron) or with other medical conditions known to prolong the QT interval.
Adverse Reactions
Common adverse reactions reported in ≥ 2% of adult patients who received BARHEMSYS 5 mg (n=748) and at a higher rate than placebo (n=741) in clinical trials for the prevention of PONV were: chills (4% vs. 3%), hypokalemia (4% vs. 2%), procedural hypotension (3% vs. 2%), and abdominal distention (2% vs. 1%).
Serum prolactin concentrations were measured in one prophylaxis study where 5% (9/176) of BARHEMSYS-treated patients had increased blood prolactin reported as an adverse reaction compared with 1% (1/166) of placebo-treated patients.
The most common adverse reaction, reported in ≥ 2% of adult patients who received BARHEMSYS 10 mg (n=418) and at a higher rate than placebo (n=416), in clinical trials for the treatment of PONV was infusion site pain (6% vs. 4%).
Use in Specific Populations
Lactation
Amisulpride is present in human milk. There are no reports of adverse effects on the breastfed child and no information on the effects of amisulpride on milk production.
BARHEMSYS may result in an increase in serum prolactin levels, which may lead to a reversible increase in maternal milk production. In a clinical trial, serum prolactin concentrations in females (n=112) increased from a mean of 10 ng/mL at baseline to 32 ng/mL after BARHEMSYS treatment and from 10 ng/mL to 19 ng/mL in males (n=61). No clinical consequences due to elevated prolactin levels were reported.
To minimize exposure to a breastfed infant, lactating women may consider interrupting breastfeeding and pumping and discarding breast milk for 48 hours after receiving a dose of BARHEMSYS.
Pediatric Use
Safety and effectiveness in pediatric patients have not been established.
Geriatric Use
No overall differences in safety or effectiveness were observed between these patients and younger patients, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.
Renal Impairment
Avoid BARHEMSYS in patients with severe renal impairment (estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73 m2). The pharmacokinetics of amisulpride in patients with severe renal impairment have not been adequately studied in clinical trials. Amisulpride is known to be substantially excreted by the kidneys, and patients with severe renal impairment may have increased systemic exposure and an increased risk of adverse reactions.
No dosage adjustment is necessary in patients with mild to moderate renal impairment (eGFR ≥ 30 mL/min/1.73 m2).
Drug Interactions
- BARHEMSYS causes dose- and concentration-dependent QT prolongation. To avoid potential additive effects, avoid use of BARHEMSYS in patients taking droperidol.
- ECG monitoring is recommended in patients taking other drugs known to prolong the QT interval (e.g., ondansetron).
- Reciprocal antagonism of effects occurs between dopamine agonists (e.g., levodopa) and BARHEMSYS. Avoid using levodopa with BARHEMSYS.
Forward looking statements
This announcement includes forward-looking statements, which are based on current expectations and projections about future events. These statements may include, without limitation, any statements preceded by, followed by or including words such as "believe", "expect", "intend", "may", "plan", "will", "should", "could" and other words and terms of similar meaning or the negative thereof. Forward-looking statements may and often do differ materially from actual results. These forward-looking statements are subject to risks, uncertainties and assumptions about the Company and its subsidiaries and investments, including, among other things, the development of its business, trends in its operating industry, and future capital expenditures and acquisitions. By their nature, forward-looking statements involve risk and uncertainty because they relate to future events and circumstances. Any forward-looking statements reflect the Company's current view with respect to future events and are subject to risks relating to future events and other risks, uncertainties and assumptions relating to the Group's business, results of operations, financial position, prospects, growth or strategies and the industry in which it operates. Save as required by law or applicable regulation, the Company and its affiliates expressly disclaim any obligation or undertaking to update, review or revise any forward-looking statement contained in this announcement whether as a result of new information, future developments or otherwise. Forward-looking statements speak only as of the date they are made.