For Relapsing Forms of Multiple Sclerosis
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Therapeutic Use of a Selective S1P1 Receptor Modulator Ponesimod in Autoimmune Diabetes
Therapeutic Use of a Selective S1P1 Receptor Modulator Ponesimod in Autoimmune Diabetes Sylvaine You1,2, Luca Piali3, Chantal Kuhn1,2, Beat Steiner3, Virginia Sauvaget1,2, Fabrice Valette1,2, Martine Clozel3, Jean-Franc¸ois Bach1,2, Lucienne Chatenoud1,2* 1 Universite´ Paris Descartes, Sorbonne Paris Cite´, Paris, France, 2 Institut National de la Sante´ et de la Recherche Me´dicale, Unite´ 1013, Paris, France, 3 Actelion Pharmaceuticals Ltd, Allschwil, Switzerland Abstract In the present study, we investigated the therapeutic potential of a selective S1P1 receptor modulator, ponesimod, to protect and reverse autoimmune diabetes in non-obese diabetic (NOD) mice. Ponesimod was administered orally to NOD mice starting at 6, 10, 13 and 16 weeks of age up to 35 weeks of age or to NOD mice showing recent onset diabetes. Peripheral blood and spleen B and T cell counts were significantly reduced after ponesimod administration. In pancreatic lymph nodes, B lymphocytes were increased and expressed a transitional 1-like phenotype. Chronic oral ponesimod treatment efficiently prevented autoimmune diabetes in 6, 10 and 16 week-old pre-diabetic NOD mice. Treatment withdrawal led to synchronized disease relapse. Ponesimod did not inhibit the differentiation of autoreactive T cells as assessed by adoptive transfer of lymphocytes from treated disease-free NOD mice. In addition, it did not affect the migration, proliferation and activation of transgenic BDC2.5 cells into the target tissue. However, ponesimod inhibited spreading of the T cell responses to islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP). Treatment of diabetic NOD mice with ponesimod induced disease remission. However, here again, upon treatment cessation, the disease rapidly recurred. -
From the Academy
FROM THE ACADEMY Joint American Academy of DermatologyeNational Psoriasis Foundation guidelines of care for the management and treatment of psoriasis with phototherapy Craig A. Elmets, MD (Co-Chair),a HenryW.Lim,MD,b Benjamin Stoff, MD, MA,c Cody Connor, MD,a Kelly M. Cordoro, MD,d Mark Lebwohl, MD,e AprilW.Armstrong,MD,MPH,f Dawn M. R. Davis, MD,g Boni E. Elewski, MD,a Joel M. Gelfand, MD, MSCE,h Kenneth B. Gordon, MD,i AliceB.Gottlieb,MD,PhD,j Daniel H. Kaplan, MD, PhD,k Arthur Kavanaugh, MD,l Matthew Kiselica, BA/BS,m Dario Kivelevitch, MD,n Neil J. Korman, MD, PhD,o Daniela Kroshinsky, MD, MPH,p Craig L. Leonardi, MD,q Jason Lichten, MD,m NehalN.Mehta,MD,MSCE,r Amy S. Paller, MD,s Sylvia L. Parra, MD,t Arun L. Pathy, MD,u Elizabeth A. Farley Prater, MD,v Reena N. Rupani, MD,e Michael Siegel, PhD,m BruceE.Strober,MD,PhD,w,x Emily B. Wong, MD,y Jashin J. Wu, MD,z Vidhya Hariharan, PhD,aa and Alan Menter, MD (Co-Chair)n Birmingham, Alabama; Detroit, Michigan; Atlanta, Georgia; San Francisco, Los Angeles, San Diego, and Irvine, California; New York, New York; Rochester, Minnesota; Philadelphia and Pittsburgh, Pennsylva- nia; Milwaukee, Wisconsin; Portland, Oregon; Dallas and San Antonio, Texas; Cleveland, Ohio; Boston, Massachusetts; St. Louis, Missouri; Bethesda, Maryland; Chicago and Rosemont, Illinois; Sumter, South Carolina; Centennial, Colorado; Oklahoma City, Oklahoma; Farmington, Connecticut; and Waterloo, Ontario, Canada Psoriasis is a chronic inflammatory disease involving multiple organ systems and affecting approximately 3.2% of the world’s population. -
AUBAGIO* (Teriflunomide)
AUBAGIO* (teriflunomide) * Bolded medications are the preferred products RATIONALE FOR INCLUSION IN PA PROGRAM Background Aubagio (teriflunomide) is indicated for relapsing multiple sclerosis. It is an anti-inflammatory immunomodulatory agent, which inhibits dihydroorotate dehydrogenase, a mitochondrial enzyme involved in de novo pyrimidine synthesis. The exact mechanism by which teriflunomide exerts its therapeutic effect in multiple sclerosis is unknown, but may involve a reduction in the number of activated lymphocytes in the CNS (1). Regulatory Status FDA-approved indication: Aubagio is a pyrimidine synthesis inhibitor indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing- remitting disease, and active secondary progressive disease (1). The Aubagio label includes a boxed warning citing the risk of hepatotoxicity. Aubagio is contraindicated in patients with severe hepatic impairment. Severe liver injury, including fatal liver failure, has been reported in patients treated with leflunomide, which is indicated for rheumatoid arthritis. A similar risk would be expected for teriflunomide because recommended doses of teriflunomide and leflunomide result in a similar range of plasma concentrations of teriflunomide. Concomitant use of Aubagio with other potentially hepatotoxic drugs may increase the risk of severe liver injury. Obtain transaminase and bilirubin levels within 6 months before initiation of Aubagio and monitor ALT levels at least monthly for six months after starting Aubagio. If drug induced liver injury is suspected, discontinue Aubagio and start an accelerated elimination procedure. Elimination of Aubagio can be accelerated by administration of cholestyramine or activated charcoal for 11 days (1). Aubagio also carries a boxed warning on the risk of teratogenicity. -
Sphingosine-1-Phosphate: Its Pharmacological Regulation and the Treatment of Multiple Sclerosis: a Review Article
biomedicines Review Sphingosine-1-Phosphate: Its Pharmacological Regulation and the Treatment of Multiple Sclerosis: A Review Article Stanley Cohan, Elisabeth Lucassen, Kyle Smoot, Justine Brink and Chiayi Chen * Providence Multiple Sclerosis Center, Providence Brain and Spine Institute, Providence St, Vincent Medical Center, Portland, OR 97225, USA; [email protected] (S.C.); [email protected] (E.L.); [email protected] (K.S.); [email protected] (J.B.) * Correspondence: [email protected]; Tel.: +1-503-216-1012 Received: 27 May 2020; Accepted: 15 July 2020; Published: 18 July 2020 Abstract: Sphingosine-1-phosphate (S1P), via its G-protein-coupled receptors, is a signaling molecule with important regulatory properties on numerous, widely varied cell types. Five S1P receptors (S1PR1-5) have been identified, each with effects determined by their unique G-protein-driven downstream pathways. The discovery that lymphocyte egress from peripheral lymphoid organs is promoted by S1P via S1PR-1 stimulation led to the development of pharmacological agents which are S1PR antagonists. These agents promote lymphocyte sequestration and reduce lymphocyte-driven inflammatory damage of the central nervous system (CNS) in animal models, encouraging their examination of efficacy in the treatment of multiple sclerosis (MS). Preclinical research has also demonstrated direct protective effects of S1PR antagonists within the CNS, by modulation of S1PRs, particularly S1PR-1 and S1PR-5, and possibly S1PR-2, independent of effects upon lymphocytes. Three of these agents, fingolimod, siponimod and ozanimod have been approved, and ponesimod has been submitted for regulatory approval. In patients with MS, these agents reduce relapse risk, sustained disability progression, magnetic resonance imaging markers of disease activity, and whole brain and/or cortical and deep gray matter atrophy. -
Annual Report on Annual Reports 2016
ANNUAL REPORT ON ANNUAL REPORTS 2016 TOP 400 ANNUAL REPORTS WHO RANKS WHERE? 100 ANNUALS IN BRIEF BEST REPORTING PRACTICES Company Value > Report Value Annual Report on Annual Reports 2016 Contents Report rating scale 3 Top 400 annual reports 4 Who ranks where? 25 From ABB to ZTE 100 annuals in brief 58 From Abbott to Yamaha How important is the annual report today? 92 Views from Cecilia Ketels, Kellie Friery, Renee Carter, David Robinson, Kaevan Gazdar, Elena Moskvina, Thomas Rosenmayr, Rob Stangroom, Andrey Kozhevnikov, Ana Santamarina, Katie Holcomb, Ananda Jagoda Best practices on key report attibutes 100 Strategy, message, investor information, risks, style, online… How we make it 121 How is your report doing? The report scan 127 The report rating panel 128 Robert Berick, Susan Blesener, Renee Carter, Vero Escarmelle, Helena Fournial, Kaevan Gazdar, Mike Guillaume, Pradip Seth, Eva Wolosiuk Making reports pay off 133 e.com – ReportWatch 135 2 Report rating scale A+ ééééé First-rate A éééé(é) Excellent A- éééé Very good B+ ééé(é) Sound B ééé Average B- éé(é) Uneven C+ éé Common C é(é) Substandard C- é Poor D (é) Uncompetitive 3 Top 400 annual reports AkzoNobel (No. 1) Electrolux (No. 2 ) SCA (No. 3) Volvo (No. 4) 4 Report rank Company Country Report rating Compare 1 AKZONOBEL Netherlands A+ DUPONT 2 ELECTROLUX Sweden A+ WHIRLPOOL 3 SCA Sweden A+ KIMBERLY-CLARK 4 VOLVO Sweden A+ DAIMLER 5 POTASHCORP Canada A+ AGRIUM 6 ATLAS COPCO Sweden A SANDVIK 7 STORA ENSO Finland A UPM 8 BOLIDEN Sweden A GLENCORE 9 WIENERBERGER Austria A BORAL 10 -
