Genentech, Inc. announced today a phased voluntary withdrawal of the
psoriasis drug Raptiva® (efalizumab) from the U.S. market.
The company’s decision is based on the association of Raptiva with an
increased risk of progressive multifocal leukoencephalopathy (PML), a
rare and usually fatal disease of the central nervous system. Raptiva is
indicated for the treatment of chronic moderate-to-severe plaque
psoriasis in adults 18 years or older who are candidates for systemic
therapy or phototherapy.
Effective immediately, physicians should not issue prescriptions for
Raptiva for any new patients and should promptly contact patients
currently receiving Raptiva to assess the most appropriate treatment
alternatives. Raptiva will no longer be available after June 8, 2009.
This transition period is intended to allow patients, who are currently
taking Raptiva, enough time to work with their doctors to appropriately
discontinue use of Raptiva. Because of the potential for severe
psoriasis worsening with abrupt discontinuation of Raptiva, it is
important that patients talk with their doctor before stopping treatment.
Genentech estimates that approximately 2,000 patients in the United
States may currently be receiving Raptiva for chronic plaque psoriasis.
Since FDA approval in 2003, approximately 46,000 patients worldwide have
been treated with Raptiva.
"Our decision to remove Raptiva from the market reflects Genentech’s
commitment to patient safety,” said Hal Barron, M.D., Genentech's senior
vice president, development and chief medical officer. "Although we
believe that many psoriasis patients are benefiting from Raptiva, the
balance between benefit and risk in the psoriasis population for which
Raptiva was approved has significantly changed.”
The Raptiva prescribing information was updated in October 2008 to
include a boxed warning on the risk of serious infections, including
PML, in patients receiving Raptiva. The Raptiva prescribing information
was further updated in March 2009 to include additional information on
the risk of PML and a new Medication Guide for patients.
There have been three cases of diagnosed PML in patients receiving
Raptiva and one patient treated with Raptiva who developed progressive
neurologic symptoms and died of unknown cause. It is not known whether
other, unreported cases have occurred. Dear Healthcare Provider letters
were issued to inform prescribers about the risk of PML with Raptiva as
these cases were identified.
The company has taken immediate steps to inform potential prescribers,
patients, clinical trial investigators, and distributors of the decision
to withdraw Raptiva from the market in the United States. Copies of
these letters have been posted today to the Genentech web site http://www.gene.com
and are available by clicking the Raptiva link at http://www.gene.com/gene/products.
Physicians with questions about Raptiva use may contact Genentech
Medical Communications at 1-800-821-8590.
The company’s actions have been taken after consultation with the U.S.
Food and Drug Administration. Genentech is working with Merck Serono,
its licensee outside the U.S. and Japan to inform regulatory authorities
outside of the United States of Genentech’s decision to withdraw Raptiva
from the U.S. market.
For the full year 2008, U.S. sales of Raptiva were approximately $108
million. As a result of the phased withdrawal and resultant excess
Raptiva inventories, the company will be reporting a
one-time cost-of-sales charge of approximately $125 million in its
results for the first half of 2009. After taking into account taxes and
non-controlling interests, the impact on the Group's net income and EPS
will not be significant, and Roche’s previously communicated targets for
2009 are not affected by this.
About PML
PML is a rare, progressive, demyelinating disease of the central nervous
system that leads to death or severe disability. PML is caused by
activation of the John Cunningham, (JC) virus. The JC virus resides in
latent form in up to 80 percent of healthy adults, typically only
causing PML in immunocompromised patients. The factors leading to
activation of the latent infection are not fully understood, though
abnormalities in T-cells may be important for reactivation and PML. PML
has been reported in the published literature in HIV-positive patients,
as well as immunosuppressed cancer patients (including patients with
hematologic malignancies), organ transplant recipients, and patients
with autoimmune diseases. There are no known interventions that can
reliably prevent or adequately treat PML.
About Psoriasis
Psoriasis occurs when new skin cells grow abnormally, resulting in
thick, red, and scaly, inflamed patches. Plaque psoriasis, the most
common form of the disease, affects approximately 2.3 million Americans
and is characterized by inflamed patches of skin ("lesions") topped with
silvery white scales. Psoriasis can be limited to a few spots or involve
extensive areas of the body, appearing most commonly on the scalp,
knees, elbows and trunk. Although it is highly visible, psoriasis is not
a contagious disease. While there are a number of medications that may
help control the symptoms of psoriasis, there currently is no known cure.
About Genentech
Founded more than 30 years ago, Genentech is a leading biotechnology
company that discovers, develops, manufactures and commercializes
medicines to treat patients with serious or life-threatening medical
conditions. The company, a wholly-owned member of the Roche Group, has
headquarters in South San Francisco, California. For additional
information about the company, please visit http://www.gene.com.