lunes, 25 de junio de 2018

OLUMIANT: New Drug Trials Snapshot Posted


A new  DRUG TRIALS SNAPSHOT is now available.
OLUMIANT is a drug for treatment of adult patients with rheumatoid arthritis (RA) whose disease was not well controlled using RA medications called Tumor Necrosis Factor (TNF) antagonists.
OLUMIANT is a tablet taken by mouth once daily.
See more  Drug Trials Snapshots or contact us with questions at Snapshots@fda.hhs.gov.

Drug Trials Snapshots: OLUMIANT

HOW TO USE THIS SNAPSHOT
The information provided in Snapshots highlights 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 OLUMIANT Package Insert for complete information.
OLUMIANT (baricitinib)
Ō-loo'-mēant
Eli Lilly and Company 
Approval date: May 31, 2018

DRUG TRIALS SNAPSHOT SUMMARY:

What is the drug for?

OLUMIANT is a drug for treatment of adult patients with rheumatoid arthritis (RA) whose disease was not well controlled using RA medications called Tumor Necrosis Factor (TNF) antagonists.

How is this drug used?

OLUMIANT is a tablet taken by mouth once daily.

What are the benefits of this drug?

In the clinical trials, a greater proportion of patients who received OLUMIANT achieved an improvement in the signs and symptoms of RA in comparison to patients who received a placebo.

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

  • Sex: OLUMIANT worked similarly in men and women.
  • Race: OLUMIANT worked similarly among studied races.
  • Age: OLUMIANT worked similarly in patients younger and older than 65 years of age.

What are the possible side effects?

OLUMIANT may cause life threatening infections, because it can decrease the ability of the immune system to fight infections.
Other serious side effects include blood clots in the legs called thrombosis, blood clots in the lungs called embolus, cancers, and tears in the stomach and intestines.
The most common side effects of OLUMIANT are upper respiratory infections, nausea, and herpes.

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 occurrence of side effects was similar among studied races.
  • Age: The occurrence of side effects was similar in patients younger and older than 65 years of age.

WHO WAS IN THE CLINICAL TRIALS?

Who participated in the clinical trials?

The FDA approved OLUMIANT based on evidence primarily from four clinical trials (Trial 1/NCT01711359, Trial 2/NCT01710358, Trial 3/NCT01721057, and Trial 4/NCT01721044) of 2456 patients with moderate to severe rheumatoid arthritis. The trials were conducted at 738 sites in Canada, Central America, Europe, Japan, South America, and the United states.
Figure 1 summarizes how many men and women were in the clinical trials used to evaluate side effects (safety population).
Figure 1. Baseline Demographics by Sex (safety population)
Pie chart summarizing how many males and females were in the clinical trials. In total, 504 men (20%) and 2042 (80%) women participated in the clinical trials.
FDA Review
Figure 2 summarizes the percentage of patients by race in the clinical trials used to evaluate side effects (safety population).
Figure 2. Baseline Demographics by Race (safety population)
Pie chart summarizing the percentage of patients by race enrolled in the clinical trials. In total, 1711 White (67%), 73 Black or African American (3%), 629 Asian (25%) and 123 Other patients (5%) participated in the clinical trials
FDA Review
Table 1. Demographics of Safety Trials by Race
RaceNumber of PatientsPercentage
White171167%
Black or African American733%
Asian62925%
American Indian or Alaska Native1044%
Native Hawaiin or Other Pacific Islander2less than 1%
Other221%
Missing5less than 1%
FDA Review
Figure 3 summarizes the percentage of patients by age based on the safety population.
Figure 3. Baseline Demographics by Age (safety population)
Pie charts summarizing how many individuals of certain age groups were enrolled in the clinical trials. In total, 2092 patients (82%) were less than 65 years old, and 454 patients (18%) were 65 years and older
FDA Review

How were the trials designed?

The benefit and side effects of OLUMIANT* were evaluated primarily in four clinical trials of patients with moderate to severely active rheumatoid arthritis. Each trial had a different design and/or treatment duration.
Trial 1: Trial 1 evaluated patients with rheumatoid arthritis, who had not received more than 3 doses of methotrexate, and never received drugs to slow progression of arthritis. Patients were randomly assigned to receive baricitinib 4 mg, baricitinib 4 mg plus methotrexate, or methotrexate daily for 52 weeks. Neither the patients nor the healthcare providers knew which treatment was being given until after the trial was completed. The benefit of OLUMIANT was assessed using ACR20 after 24 weeks of treatment by comparing baricitinib 4 mg alone to baricitinib 4 mg plus methotrexate and to methotrexate alone. ACR20 measures 20% improvement of arthritis. The ACR20 response is based on standardized criteria used to assess the benefit of arthritis medications on signs and symptoms of RA, such as improvement in the number of tender and swollen joints.
Trial 2: Trial 2 evaluated patients with rheumatoid arthritis who did not improve on methotrexate. Patients were randomly assigned to receive baricitinib 4 mg once daily, adalimumab (a drug that treats RA) every 2 weeks, or placebo, as additions to treatment with methotrexate, for 52 weeks. Neither the patients nor the healthcare providers knew which treatment was being given until after the trial was completed. The benefit of OLUMIANT was assessed using ACR20 after 12 weeks of treatment by comparing baricitinib 4 mg to adalimumab and placebo. From Week 16, patients that did not respond to treatment could receive baricitinib 4 mg once daily.
Trial 3: Trial 3 evaluated patients with rheumatoid arthritis, who did not improve on or tolerate drugs that slow the progression of rheumatoid arthritis. Patients were randomly assigned to receive OLUMIANT, baricitinib 4 mg, or placebo added to existing treatment with drugs that slow the progression of rheumatoid arthritis for 24 weeks. The benefit of OLUMIANT was assessed using ACR20 after 12 weeks of treatment by comparing OLUMIANT to and placebo. From Week 16, patients that did not respond to treatment could receive baricitinib 4 mg once daily.
Trial 4: Trial 4 evaluated patients with rheumatoid arthritis, who did not improve on or tolerate drugs that slow the progression of rheumatoid arthritis. Patients received OLUMIANT or baricitinib 4 mg once daily, or placebo added to treatment with drugs that slow the progression of rheumatoid arthritis for 24 weeks. The benefit of OLUMIANT was assessed using ACR20 after 12 weeks of treatment by comparing OLUMIANT to placebo. From Week 16, patients who did not respond to treatment, could receive baricitinib 4 mg once daily.
*OLUMIANT is equivalent to baricitinib 2 mg, baricitinib 4 mg is not an approved dose.

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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