Oral MS Disease-Modifying Therapies C21142-A
Drug and Biologic Coverage Criteria Effective Date: 05/01/2019 Last P&T Approval/Version: 07/28/2021 Next Review Due By: 08/2022 Policy Number: C21142-A Oral MS Disease-Modifying Therapies PRODUCTS AFFECTED Mayzent (siponimod), Aubagio (teriflunomide), Gilenya (fingolimod), Mavenclad (cladribine), Tecfidera (dimethyl fumarate), Vumerity (diroximel fumarate), Bafiertam (monomethyl fumarate),dimethyl fumarate, Zeposia (ozanimod), Ponvory (ponesimod) COVERAGE POLICY Coverage for services, procedures, medical devices, and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Coverage Guideline must be read in its entirety to determine coverage eligibility, if any. This Coverage Guideline provides information related to coverage determinations only and does not imply that a service or treatment is clinically appropriate or inappropriate. The provider and the member are responsible for all decisions regarding the appropriateness of care. Providers should provide Molina Healthcare complete medical rationale when requesting any exceptions to these guidelines Documentation Requirements: Molina Healthcare reserves the right to require that additional documentation be made available as part of its coverage determination; quality improvement; and fraud; waste and abuse prevention processes. Documentation required may include, but is not limited to, patient records, test results and credentials of the provider ordering or performing a drug or service. Molina Healthcare may deny reimbursement or take additional appropriate action if the documentation provided does not support the initial determination that the drugs or services were medically necessary, not investigational or experimental, and otherwise within the scope of benefits afforded to the member, and/or the documentation demonstrates a pattern of billing or other practice that is inappropriate or excessive DIAGNOSIS: Multiple Sclerosis REQUIRED MEDICAL INFORMATION: A. -
Risk Assessment and Risk Mitigation Review(S)
CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 213498Orig1s000 RISK ASSESSMENT and RISK MITIGATION REVIEW(S) Division of Risk Management (DRISK) Office of Medication Error Prevention and Risk Management (OMEPRM) Office of Surveillance and Epidemiology (OSE) Center for Drug Evaluation and Research (CDER) Application Type NOA Application Number 213498 POU FA Goal Date March 18, 2021 OSE RCM # 2020-534 Reviewer Name(s) Carlisha Gentles, PharmD, BCPS Team Leader Jacqueline Sheppard, PharmD Deputy Director Doris Auth, PharmD Review Completion Date March 2, 2021 Subject Eva luation of Need for a REMS Established Name Ponesimod Trade Name Ponvory Name of Applicant Janssen Pharmaceuticals Inc Therapeutic Class Sphingosine 1-phosphate (SlP) receptor modulator Formulation(s) Film-coated tablets: 2 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7 mg, 8 mg, 9 mg, 10 mg, 20 mg Dosing Regimen Treatment init iation with a 14-day titration (see table), followed by a maintenance regimen of 20 mg orally once daily Treatment init iation titration: Titration Day Daily Dose Day 1 a nd 2 2mg Day 3 a nd 4 3mg Day 5 a nd 6 4mg Day7 Smg Dav8 6mg Day9 7mg Day10 8mg Day ll 9mg Day 12, 13, and 14 10mg 1 Reference ID 4755518 Table of Contents EXECUTIVE SUMMARY ......................................................................................................................................................... 3 1 Introduction .................................................................................................................................................................... -
COMPARISON of the WHO ATC CLASSIFICATION & Ephmra/Intellus Worldwide ANATOMICAL CLASSIFICATION
