U.S.
Food & Drug Administration Approved the use of Reyataz (atazanavir sulfate)
Boosted with Ritonavir, in Combination Therapy, for Previously Untreated HIV-1
Infected Adult Patients Based on CASTLE Study Princeton,
NJ -- October 1, 2008 -- Bristol-Myers Squibb Company announced today that the
U.S. Food & Drug Administration (FDA) approved the use of Reyataz (atazanavir
sulfate) 300 mg once-daily boosted with ritonavir 100 mg as part of combination
therapy in previously untreated (treatment-naive) HIV-1 infected patients. Reyataz
boosted with ritonavir (Reyataz/r) taken once daily with food is recognized by
the U.S. Department of Health and Human Services (DHHS) as a preferred component
of combination HIV therapy for treatment-naive patients(1). For
treatment-naive patients who are unable to tolerate ritonavir, Reyataz 400 mg
(without ritonavir), taken once daily with food, is recommended. This
use of once-daily Reyataz/r in HIV-1 infected treatment-naive adult patients is
based on 48-week results from the CASTLE study, which demonstrated similar antiviral
efficacy of Reyataz/r to twice-daily lopinavir/ritonavir (lopinavir/r) [Kaletra],
each as part of HIV combination therapy, in treatment-naive HIV-1 infected adult
patients. Within
the CASTLE study, the Reyataz/r arm was associated with low increases from baseline
in total cholesterol (13 percent), LDL ["bad"] cholesterol (14 percent),
HDL ["good"] cholesterol (29 percent), and triglycerides (15 percent).
The lopinavir/r arm was associated with 25 percent increase in total cholesterol,
19 percent increase in LDL cholesterol, 37 percent increase in HDL cholesterol,
and 52 percent increase in triglycerides. Two percent of patients in the Reyataz/r
arm and eight percent of patients in the lopinavir/r arm required lipid-lowering
therapy in the study, compared to 1 percent in each arm at baseline. Safety
events in this study were consistent with prior experience. Grade 2-4 treatment-related
adverse events that occurred in two percent or greater of patients in the CASTLE
study included jaundice (4 percent and zero percent), nausea (4 percent and 8
percent), diarrhea (2 percent and 11 percent) and rash (3 percent and 2 percent)
in the Reyataz/r and lopinavir/r arms, respectively. Grade 3-4 increases in total
bilirubin were seen in 34 percent of patients in the Reyataz/r arm and in less
than 1 percent of patients in the lopinavir/r arm. "Bristol-Myers
Squibb is committed to developing medicines that enhance the care of people living
with HIV and AIDS," said Elliott Sigal, MD, PhD, Executive Vice President,
Chief Scientific Officer and President, Research and Development, Bristol-Myers
Squibb. "Boosted Reyataz provides health care professionals a newly approved,
once-daily dosing option as part of combination therapy for patients naive to
HIV therapy." About
the CASTLE Study The
CASTLE study is the first large-scale (n=883), open-label, randomized study designed
to demonstrate the non-inferiority of Reyataz/r to lopinavir/r in treatment-naive
HIV-1 infected adult patients. Forty-eight week data from the study were presented
earlier this year at the 15th Conference on Retroviruses and Opportunistic Infections
(CROI) in Boston, Mass., and previously announced in a press release on February
6, 2008. Data from the CASTLE study were also published in the August 23 issue
of The Lancet. Important
Information About Reyataz (atazanavir sulfate) 200 mg, 300 mg Capsules Reyataz
is a prescription medicine used in combination with other medicines to treat people
who are infected with the human immunodeficiency virus (HIV). Reyataz
has been studied in 48-week trials in both patients who have taken or have never
taken anti-HIV medicines. Reyataz
does not cure HIV or help prevent passing HIV to others. Reyataz
should not be taken by patients allergic to Reyataz or to any of its ingredients. Reyataz
should not be taken with the following medicines: rifampin, Camptosar (irinotecan),
Versed (midazolam) when taken by mouth, Halcion (triazolam), ergot medicines,
Propulsid (cisapride), St. John's wort (Hypericum perforatum), Mevacor (lovastatin),
Zocor (simvastatin), Orap (pimozide), Crixivan (indinavir), or Viramune (nevirapine). Patients
taking Reyataz should speak with their healthcare provider before taking the following
medicines: hormonal contraceptives such as birth control pills or contraceptive
patch, Viagra (sildenafil), Levitra (vardenafil), Cialis (tadalafil), Vfend (voriconazole),
AcipHex (rabeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Prilosec
(omeprazole), Protonix (pantoprazole), Axid (nizatidine), Pepcid AC (famotidine),
Tagamet (cimetidine), or Zantac (ranitidine), Advair (fluticasone propionate and
salmeterol inhalation powder), Flonase or Flovent (fluticasone propionate), or
Sustiva (efavirenz). The
above lists of medicines are not complete. The use of all prescription and non-prescription
medicines, vitamins, herbal supplements, or other health preparations should be
discussed with a healthcare provider. Any
side effects, symptoms, or conditions, including the following, should be reported
to a healthcare provider right away: --
Mild rash (redness and itching) without other symptoms sometimes occurs in
patients taking Reyataz, most often in the first few weeks after the medicine
is started, and usually goes away within two weeks with no change in treatment.
-- Severe
rash has occurred in a small number of patients taking Reyataz. This type
of rash is associated with other symptoms which could be serious and potentially
cause death. If rash develops with any of the following symptoms, the patient
should stop using Reyataz and call a healthcare provider right away:
Shortness of breath
General ill-feeling or "flu-like" symptoms
Fever
Muscle or joint aches
Conjunctivitis (red or inflamed eyes, like "pink-eye")
Blisters
Mouth sores
Swelling of the face
--
Yellowing of the skin and/or eyes may occur due to increases in bilirubin
levels in the blood (bilirubin is made by the liver). --
A change in the way the heart beats may occur and could be a symptom of a
heart problem.
-- Diabetes and high blood sugar may occur in patients
taking protease inhibitor medicines like Reyataz.
-- In patients with
liver disease, including hepatitis B or C, the liver disease may get worse
when taking anti-HIV medicines like Reyataz.
-- Kidney stones have
been reported in patients taking Reyataz. Signs or symptoms of kidney stones include
pain in the side, blood in the urine, and pain when urinating.
-- End
stage kidney disease managed with hemodialysis. --
Some patients with hemophilia have increased bleeding problems with protease
inhibitor medicines like Reyataz.
-- Changes in body fat have been
seen in some patients taking anti-HIV medicines. The cause and long-term effects
are not known at this time.
Other side effects of Reyataz taken with other
anti-HIV medicines include: nausea, headache, stomach pain, vomiting, diarrhea,
depression, fever, dizziness, trouble sleeping, numbness, and tingling or burning
of hands or feet.
Reyataz
should be taken once daily with food (a meal or snack). Reyataz and other anti-HIV
medicines should be taken exactly as instructed by healthcare providers. Please
see accompanying Full Prescribing Information, or visit www.reyataz.com
or www.BMS.com. About
Bristol-Myers Squibb Bristol-Myers
Squibb is a global biopharmaceutical company whose mission is to extend and enhance
human life. For more information visit www.bms.com. (1)
Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for
the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department
of Health and Human Services. January 29, 2008; 1-128. Available at http://aidsinfo.nih.gov.
Accessed September 25, 2008. |