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Ortho Biotech Supports FDA Advisory Committees' Recommendations on Use of ESAs in Chronic Renal Failure Patients

GAITHERSBURG, Md., Sept. 11 /PRNewswire/ -- Ortho Biotech is pleased with recommendations of the Food and Drug Administration (FDA) Cardiovascular and Renal Drugs Advisory Committee (CRDAC) and Drug Safety and Risk Management Advisory Committee (DSRMAC) resulting from the Committees' evaluation of the use of erythropoiesis-stimulating agents (ESAs) for patients with chronic renal failure (CRF).

"Ortho Biotech supports the Committees' recommendation not to change the target hemoglobin, supporting the company's position that PROCRIT(R) (Epoetin alfa) is a safe and effective therapeutic option in the management of anemia in patients with chronic renal failure (CRF) when patients are treated according to the label," said Marsha Wolfson, M.D., Senior Director, Nephrology Clinical Affairs, Ortho Biotech. The studies examined by the FDA Advisory Committees evaluated hemoglobin targets above 13 grams per deciliter of blood (g/dL). In March 2007, label guidance for all ESAs was revised to reflect a maximum hemoglobin of 12 g/dL.

"We are also pleased that the Committees agreed that ESA dosages used to achieve the hemoglobin levels in the Normal Hematocrit and CHOIR studies are sufficient to form the basis for ESA dosage recommendations," Dr. Wolfson commented. "Furthermore, we support the Committee's recommendation on additional label guidance and further analyses toward identifying and appropriately treating patients who exhibit a poor response to ESAs."

At the meeting, the nation's leading kidney physicians and patient organizations reaffirmed during the public comment session that ESAs remain the only viable alternative to blood transfusions for the treatment of anemia in CRF patients. Nearly two decades of clinical evidence, and physician and patient experience reinforce that ESAs provide clear clinical benefit in CRF patients, and we are pleased that the Committees acknowledged the medications' role avoiding transfusion and improving physician-assessed and patient- reported outcomes.

Ortho Biotech looks forward to working closely with the FDA to help ensure that healthcare professionals have the information they need to continue to use PROCRIT safely and effectively, particularly with respect to the issues raised in today's discussions.

About PROCRIT (Epoetin alfa)

PROCRIT can be used for the treatment of anemia in patients with most types of cancer receiving chemotherapy, with chronic renal failure who are on dialysis and those who are not on dialysis, who are being treated with zidovudine for HIV infection, and to reduce the need for transfusion in anemic patients who are scheduled for elective noncardiac, nonvascular surgery. Depending on the country in which Epoetin alfa is marketed, these indications may differ.

Important U.S. Safety Information for PROCRIT

From the Boxed Warnings

-- Use the lowest dose of PROCRIT that will gradually increase the

hemoglobin (Hb) concentration to the lowest level sufficient to avoid

the need for red blood cell (RBC) transfusion.

-- PROCRIT and other erythropoiesis-stimulating agents (ESAs) increased

the risk for death and for serious cardiovascular events (including

serious arterial and venous thromboembolic events, myocardial

infarction, stroke, congestive heart failure) when administered to

target a Hb of greater than 12 g/dL. A rate of hemoglobin rise of

greater than 1 g/dL over 2 weeks may also contribute to these risks.

-- Cancer patients: Use of ESAs:

-- Shortened the time to tumor progression in patients with advanced

head and neck cancer receiving radiation therapy when administered

to target a Hb of greater than 12 g/dL.

-- Shortened overall survival and increased deaths attributed to

disease progression at 4 months in patients with metastatic breast

cancer receiving chemotherapy when administered to target a Hb of

greater than 12 g/dL.

-- Increased the risk of death when administered to target a Hb of 12

g/dL in patients with active malignant disease receiving neither

chemotherapy nor radiation therapy. ESAs are not indicated for this


-- Patients receiving PROCRIT pre-operatively for reduction of allogeneic

RBC transfusions: A higher incidence of deep venous thrombosis was

documented in patients receiving PROCRIT who were not receiving

prophylactic anticoagulation. Antithrombotic prophylaxis should be

strongly considered when PROCRIT is used to reduce allogeneic RBC



PROCRIT is contraindicated in patients with uncontrolled hypertension or with known hypersensitivity to albumin (human) or mammalian cell-derived products.

Additional Important Safety Information

-- Monitor Hb regularly during therapy, more frequently following a dosage

adjustment or until Hb becomes stable.

-- Cases of pure red cell aplasia (PRCA) and of severe anemia, with or

without other cytopenias, associated with neutralizing antibodies to

erythropoietin have been reported in patients with chronic renal

failure receiving PROCRIT by subcutaneous administration. If any

patient develops a sudden loss of response to PROCRIT, accompanied by

severe anemia and low reticulocyte count, and anti-erythropoietin

antibody-associated anemia is suspected, withhold PROCRIT and other

erythropoietic proteins. Contact ORTHO BIOTECH (1-888-2ASKOBI or

1-888-227-5624) to perform assays for binding and neutralizing

antibodies. If erythropoietin antibody-mediated anemia is confirmed,

PROCRIT should be permanently discontinued and patients should not be

switched to other erythropoietic proteins.

-- The safety and efficacy of PROCRIT therapy have not been established in

patients with a known history of a seizure disorder or underlying

hematologic disease (eg, sickle cell anemia, myelodysplastic syndromes,

or hypercoagulable disorders).

-- In some female patients, menses have resumed following PROCRIT therapy;

the possibility of pregnancy should be discussed and the need for

contraception evaluated.

-- Prior to and regularly during PROCRIT therapy monitor iron status;

transferrin saturation should be greater than or equal to 20% and

ferritin should be greater than or equal to 100 ng/mL. During therapy

absolute or functional iron deficiency may develop and all patients

will eventually require supplemental iron to adequately support

erythropoiesis stimulated by PROCRIT.

-- In studies, the most common side effects included fever (pyrexia),

diarrhea, nausea, vomiting, swelling of hands or feet (edema), lack or

loss of strength or weakness (asthenia, fatigue), shortness of breath,

high blood pressure, headache, joint pain (arthralgias), abnormal skin

sensations (as tingling or tickling or itching or burning;

paresthesia), rash, constipation, and upper respiratory infection.

Please visit for the full Prescribing Information, including the Boxed Warning.

About Ortho Biotech Products, L.P.

Ortho Biotech Products, L.P. is a leading biopharmaceutical company devoted to helping improve the lives of patients with cancer and with anemia due to multiple causes, including chronic kidney disease. Since it was founded in 1990, Ortho Biotech and its worldwide affiliates have earned a global reputation for researching, manufacturing and marketing innovative products that enhance patients' health. Located in Bridgewater, N.J., Ortho Biotech is an established market leader in Epoetin alfa therapy for anemia management. The company also markets treatments for recurrent ovarian cancer, rejection of transplanted organs and other serious illnesses. For more information, visit

SOURCE Ortho Biotech Products, L.P.
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