COMPARISON OF THE WHO ATC CLASSIFICATION & EphMRA/Intellus Worldwide ANATOMICAL CLASSIFICATION: VERSION June 2019 2 Comparison of the WHO ATC Classification and EphMRA / Intellus Worldwide Anatomical Classification The following booklet is designed to improve the understanding of the two classification systems. The development of the two systems had previously taken place separately. EphMRA and WHO are now working together to ensure that there is a convergence of the 2 systems rather than a divergence. In order to better understand the two classification systems, we should pay attention to the way in which substances/products are classified. WHO mainly classifies substances according to the therapeutic or pharmaceutical aspects and in one class only (particular formulations or strengths can be given separate codes, e.g. clonidine in C02A as antihypertensive agent, N02C as anti-migraine product and S01E as ophthalmic product). EphMRA classifies products, mainly according to their indications and use. Therefore, it is possible to find the same compound in several classes, depending on the product, e.g., NAPROXEN tablets can be classified in M1A (antirheumatic), N2B (analgesic) and G2C if indicated for gynaecological conditions only. The purposes of classification are also different: The main purpose of the WHO classification is for international drug utilisation research and for adverse drug reaction monitoring. This classification is recommended by the WHO for use in international drug utilisation research. The EphMRA/Intellus Worldwide classification has a primary objective to satisfy the marketing needs of the pharmaceutical companies. Therefore, a direct comparison is sometimes difficult due to the different nature and purpose of the two systems. -
Sales of $20.7 Billion Reflecting Growth of 1.9%, Operational Growth of 3.2
RESULTS HAVE BEEN UPDATED IN ACCORDANCE WITH THE FORM 8-K FILED ON OCTOBER 23, 2019 JOHNSON & JOHNSON REPORTS 2019 THIRD-QUARTER RESULTS: • Sales of $20.7 billion reflecting growth of 1.9%, operational growth of 3.2%* and adjusted operational growth of 5.2%* • EPS of $0.66 decreased (54.2)%; adjusted EPS of $2.12 increased 3.4%* • Company increasing Full Year Sales and EPS guidance due to strong performance New Brunswick, N.J. (October 23, 2019) – Johnson & Johnson (NYSE: JNJ) today announced results for third-quarter 2019. “Our third-quarter results represent strong performance, driven by competitive underlying growth in Pharmaceuticals and Medical Devices, as well as continued optimization in our Consumer business,” said Alex Gorsky, Chairman and Chief Executive Officer. “As we look ahead, we remain confident in the strength of our broad-based business model, which is fueled by our disciplined portfolio management, focus on transformational innovation and dedicated employees around the world who position us for success today and well into the future.” OVERALL FINANCIAL RESULTS: THIRD QUARTER ($ in Millions, except EPS) 2019 2018 % Change Reported Sales $ 20,729 $ 20,348 1.9% Net Earnings 1,753 3,934 (55.4) EPS (diluted) $ 0.66 $ 1.44 (54.2) Non-GAAP* THIRD QUARTER ($ in Millions, except EPS) 2019 2018 % Change Operational Sales1,2 3.2% Adjusted Operational Sales1,3 5.2 Adjusted Net Earnings1,4 5,672 5,590 1.5 Adjusted EPS (diluted)1,4 $ 2.12 $ 2.05 3.4 1 Non-GAAP financial measure; refer to reconciliations of non-GAAP financial measures -
Teriflunomide (Aubagio) Reference Number: CP.PHAR.262 Effective Date: 08.01.16 Last Review Date: 05.20 Line of Business: Commercial, HIM, Medicaid Revision Log
Clinical Policy: Teriflunomide (Aubagio) Reference Number: CP.PHAR.262 Effective Date: 08.01.16 Last Review Date: 05.20 Line of Business: Commercial, HIM, Medicaid Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description Teriflunomide (Aubagio®) is a pyrimidine synthesis inhibitor. FDA Approved Indication(s) Aubagio is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. Policy/Criteria Provider must submit documentation (such as office chart notes, lab results or other clinical information) supporting that member has met all approval criteria. It is the policy of health plans affiliated with Centene Corporation® that Aubagio is medically necessary when the following criteria are met: