Miraxion results look promising

HD Lighthouse Contributing Editor's Comment: 

When Amarin announced in April 2007 that six months of treatment with Miraxion had resulted in no statistically significant improvement in a Phase III clinical trial, the HD community was disappointed.

The Lighthouse decided to wait for further analysis before commenting.  Six months may not have been long enough to achieve reliable results.  A detailed analysis of the data might also have revealed that Miraxion was effective only in a subpopulation.  

It turms out that at the one year mark, the data does look good for the group as a whole.  The FDA is requiring another Phase III clinical trial before allowing a New Drug Application to be filed.  We'll report when we learn more about when and where such a trial will be conducted. 

-- Marsha L. Miller, Ph.D.
Posted to the HDL: 11-19-2007

Amarin Announces Completion of Comprehensive Data Analysis From Phase III Huntington's Disease Program

LONDON, United Kingdom, November 19, 2007. Amarin Corporation plc (NASDAQ: AMRN) (“Amarin” or “Company”) today announced that management has met with the U.S. Food and Drug Administration (FDA) following the completion of a comprehensive data review from its large-scale Phase III studies of Miraxion to treat Huntington’s disease (HD). The FDA indicated that one additional Phase III trial demonstrating robust results, in conjunction with the confirmatory evidence from the existing clinical data, may be sufficient clinical data to support a New Drug Application.

Rick Stewart, Chief Executive Officer of Amarin, commented “We are pleased with the results of the comprehensive clinical data review and are encouraged by the outcome of our recent dialogue with the FDA. We are now in discussions with the Huntington Study Group to determine the optimal design of such a single Phase III trial. We are also considering whether Amarin will conduct this study itself or seek a collaborative partner with which to advance Miraxion in Huntington’s disease.”

Since the most recent update on Miraxion to treat HD on August 1, 2007, the Company has continued a comprehensive analysis of all clinical data with its advisors. This additional analysis supports the preliminary findings, suggesting a clinical benefit from a longer treatment period for Miraxion.

Positive 12-month results from U.S. Phase III Trial (TREND-HD) The TREND-HD trial, conducted by the Huntington Study Group in the U.S. and Canada in 316 patients, was a 6-month, double-blind placebo controlled study followed by a further 6-month extension period where all patients received 2 grams per day of Miraxion. The primary endpoint was the 6-month change in TMS-4, a scale that measures motor symptoms. As previously announced on April 24, 2007, at the 6-month time point, there was no statistically significant difference in efficacy between the Miraxion group and the placebo group.

Analysis of the 12-month data showed a statistically significant difference in TMS-4 between the long term Miraxion group (12-months treatment) and those patients who had switched to Miraxion at 6-months. Treatment codes were not broken at the switching point so investigators and patients remained blinded to receipt of Miraxion or placebo in the initial 6-month period. These results suggest that there is benefit from a longer treatment period with Miraxion and are consistent with the 24-month open-label data from the earlier 135-patient trial completed in 2003.

Positive Additional Analysis A longitudinal analysis, which is a widely accepted and validated alternative statistical methodology, was applied to all available clinical data as part of the comprehensive review.

TREND-HD Trial Outcome The longitudinal methodology was applied to both the 3 and 6-month combined results as well as the 3, 6, 9 and 12-month combined results. A statistically significant difference between the Miraxion and placebo groups was identified in each of the 3-6 month and the 3, 6, 9 and 12-month analyses.

Earlier 135 patient Trial Outcome In the earlier 135-patient study, the longitudinal analysis showed a statistically significant difference between Miraxion and placebo in the per protocol patient groups and, additionally, a greater degree of statistical significance in the intent to treat genetic sub-group of patients with a CAG< 44 than in the previous analysis.

Analysis was also conducted on the 24-month open label data from the 135-patient trial, in which patients initially randomized to treatment with placebo had been switched to Miraxion and treated for 12 months. After switching to Miraxion, these patients demonstrated an effect of similar magnitude to patients randomized to treatment with Miraxion at baseline.

About Amarin

Amarin is committed to improving the lives of patients suffering from central nervous system and cardiovascular diseases. Our goal is to be a leader in the research, development and commercialization of novel drugs that address unmet patient needs.

Amarin’s CNS development pipeline includes Miraxion for Huntington’s disease, two programs in Parkinson’s disease, one in epilepsy and one in memory and cognition. Amarin is initiating a series of cardiovascular preclinical and clinical programs to capitalize on the known therapeutic benefits of essential fatty acids in cardiovascular disease. Amarin also has a proprietary lipid-based technology platform for the targeted transport of molecules through the liver and/or to the brain that can be leveraged in a wide range of disease applications for its own product pipeline or with potential partners.

Source: press release from Amarin