Statistically Significant Decrease in Blood Pressure in Hard-to-Treat Patient Population
FOSTER CITY, Calif.--(BUSINESS WIRE)--Apr. 2, 2009--
Gilead Sciences, Inc. (Nasdaq: GILD) today announced that DAR-311
(DORADO), a Phase III clinical trial evaluating the company’s endothelin
receptor antagonist (ERA) darusentan for the treatment of resistant
hypertension, met its co-primary efficacy endpoints of change from
baseline to week 14 in trough sitting systolic blood pressure (SBP) and
trough sitting diastolic blood pressure (DBP). DORADO is one of two
ongoing Phase III clinical trials evaluating the safety, efficacy and
tolerability of darusentan as an add-on treatment for resistant
hypertension, defined as the failure to achieve goal blood pressure
while adhering to full doses of an appropriate three-drug regimen that
includes a diuretic. The second study, DAR-312 (DORADO-AC), is
approximately 90 percent enrolled and is expected to be completed by the
end of 2009.
In the DAR-311 study, reductions in mean trough sitting SBP from
baseline of 8.6 mmHg, 16.5 mmHg, 18.1 mmHg and 18.1 mmHg were observed
for the placebo, darusentan 50 mg, 100 mg and 300 mg groups,
respectively, after 14 weeks of treatment. Reductions in mean trough
sitting DBP from baseline of 5.3 mmHg, 10.1 mmHg, 9.9 mmHg and 10.7 mmHg
were observed for the placebo, darusentan 50 mg, 100 mg and 300 mg
groups, respectively, after 14 weeks of treatment. These results were
statistically significant for all darusentan groups (p<0.001).
The most common treatment-emergent adverse event was peripheral
edema/fluid retention, which was reported in 17, 32, 36 and 29 percent
of patients in the placebo, darusentan 50 mg, 100 mg and 300 mg groups,
respectively. Most cases were mild to moderate in severity. Across all
study groups, 0 percent, 1.2 percent, 4.9 percent and 5.9 percent of
patients in the placebo, darusentan 50 mg, 100 mg and 300 mg groups,
respectively, discontinued study drug due to edema. Decreases in
hemoglobin (0.19 g/dL, 0.92 g/dL, 0.93 g/dL and 1.08 g/dL in the
placebo, darusentan 50 mg, 100 mg and 300 mg, respectively) and
decreases in hematocrit (0.89 percent, 2.89 percent, 2.54 percent and
2.88 percent in the placebo, darusentan 50 mg, 100 mg and 300 mg,
respectively) were also observed. Liver function test results were
comparable between treatment groups. Observed serum aminotransferase
concentrations above three times the upper limit of the normal range
were reported in three patients, one each in the placebo, 100 mg and 300
mg darusentan groups. One death (sudden cardiac death) occurred during
the study; this patient was receiving placebo. Full study results
highlighting efficacy and safety will be submitted for presentation at a
scientific meeting later this year.
“Failure to control blood pressure elevates the risk of a number of
life-threatening cardiovascular conditions such as stroke, heart attack
and heart failure, suggesting an unmet need for novel antihypertensive
drugs with unique mechanisms of action that can be added to existing
treatment regimens in patients with resistant hypertension. In this
study, more than half of the patients treated with darusentan achieved
goal blood pressure, as compared to approximately one quarter of
patients receiving placebo,” said Norbert Bischofberger, PhD, Gilead’s
Executive Vice President, Research and Development and Chief Scientific
Officer. “We look forward to presenting full results from this study and
to completing our second Phase III study, which will further
characterize darusentan’s safety and efficacy profile.”
Darusentan is an investigational compound and has not yet been
determined safe or efficacious in humans.
About the Phase III DORADO Clinical
Program
The DORADO program is designed to evaluate the safety and efficacy of
darusentan for reducing SBP and DBP in resistant hypertension patients
currently treated with full doses of three or more antihypertensive
medications, one of which is a diuretic.
