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Novartis receives approval in the European Union for Exforge HCT®, a new 3-in-1 treatment for high blood pressure


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Copyright © Hugin AS 2009. All rights reserved.
2009-10-23 07:17:02 -


London, October , 23, 2009
Corporate news announcement processed and transmitted by Hugin AS.
The issuer is solely responsible for the content of this 
announcement. 
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  * Exforge HCT combines the efficacy of three widely prescribed
    blood pressure treatments, valsartan, amlodipine and
    hydrochlorothiazide, in a single pill

  * Up to 85% of patients may need multiple medications to help
    control their blood pressure[1],[2], underscoring the need for
    more effective combination treatments

  * Single-pill combinations reduce daily pill burden and simplify
    treatment schedules[3]

Basel, October 23, 2009 - The European Commission has granted
Novartis marketing authorization for Exforge HCT®, a new 3-in-1
treatment for people with high blood pressure.

Exforge HCT  combines in  a once-daily  single pill  the efficacy  of
three widely prescribed blood  pressure medications: the  angiotensin
receptor blocker  valsartan (Diovan®),  the calcium  channel  blocker
amlodipine, and  the diuretic  hydrochlorothiazide (HCT).  All  three
have  been  used  extensively  for   many  years  in  patients   with
hypertension.

"Novartis is committed  to helping patients  improve their  treatment
compliance. Simplified treatment  regimens and  reduced pill  burdens
have been shown to help achieve  this," said Joe Jimenez, CEO of  the
Novartis Pharmaceuticals  Division. "We  are  pleased that  with  the
approval of  Exforge  HCT, a  new  3-in-1 treatment  for  high  blood
pressure is now available to patients  in the EU. With Diovan as  the
foundation of this new therapy, we are confident that it will  become
an important new treatment option."

In the EU, Exforge HCT is indicated for substitution therapy in adult
patients  whose  blood  pressure  is  adequately  controlled  on  the
combination of valsartan, amlodipine and  HCT, taken either as  three
single-component  formulations   or  as   a  dual-component   and   a
single-component formulation[4].

High blood pressure, or  hypertension, is one  of the most  important
but treatable risk  factors for cardiovascular  disease - the  number
one cause of death worldwide[5]. Nearly half of Europeans suffer from
high blood  pressure[6] and  up to  85% of  these patients  may  need
multiple  medications  to  help  reach  treatment  goals[1],[2].  The
primary patient-related factor for hypertension treatment failure  is
non-compliance with  the prescribed  antihypertensive  medication[7].
Patients therefore may find treatment more convenient with one single
pill rather  than multiple  separate pills.  One recent,  large-scale
study showed that approximately 75% of patients achieved their  blood
pressure treatment goal after switching to a single-pill  combination
therapy[8].

"It is not uncommon for  patients with severe hypertension, or  those
requiring stricter  blood pressure  control, to  need three  or  more
medications," said Professor  Rainer Düsing,  MD, of  the Faculty  of
Medicine, University of Bonn, Germany. "Now that this new single-pill
triple-combination option is available, appropriate patients may find
it  easier  to  comply  with  their  prescribed  treatment   regimens
involving a  once-daily  single  pill  versus  multiple  medications,
especially if  it has  also been  proven to  be highly  effective  at
helping patients reach their blood pressure goals."

Exforge HCT was approved  in the United States  by the Food and  Drug
Administration (FDA) in April 2009  for the second-line treatment  of
high blood pressure[9]. It was  approved in Switzerland in  September
2009 for  the  treatment of  patients  whose blood  pressure  is  not
adequately controlled by dual therapy[10].

The EU  approval was  supported by  the results  of Study  230211,  a
multinational, randomized,  double-blind, parallel-group,  Phase  III
study designed to compare the  efficacy and safety of triple  therapy
(valsartan, amlodipine and HCT) with the various dual combinations of
its   components    -    valsartan/HCT,    amlodipine/valsartan    or
amlodipine/HCT -  in patients  with moderate-to-severe  hypertension.
The  trial  was  conducted  in  15  countries,  with  2,271  patients
randomized to double-blind treatment.

Study 2302 showed that triple therapy was more effective in  reducing
systolic and diastolic blood pressure  than dual combinations of  its
components  in  patients  with  moderate-to-severe  hypertension[11].
Reductions in mean sitting systolic blood  pressure of 40 to 50  mmHg
were achieved, with up to 58% more patients receiving triple  therapy
achieving overall blood  pressure control versus  dual therapy  (i.e.
blood pressure  <140/90 mmHg).  The maximum  dose of  triple  therapy
(valsartan/amlodipine/HCT  10/320/25   mg)  demonstrated   additional
reductions of  18-29%  in  systolic  blood  pressure  and  19-32%  in
diastolic blood pressure  when compared to  all dual combinations  of
its  components  at  the   same  doses.  Ambulatory  blood   pressure
monitoring showed that the blood pressure- lowering effect of  triple
therapy  was  maintained  throughout   the  24-hour  period[12].   In
addition, the study showed that  triple therapy was highly  effective
regardless of  patients' age,  gender,  race, ethnicity  or  baseline
blood  pressure,  and  was  generally  well  tolerated  versus   dual
therapy[11].

