FDA Approves EVENITY (romosozumab-aqqg) For The Treatment Of Osteoporosis In Postmenopausal Women At High Risk For Fracture

Amgen and UCB announced that the U.S. Food and Drug Administration (FDA) has approved EVENITY (romosozumab-aqqg) for the treatment of osteoporosis in postmenopausal women at high risk for fracture. EVENITY is the first and only bone builder with a unique dual effect that both increases bone formation and to a lesser extent reduces bone resorption (or bone loss) to rapidly reduce the risk of fracture. A full course of EVENITY therapy is 12 monthly doses administered by a healthcare provider.2 Since osteoporosis is a chronic disease, continued therapy with an anti-resorptive agent should be considered once EVENITY therapy is completed.

“One in two women will experience a fracture due to osteoporosis in her lifetime. These fractures can be devastating, with many leading to hospital stays and life-altering consequences. The FDA approval of EVENITY represents an important therapeutic development for patients who need a medicine that can rapidly increase bone mineral density and help reduce the risk of future fractures within 12 months,” said David M. Reese, M.D., executive vice president of Research and Development at Amgen. “Postmenopausal osteoporosis is a significant women’s health issue that far too often gets overlooked. As a leader in bone health with more than 20 years of osteoporosis research experience, Amgenis as committed as ever to combatting this disease to help women at high risk for fracture reduce their risk of a first and subsequent fracture.”

Osteoporosis is a serious, chronic condition with no cure. According to the World Health Organization (WHO), osteoporosis is a major public health crisis, affecting millions of people worldwide. In the U.S. alone, 10 million Americans suffer from osteoporosis. Osteoporosis-related fractures, known as bone breaks, are common, and the disease is responsible for an estimated two million fractures per year. After her first fracture, a woman is five times more likely to suffer another fracture within a year. In fact, her fracture risk remains elevated over time if left untreated. Fractures for postmenopausal women can be life-altering events which can lead to loss of mobility. Each year, osteoporosis-related fractures account for 432,000 hospital admissions and 180,000 nursing home admissions. Given the aging population in the U.S., annual direct costs from osteoporosis are expected to reach approximately $25.3 billion by 2025.

“After spending 30 years caring for women with osteoporosis and in clinical research, I know that women at high risk of fracture need another therapy that reduces fractures quickly,” said Felicia Cosman, M.D., professor of medicine at Columbia University College of Physicians and Surgeons in New York, co-editor in chief of the journal Osteoporosis International and principal investigator of the FRAME trial. “EVENITY acts by a novel mechanism of action to reduce the risk of new vertebral fracture within 12 months, and it produces rapid and dramatic improvements in bone mass. These benefits are sustained upon transition to an anti-resorptive medication and address a critical need for patients at high risk of fracture.”

The FDA based its approval of EVENITY on the results of two Phase 3 studies. In the placebo-controlled FRAME study, treatment with EVENITY resulted in a significant reduction of new vertebral (spine) fracture at 12 months compared to placebo. This significant reduction in fracture risk persisted through the second year in women who received EVENITY during the first year and transitioned to denosumab compared to those who transitioned from placebo to denosumab. In addition, EVENITY significantly increased bone mineral density (BMD) at the lumbar spine, total hip and femoral neck compared to placebo at 12 months. Following the transition from EVENITY to denosumab at month 12, BMD continued to increase through month 24.

In the active-controlled ARCH study, treatment with EVENITY for 12 months followed by 12 months of alendronate significantly reduced the incidence of new vertebral fracture at 24 months. EVENITY followed by alendronate significantly reduced the risk of clinical fracture (defined as a composite of symptomatic vertebral fracture and nonvertebral fracture) after a median follow-up of 33 months. EVENITY significantly increased BMD at the lumbar spine, total hip and femoral neck at 12 months compared to alendronate. Twelve months of treatment with EVENITY followed by 12 months of treatment with alendronate significantly increased BMD compared with alendronate alone.

EVENITY has a Boxed Warning in its product label which advises that EVENITY may increase the risk of myocardial infarction (heart attack), stroke and cardiovascular death. EVENITY should not be initiated in patients who have had a heart attack or stroke within the preceding year. Consider whether the benefits outweigh the risks in patients with other cardiovascular risk factors. If a patient experiences a heart attack or stroke during therapy, EVENITY should be discontinued.

The most common adverse reactions (≥5 percent) reported with EVENITY were arthralgia (joint pain) and headache.

This approval comes with a post-marketing requirement from the FDA to assess the cardiovascular safety of EVENITY in postmenopausal osteoporosis women. The requirement includes a five-year observational feasibility study, potentially followed by a comparative safety study or trial. Amgen is committed to the safety of patients and will continue to monitor all safety data as it emerges.

“Women who experience a fracture due to osteoporosis are at significant risk for another fracture within one to two years; however, many of these patients are not diagnosed with osteoporosis as the underlying cause of fracture so they do not  receive the proper care, and as a result, may experience new fractures,” said Dr. Pascale Richetta, head of bone and executive vice president, UCB. “We are excited EVENITY is now approved in the U.S. and that physicians will have a new treatment option for postmenopausal women with osteoporosis who are at high risk for fracture.”

“Osteoporosis is a serious disease that is underdiagnosed and often goes untreated. In fact, approximately 80 percent of patients who have had one or more osteoporotic-related fractures are not being identified or treated,” said Elizabeth Thompson, chief executive officer, National Osteoporosis Foundation. “This approval is great news for patients and physicians because it gives them another much needed treatment option to help reduce the risk of life changing fractures.”

Amgen is committed to supporting the osteoporosis community and to helping appropriate patients with affordable access to EVENITY. The Amgen Assist support program can help patients and physician offices navigate insurance coverage and identify access resources for patients. Amgen also provides patient assistance for its medicines marketed in the U.S. in a variety of ways, including free medicines through The Amgen Safety Net Foundation for qualifying individuals with no or limited drug coverage.

EVENITY is expected to be available in approximately one week from select wholesalers in the U.S., at which time the price of EVENITY will be publicly available.