ALISO VIEJO, Calif.
July 16, 2014
Avanir Pharmaceuticals, Inc.
(NASDAQ: AVNR) today announced interim data from the phase IV PRISM II study showing that treatment with NUEDEXTA
substantially reduced symptoms of pseudobulbar affect (PBA) in patients with Alzheimer's disease/dementia. PBA is a distressing neurologic condition characterized by sudden and uncontrolled outbursts of laughing and/or crying in patients with neurologic disease and injury. A standard quality of life measure also showed clear improvement over the 3-month treatment period. The data were presented today,
Wednesday, July 16, 2014
at the Alzheimer's Association International Conference (AAIC), being held at the Bela Center in
"These initial data showing reduced symptoms of pseudobulbar affect (PBA) in patients with PBA secondary to Alzheimer's and dementia are consistent with the benefits we saw in the pivotal phase III study, in PBA patients with ALS and MS, and provide further evidence that NUEDEXTA may offer relief from the debilitating episodes of PBA," said
, MD, chief medical officer at Avanir. "PRISM II has now completed enrollment of patients with dementia and continues to enroll patients with stroke and traumatic brain injury, two additional important causes of PBA. We look forward to reporting data from these additional cohorts later this year."
"PBA can have a devastating impact on the lives of patients that are already suffering with neurologic disorders such as Alzheimer's disease and other dementias," said Stephen D'Amico, MD, CMD, medical director at Cornerstone Medical Group,
. "The reduction in PBA symptoms and improvement in quality of life measures seen in this study are evidence of the clinically meaningful impact that treatment with NUEDEXTA may have."
PRISM II assessed the safety and efficacy of NUEDEXTA in treating PBA in patients with Alzheimer's disease/dementia, stroke and TBI. While the Alzheimer's disease/dementia cohort is now fully enrolled at 134 patients, at the time of interim analysis 96 patients had evaluable safety data and 68 had effectiveness data (at least 30 treatment days). The study endpoints included a PBA symptom rating (Center for Neurologic Study-Lability Scale; CNS-LS; 7=no symptoms – 35=maximum symptoms), number of weekly PBA episodes, Mini-Mental State Examination (MMSE), quality of life (QOL; 0=no impairment-10=maximum impairment) improvements, and Clinician and Patient Global Impression of Change (CGI-C; PGI-C).
About PRISM II
- At baseline patients had a mean CNS-LS score of 20.2 and were suffering from a median of 29 PBA episodes per week.
- At the end of the study period, mean CNS-LS improved to 12.8 ( P<0.001 compared with baseline) and the median number of PBA episodes decreased to 5 per week.
- At the end of the treatment period, consistent improvement was observed in other effectiveness measures
- Mean QOL scores improved from 6.1 at baseline to 2.8 at endpoint (P<0.001)
- 77.8% of patients or caregivers rated themselves/the patient as being much/very improved on the PGI-C
- 79.3% of clinicians rated the patient to be much/very much improved on the CGI-C
- MMSE mean score improved by 0.4 points at end of study from a baseline of 19.0
- Adverse Events (AE) were reported by a total of 35 (36.5%) patients (6.3% treatment-related), most commonly headache (9.4%), urinary tract infection (5.2%), and diarrhea (4.2%). Eleven patients had serious AEs (only one deemed treatment-related). Thirteen patients discontinued for AEs. This AE profile was generally consistent with that observed in other trials of NUEDEXTA.
The objectives of the study are to evaluate the safety, tolerability, and effectiveness of NUEDEXTA capsules containing 20 mg dextromethorphan (DM) and 10 mg quinidine (Q) for treatment of PBA in patients with prevalent neurological conditions including Alzheimer's disease/dementia, stroke and traumatic brain injury over a 12 week period.
PRISM II is a nationwide, open-label, multicenter, 12-week study enrolling up to approximately 450 patients at approximately 100 study centers. Eligible patients are aged
18 years with a clinical diagnosis of PBA and baseline score
13 on the Center for Neurologic Study-Lability Scale (CNS-LS). Patients with TBI due to a penetrating head injury are excluded. Patients are treated with NUEDEXTA mg twice daily. The primary endpoint is change from baseline in scores measured by the CNS-LS, a PBA rating instrument originally validated in patients with PBA secondary to ALS and MS. Determination of effectiveness is based on a comparison of CNS-LS change in PRISM II with results of previous phase III studies. Additional outcomes measures include: number of weekly PBA episodes (laughing and/or crying); Mini-Mental State Examination; quality of life; Clinician and Patient Global Impression of Change (CGIC; PGIC); patients' satisfaction with treatment; Patient Health Questionnaire (PHQ-9) (to evaluate mood symptoms), and the Neurobehavioral Functioning Inventory for TBI patients. Safety measures include monitoring of adverse events, concomitant medication usage, and vital signs.
Poster Presentation Details:
Title: PRISM II: An Open-Label Study to Assess the Safety, Tolerability, and Effectiveness of Dextromethorphan 20 mg/Quinidine 10 mg (NUEDEXTA) in Pseudobulbar Affect (PBA) Secondary to Dementia, Stroke, or Traumatic Brain Injury (TBI): Early Results of the Alzheimer's Disease/Dementia Cohort
Poster Number: 45758