The Medicines Company has discontinued its phase-3 Champion clinical trial programme of cangrelor in patients undergoing percutaneous coronary intervention (PCI).
The programme's independent Interim Analysis Review Committee (IARC), after conferring with the Drug Safety Monitoring Board, reported to the company that the Champion-Platform trial would not meet the goal of demonstrating persuasive evidence of clinical effectiveness that could form the basis for regulatory approval. This placebo-controlled trial compared treatment with cangrelor (in combination with usual care) to usual care in patients who require PCI.
The IARC also reported to the company that, based on updated information, the Champion-PCI trial, a clinical trial comparing treatment with cangrelor to clopidogrel (600 mg loading dose) in patients who require PCI, showed no significant differences in measures of clinical effectiveness.
Safety findings for the programme were consistent with those expected from short-term P2Y12 platelet inhibition and included an increase in minor bleeding among patients given cangrelor in comparison to placebo, but not in comparison to clopidogrel.
Based on the totality of these data, the IARC has recommended that enrolment in both trials be discontinued and that all remaining data should be collected and analyzed. The Company is in the process of notifying the investigators and regulatory agencies of the discontinuation of the Champion programme.
The IARC also recommended that the company should consider focusing on short-term use of cangrelor in settings where oral drugs cannot be used or when a short half-life is highly desirable. The company had previously begun studying cangrelor in such a setting. This research, known as the Bridge study aims to establish the dosage of cangrelor that achieves greater than or equal to 60 per cent inhibition of platelet aggregation for five days. The company plans to enrol approximately 200 patients who discontinue clopidogrel in preparation for cardiac surgery. The aim is to show safe 'bridging' of patients during the pre- and post-surgical period of risk. If successful, this approach may form the basis for subsequent regulatory filings.
"We are disappointed that the Champion programme has not provided sufficient evidence of the clinical effectiveness of cangrelor to warrant completion of these phase-3 trials. We thank the investigators and oversight committees for their work and we will follow their guidance. The trials are being discontinued; we plan to finalize data collection and analyses, and we expect that the data will be presented at a major cardiology meeting in due course. We will now move forward more quickly with our studies where cangrelor is tested to enable safe 'bridging' of patients undergoing surgery. In this setting of high unmet medical need, long-term clopidogrel is often discontinued at considerable risk to patients. The rapid onset, offset and titratable anti-platelet pharmacology of cangrelor seems ideally suited for this potential use. The development of cangrelor will therefore continue," said Clive Meanwell, chief executive officer of The Medicines Company.
"Looking longer term, it is important to note that The Medicines Company is not dependent on a single product. We have a diversified portfolio of current and pipeline products, industry-leading operational capabilities and we are cash flow positive. We believe the Company is well positioned to deliver future growth and long-term shareholder value. We remain committed to our strategy of building a leading global critical care hospital medicines business. We will continue to focus on our market-leading Angiomax product, the Angiox business, the ongoing Cleviprex launch in the United States and international Cleviprex regulatory filings now underway, advancing phase-3 trials of oritavancin and on our early stage development program with CU2010," he continued.
The company noted that the discontinuation of the Champion programme will result in cost savings of approximately $5 million in 2009.
Cangrelor is an investigational intravenous antiplatelet agent exclusively licensed in December 2003 from AstraZeneca.
The Medicines Company is focused on advancing the treatment of critical care patients through the delivery of innovative, cost-effective medicines to the worldwide hospital marketplace.