Raritan, NJ (September 7, 2012) — Janssen Research & Development, LLC (Janssen) announced today that it has submitted the Complete Response to the U.S. Food and Drug Administration (FDA) for the use of XARELTO® (rivaroxaban) to reduce the risk of secondary cardiovascular events in patients with acute coronary syndrome (ACS). The response includes specific information requested by the FDA in their letter issued to Janssen on June 21, 2012.
Janssen also has resubmitted the supplemental New Drug Application (sNDA) for XARELTO® to reduce the risk of stent thrombosis in patients with ACS, which the company withdrew on July 9, 2012 based on its connection to the above mentioned sNDA for XARELTO®. Data from the ATLAS ACS 2 TIMI 51 trial support both sNDAs.
“We are confident in the results of the ATLAS ACS 2 TIMI 51 trial and have relied on the data from that study to develop our comprehensive responses to questions raised by the FDA in their review of our application,” said Paul Burton, M.D., Ph.D., Vice President at Janssen R&D. “We look forward to working with the agency to make XARELTO® available to patients who experience a heart attack and need treatment to reduce the risk of another heart attack, a blocked coronary stent or death.”
XARELTO® is approved for three clinical uses in the U.S.: to reduce the risk of blood clots in the legs and lungs of people who have just had knee replacement surgery, to reduce this risk in people who have just had hip replacement surgery, and to reduce the risk of both hemorrhagic and thrombotic strokes as well as other blood clots in people with atrial fibrillation not caused by a heart valve problem.
ACS is a complication of coronary heart disease, which is the leading cause of death in the U.S. and one of the most prevalent non-communicable diseases in the world. ACS occurs when a blood clot blocks a coronary artery, reducing blood supply to the heart. This disruption of blood flow can cause a heart attack, or unstable angina, a condition signifying that a heart attack may soon occur. Each year, an estimated 1.2 million patients in the U.S. are discharged from the hospital with a diagnosis of ACS.
Coronary stents are implanted in more than 1.5 million patients each year. Stent thrombosis is uncommon, but may result in a catastrophic complication after a stent has been inserted into a patient’s coronary artery. Stent thrombosis can result in a heart attack or even death.
About XARELTO® (rivaroxaban)
XARELTO®belongs to a group of medicines called anticoagulants, and works by blocking the blood clotting Factor Xa, thereby reducing the tendency to form clots. XARELTO®is approved for three uses: to reduce the risk of blood clots in the legs and lungs of people who have just had knee replacement surgery, to reduce this risk in people who have just had hip replacement surgery, and to reduce the risk of both hemorrhagic and thrombotic strokes as well as other blood clots in people with atrial fibrillation not caused by a heart valve problem. There is limited information on how XARELTO® compares to a medicine called warfarin in reducing the risk of stroke when the blood levels of warfarin are well-controlled. The blood levels of warfarin often vary in patients.
XARELTO® has the broadest profile of any of the newer oral anticoagulants either in market today or coming to the U.S. market in the foreseeable future, and is broadly available for more than 90% of commercial and Medicare health plan members. To date, more than 1.5 million patients have received XARELTO® worldwide and more than 500,000 prescriptions have been written for XARELTO® in the U.S. alone.
The extensive program of clinical trials evaluating rivaroxaban makes the compound the most studied oral, Factor Xa inhibitor in the world today. By the time of its completion, more than 75,000 patients will have participated in the rivaroxaban clinical development program. There are five filings currently under review at the FDA. Rivaroxaban is being developed jointly by Janssen and Bayer HealthCare. U.S. marketing rights for XARELTO® are held by Janssen Pharmaceuticals, Inc.
At Janssen, we are dedicated to addressing and solving some of the most important unmet medical needs of our time in oncology, immunology, neuroscience, infectious diseases and vaccines, and cardiovascular and metabolic diseases. Driven by our commitment to patients, we develop innovative products, services and healthcare solutions to help people throughout the world. Janssen Research & Development, LLC and Janssen Pharmaceuticals, Inc. are part of the Janssen Pharmaceutical Companies of Johnson & Johnson. Please visit http://www.janssenrnd.com for more information.
Important Safety Information
WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT XARELTO®?
For people taking XARELTO® for atrial fibrillation:
People with atrial fibrillation (an irregular heart beat) are at an increased risk of forming a blood clot in the heart, which can travel to the brain, causing a stroke, or to other parts of the body. XARELTO® lowers your chance of having a stroke by helping to prevent clots from forming. If you stop taking XARELTO®, you may have an increased risk of forming a clot in your blood.
- Do not stop taking XARELTO® without talking to the doctor who prescribes it for you. Stopping XARELTO®increases your risk of having a stroke or forming blood clots in other parts of your body.