DORADO (DAR-311) is an international Phase III double-blind,
placebo-controlled parallel group trial, in which 379 patients were
randomized to receive once-daily doses of darusentan 50 mg (n=81), 100
mg (n=81), 300 mg (n=85) or placebo (n=132).
DORADO-AC (DAR-312) is an international Phase III double-blind, placebo-
and active-controlled, parallel group trial, in which approximately 770
patients will be randomized to receive darusentan (titrated to the
optimal dose of 50, 100 or 300 mg once daily), an active comparator
(guanfacine 1 mg once daily) or placebo. The co-primary endpoints of the
trial are the changes from baseline to week 14 in trough sitting SBP and
trough sitting DBP, as measured by sphygmomanometry.
For both studies, patients who complete the 14-week assessment period
are eligible to enroll in long-term safety studies (DAR-311E and
DAR-312E).
About Darusentan
Darusentan is a propanoic-acid class endothelin receptor antagonist
(ERA) being investigated in clinical trials as an add-on oral therapy
for patients with resistant hypertension. Darusentan selectively blocks
the endothelin type-A (ETA) receptor, which if activated by
endothelin-1 (ET-1), leads to vasoconstriction (narrowing of blood
vessels) and cell proliferation. Elevated ET-1 blood concentrations have
been reported in some patients with hypertension, including several
subgroups of hypertensive patients that have been historically difficult
to treat.
About Resistant Hypertension
Resistant hypertension is defined as the failure to achieve goal blood
pressure in patients who are adhering to full doses of an appropriate
three-drug regimen that includes a diuretic. According to the Seventh
Joint National Committee on the Prevention, Detection, Evaluation and
Treatment (JNC7), an SBP of less than 140 mmHg and a DBP of less than 90
mmHg are recommended for patients with hypertension and no other serious
conditions. For patients with diabetes and chronic renal disease, target
systolic and diastolic blood pressures are more stringent – a SBP goal
of less than 130 mmHg and a DBP goal of less than 80 mmHg.
Hypertension affects approximately one billion people worldwide. While
the exact number of patients classified as resistant is unknown,
estimates suggest a prevalence of anywhere between two percent and five
percent of hypertensive patients in general practice settings in the
United States, with significantly higher rates in specialty referral
clinics. Failure to control hypertension elevates the risk of stroke,
coronary artery disease, myocardial infarction, heart failure, kidney
disease and cardiovascular mortality. Currently, there is no accepted
standard of care for treatment of patients with resistant hypertension.
About Gilead Sciences
Gilead Sciences is a biopharmaceutical company that discovers, develops
and commercializes innovative therapeutics in areas of unmet medical
need. The company’s mission is to advance the care of patients suffering
from life-threatening diseases worldwide. Headquartered in Foster City,
California, Gilead has operations in North America, Europe and Australia.
This press release includes forward-looking statements, within the
meaning of the Private Securities Litigation Reform Act of 1995, that
are subject to risks, uncertainties and other factors, including risks
related to Gilead’s ability to complete the DORADO-AC clinical trial in
the timelines currently contemplated. In addition, safety and efficacy
data from the DORADO and DORADO-AC clinical trials may not warrant
further development of darusentan for the treatment of resistant
hypertension and feedback from regulatory authorities or results from
clinical trials might result in delays or require additional trials to
be performed. These risks, uncertainties and other factors could cause
actual results to differ materially from those referred to in the
forward-looking statements. The reader is cautioned not to rely on these
forward-looking statements. These and other risks are described in
detail in Gilead’s Annual Report on Form 10-K for the year ended
December 31, 2008, as filed with the U.S. Securities and Exchange
Commission. All forward-looking statements are based on information
currently available to Gilead, and Gilead assumes no obligation to
update any such forward-looking statements.
For more information on Gilead, please call the Gilead Public Affairs
Department at
1-800-GILEAD-5 (1-800-445-3235) or visit www.gilead.com.
Source: Gilead Sciences, Inc.
Gilead Sciences, Inc.
Susan Hubbard, 650-522-5715 (Investors)
Amy
Flood, 650-522-5643 (Media)