I. Initial Approval Criteria A. Multiple Sclerosis (must meet all): 1. Diagnosis of one of the following (a, b, or c): a. Clinically isolated syndrome; b. Relapsing-remitting MS; c. Secondary progressive MS; 2. Prescribed by or in consultation with a neurologist; 3. Age ≥ 18 years; 4. Aubagio is not prescribed concurrently with other disease modifying therapies for MS (see Appendix D); 5. At the time of request, member is not receiving leflunomide; 6. Dose does not exceed 14 mg (1 tablet) per day. Approval duration: 6 months B. Other diagnoses/indications 1. Refer to the off-label use policy for the relevant line of business if diagnosis is NOT specifically listed under section III (Diagnoses/Indications for which coverage is NOT authorized): CP.PMN.53 for Medicaid. II. Continued Therapy A. -
FDA Listing of Authorized Generics As of July 1, 2021
FDA Listing of Authorized Generics as of July 1, 2021 Note: This list of authorized generic drugs (AGs) was created from a manual review of FDA’s database of annual reports submitted to the FDA since January 1, 1999 by sponsors of new drug applications (NDAs). Because the annual reports seldom indicate the date an AG initially entered the market, the column headed “Date Authorized Generic Entered Market” reflects the period covered by the annual report in which the AG was first reported. Subsequent marketing dates by the same firm or other firms are not included in this listing. As noted, in many cases FDA does not have information on whether the AG is still marketed and, if not still marketed, the date marketing ceased. Although attempts have been made to ensure that this list is as accurate as possible, given the volume of d ata reviewed and the possibility of database limitations or errors, users of this list are cautioned to independently verify the information on the list. We welcome comments on and suggested changes (e.g., additions and deletions) to the list, but the list may include only information that is included in an annual report. Please send suggested changes to the list, along with any supporting documentation to: [email protected] A B C D E F G H I J K L M N O P Q R S T U V X Y Z NDA Applicant Date Authorized Generic Proprietary Name Dosage Form Strength Name Entered the Market 1 ACANYA Gel 1.2% / 2.5% Bausch Health 07/2018 Americas, Inc. -
Immunosuppressive Therapy DR
OCTOBER 2017 Immunosuppressive Therapy DR. ANDREW MACKIN BVSc BVMS MVS DVSc FANZCVSc DipACVIM Professor of Small Animal Internal Medicine Mississippi State University College of Veterinary Medicine, Starkville, MS A number of established immunosuppressive agents have been used in small animal medicine for many decades. Some have justifiably fallen out of favor whereas, for others, new and promising uses have been described in the recent veterinary literature. Established “old favorites” have included cyclophosphamide, chlorambucil, azathioprine, danazol and vincristine, although cyclophosphamide and danazol are rarely used as immunosuppressive agents these days. Several potent immunosuppressive drugs developed over the past few decades in human medicine have recently made the leap to our small animal patients, and our use of drugs such as cyclosporine, leflunomide and mycophenolate is growing. Cyclophosphamide Cyclophosphamide, a cell-cycle nonspecific nitrogen mustard derivative alkylating agent, was one of the first major chemotherapeutic agents approved by the FDA over 50 years ago, and has since become very well-established in human medicine as both an antineoplastic drug and as an immunosuppressive agent. Within a few years of FDA approval in the late 1950s, the use of cyclophosphamide for the prevention of transplant rejection in experimental models and for the treatment of both neoplasia and immune-mediated diseases was described in both dogs and cats. Cyclophosphamide has persisted to this day as one of the core drugs used in many small animal cancer chemotherapeutic protocols. In contrast, after many years as one of the most commonly immunosuppressive drugs utilized to treat immune-mediated diseases in cats and dogs, the use of cyclophosphamide as an immunosuppressive agent in small animal patients has in the past two decades essentially faded away.