If you have to stop taking XARELTO®, your doctor may prescribe another blood thinner medicine to prevent a blood clot from forming.
For all people taking XARELTO®:
- XARELTO® can cause bleeding which can be serious, and rarely may lead to death. This is because XARELTO® is a blood thinner that reduces blood clotting. While you take XARELTO® you are likely to bruise more easily and it may take longer for bleeding to stop.
You may have a higher risk of bleeding if you take XARELTO®and other medicines that increase your risk of bleeding including:
- aspirin or aspirin containing products,
- non-steroidal anti-inflammatory drugs (NSAIDs)
- warfarin sodium (Coumadin®, Jantoven®)
- any medicine that contains heparin
- clopidogrel (Plavix®)
- prasugrel (Effient®)
- ticagrelor (Brilinta®)
Tell your doctor if you take any of these medicines. Ask your doctor or pharmacist if you are not sure if your medicine is one listed above.
Call your doctor or get medical help right away if you develop any of these signs or symptoms of bleeding:
- tingling, numbness or muscle weakness, especially in your legs. This is particularly important if you had a procedure called spinal or epidural puncture as part of your anesthesia during surgery.
- any unexpected bleeding, or bleeding that lasts a long time (such as nose bleeds that happen often, unusual bleeding from gums, or menstrual bleeding that is heavier than normal or vaginal bleeding)
- bleeding that is severe or that you cannot control
- red, pink or brown urine
- bright red or black stools (look like tar)
- cough up blood or blood clots
- vomit blood or your vomit looks like “coffee grounds”
- headaches, feeling dizzy or weak
- pain, swelling, or new drainage at wound sites
WHO SHOULD NOT TAKE XARELTO®?
Do not take XARELTO® if you:
- currently have abnormal or unusual bleeding
- are allergic to rivaroxaban or any of the ingredients of XARELTO®
WHAT SHOULD I TELL MY DOCTOR BEFORE OR WHILE TAKING XARELTO®?
Before taking XARELTO® tell your doctor if you:
- Have ever had bleeding problems
- Have liver or kidney problems
- Have any other medical condition
- Are pregnant or planning to become pregnant
- Are breastfeeding or plan to breastfeed
Tell all of your doctors and dentists that you are taking XARELTO®. They should talk to the doctor who prescribed XARELTO® for you before you have any surgery, medical or dental procedure.
Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Some of your other medicines may affect the way XARELTO®works. Certain medicines may increase your risk of bleeding.
Especially tell your doctor if you take:
- ketoconazole (Nizoral®)
- itraconazole (Onmel™, Sporanox®)
- ritonavir (Norvir®)
- lopinavir/ritonavir (Kaletra®)
- indinavir (Crixivan®)
- carbamazepine (Carbatrol®, Equetro®, Tegretol®, Tegretol®-XR, Teril™, Epitol®)
- phenytoin (Dilantin-125®, Dilantin®, Phenobarbital, Solfoton™)
- rifampin (Rifater®, Rifamate®, Rimactane®, Rifadin®)
- St. John’s wort (Hypericum perforatum)
Ask your doctor if you are not sure if your medicine is one listed above. Know the medicines you take. Keep a list of them to show your doctor and pharmacist when you get a new medicine.
HOW SHOULD I TAKE XARELTO®?
Take XARELTO®exactly as prescribed by your doctor. Do not change your dose or stop taking XARELTO®unless your doctor tells you to.
For people who have:
- atrial fibrillation: Take XARELTO®1 time a day with your evening meal. Stopping XARELTO®may increase your risk of having a stroke or forming blood clots in other parts of your body.
- hip or knee replacement surgery: Take XARELTO®1 time a day with or without food.
- Your doctor may stop XARELTO®for a short time before any surgery, medical or dental procedure. Your doctor will tell you when to start taking XARELTO®again after your surgery or procedure.
- Do not run out of XARELTO®. Refill your prescription for XARELTO®before you run out. When leaving the hospital following a hip or knee replacement, be sure that you will have XARELTO®available to avoid missing any doses.
- If you miss a dose of XARELTO®, take it as soon as you remember on the same day.
- If you take too much XARELTO®, go to the nearest hospital emergency room or call your doctor right away.
XARELTO® can cause bleeding which can be serious, and rarely may lead to death. Please see “What is the most important information I should know about XARELTO®?”
Tell your doctor if you have any side effect that bothers you or that does not go away.
Discuss any side effects with your doctor. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088. You may also report side effects to Janssen Pharmaceuticals, Inc. at 1-800-JANSSEN (526-7736).
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