The  core  of  the  Novartis  portfolio  is  its  cardiovascular  and
metabolic medications for  the treatment of  high blood pressure  and
diabetes. These include Diovan®  (valsartan), the number one  selling
blood  pressure   medication  worldwide[13];   Exforge®   (valsartan/
amlodipine), a single pill combining  two leading medicines for  high
blood pressure; Exforge HCT® (valsartan/amlodipine/HCT); and Rasilez®
(aliskiren), the first and only approved direct renin inhibitor,  and
two single pill combinations of Rasilez, Rasilez HCT  (aliskiren/HCT)
and Valturna  (aliskiren/valsartan).  For  the treatment  of  type  2
diabetes,  these  include  Galvus®   (vildagliptin,  a  novel   DPP-4
inhibitor) and Eucreas® (vildagliptin and metformin).

Disclaimer
The foregoing release contains forward-looking statements that can be
identified by terminology such as "may," "committed," "confident,"
"will," or similar expressions, or by express or implied discussions
regarding potential future revenues from Exforge HCT. You should not
place undue reliance on these statements. Such forward-looking
statements reflect the current views of management regarding future
events, and involve known and unknown risks, uncertainties and other
factors that may cause actual results with Exforge HCT to be
materially different from any future results, performance or
achievements expressed or implied by such statements. There can be no
guarantee that Exforge HCT will achieve any particular levels of
revenue in the future. In particular, management's expectations
regarding Exforge HCT could be affected by, among other things,
unexpected regulatory actions or delays or government regulation
generally; unexpected clinical trial results, including unexpected
new clinical data and unexpected additional analysis of existing
clinical data; the company's ability to obtain or maintain patent or
other proprietary intellectual property protection; competition in
general; government, industry and general public pricing pressures;
the impact that the foregoing factors could have on the values
attributed to the Novartis Group's assets and liabilities as recorded
in the Group's consolidated balance sheet, and other risks and
factors referred to in Novartis AG's current Form 20-F on file with
the US Securities and Exchange Commission. Should one or more of
these risks or uncertainties materialize, or should underlying
assumptions prove incorrect, actual results may vary materially from
those anticipated, believed, estimated or expected. Novartis is
providing the information in this press release as of this date and
does not undertake any obligation to update any forward-looking
statements contained in this press release as a result of new
information, future events or otherwise.

About Novartis
Novartis provides  healthcare  solutions that  address  the  evolving
needs of  patients  and  societies.  Focused  solely  on  healthcare,
Novartis offers a  diversified portfolio  to best  meet these  needs:
innovative medicines, cost-saving generic pharmaceuticals, preventive
vaccines, diagnostic tools and consumer health products. Novartis  is
the only company with  leading positions in each  of these areas.  In
2008, the Group's  continuing operations  achieved net  sales of  USD
41.5 billion and net income of USD 8.2 billion. Approximately USD 7.2
billion  was  invested  in  R&D  activities  throughout  the   Group.
Headquartered in Basel, Switzerland, Novartis Group companies  employ
approximately 99,000 full-time-equivalent  associates and operate  in
more than  140  countries around  the  world. For  more  information,
please visit www.novartis.com.

References
[1.] Dahlöf B, et  al. Prevention  of cardiovascular  events with  an
antihypertensive regimen of amlodipine adding perindopril as required
versus  atenolol  adding  bendroflumethiazide  as  required,  in  the
Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm
(ASCOT-BPLA):  a  multicenter  randomized  controlled  trial.  Lancet
2005;366:895-906.
[2.] Pepine CJ,  et  al.  A  calcium  antagonist  vs.  a  non-calcium
antagonist hypertension treatment strategy for patients with coronary
artery  disease:  the   International  Verapamil-Trandolapril   Study
(INVEST): a randomized controlled trial. JAMA 2003;290:2805-16.
[3.] Mancia G, et al. 2007 Guidelines for the management of  arterial
hypertension:  The  Task  Force   for  the  Management  of   Arterial
Hypertension of the European Society of Hypertension (ESH) and of the
European Society of Cardiology (ESC). Eur Heart J 2007;28:1462-536.
[4.] Exforge HCT® EU Summary of Product Characteristics. Novartis
Pharma AG.
[5.] World Health Organization. Cardiovascular diseases factsheet.
Available at:
www.who.int/mediacentre/factsheets/fs317/en/index.html.
[6.] Wolf-Maier K, et al. Hypertension prevalence and blood  pressure
levels in 6 European countries,  Canada, and the United States.  JAMA
2003;289:2363-9.
[7.] Elliott WJ. What factors contribute to the inadequate control of
elevated blood  pressure?  J  Clin  Hypertens  (Greenwich)  2008;10(1
Suppl. 1):20-6.
[8.] Jamerson   K,   et   al.    Benazepril   plus   amlodipine    or
hydrochlorothiazide for hypertension in high-risk patients. N Engl  J
Med 2008;359:2417-28.
[9.] Exforge HCT® US Prescribing Information. April 2009. Available
at: www.pharma.us.novartis.com/product/pi/pdf/exforge_hct.pdf
[10.] Exforge HCT® Swiss Prescribing Information. September 2009.
[11.] Calhoun DA, et al. Triple antihypertensive therapy with
amlodipine, valsartan, and hydrochlorothiazide. A randomized clinical
trial. Hypertension 2009;54(1):32-9.
[12.] Lacourciere Y, et al. Twenty-four hour ambulatory BP Control of
therapy with amlodipine/valsartan/HCTZ triple combination compared to
dual therapy in patients with moderate to severe hypertension.
Presented at the 19th Scientific Meeting of the European Society of
Hypertension, June 14, 2009; Abstract No: 1412. Updated information
presented at meeting.
[13.] IMS Midas Worldwide Sales Data. May 2009.

                                # # #

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