Phase III PEMPHIX Study Shows Genentech’s Rituxan (rituximab) Superior to Mycophenolate Mofetil in Patients With Pemphigus Vulgaris
October 14, 2019Genentech’s study reinforces efficacy and safety of Rituxan for treatment of PV, a rare autoimmune condition characterized by blistering of the skin and mucous membranes, showing that 40% of patients with pemphigus vulgaris (PV) achieved sustained complete remission, without the use of steroids for 16 weeks or more, when treated with Rituxan compared to 9.5% of patients on mycophenolate mofetil.
SOUTH SAN FRANCISCO, Calif.–(BUSINESS WIRE)–Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), today announced data from the Phase III PEMPHIX study evaluating the efficacy and safety of Rituxan® (rituximab) compared to mycophenolate mofetil (MMF), in adults with moderate to severe pemphigus vulgaris (PV). The study met the primary endpoint at week 52 and demonstrated that Rituxan is superior to MMF, with 40.3% of patients treated with Rituxan achieving sustained complete remission (CR) without the use of steroids for 16 consecutive weeks or more, compared to 9.5% in the MMF arm (p<0.0001). All secondary endpoints were statistically significant in favor of Rituxan: lower cumulative oral corticosteroid dose (mean difference: 1595 mg; p=0.0005), fewer flares (6 vs. 44, p<0.0001), a greater likelihood of sustained CR (hazard ratio [HR]=4.83; p=0.0003), a lesser likelihood of flare (HR=0.15; p<0.0001) and a greater improvement in the Dermatology Life Quality Index (DLQI) at week 52 (estimated mean change from baseline -8.87 vs. -6.00, p=0.0012) compared to the MMF arm. Adverse events were generally consistent with those seen in previous Rituxan clinical studies in PV and other approved autoimmune indications. Results were presented as a late-breaking oral presentation at the 28th Congress of the European Academy of Dermatology and Venereology in Madrid, Spain on October 12 at 9:00 a.m. – 9:15 a.m. CEST (Presentation D3T01.1C).
“The approval of Rituxan for the treatment of pemphigus vulgaris was the first major advancement in the treatment of this rare, serious disease in more than 60 years,” said Levi Garraway, M.D., Ph.D., chief medical officer and head of Global Product Development. “The PEMPHIX study showed that 40% of people in the study could achieve complete remission from painful blistering without the need for corticosteroids for 16 weeks or more and that Rituxan may be a superior treatment option to mycophenolate mofetil.”
The study is ongoing, with patients participating in a 48-week safety follow-up period after treatment completion or discontinuation.
PV is a rare, serious and potentially life-threatening condition characterized by progressive painful blistering of the skin and mucous membranes. MMF is an unapproved, commonly used treatment for PV that is recommended in published treatment guidelines. Rituxan became the first biologic therapy for PV when it was approved by the U.S. Food and Drug Administration (FDA) in June 2018 and the European Commission in March 2019. These approvals were based on data from the Roche-supported Ritux 3 clinical trial. The PEMPHIX study provides additional clinical evidence of the effectiveness of Rituxan for PV.
What is PEMPHIX Study
PEMPHIX is a Phase III, randomized, double-blind, double-dummy, active-comparator, parallel-arm, international, multicenter study (NCT02383589) designed to evaluate the efficacy and safety of Rituxan compared with mycophenolate mofetil (MMF) in patients with moderate to severe active pemphigus vulgaris requiring 60-120 mg/day oral prednisone (or equivalent). Participants were randomly assigned to receive Rituxan plus MMF placebo or Rituxan placebo plus MMF for 52 weeks, in combination with 60 or 80 mg oral prednisone, with the aim of tapering to 0 mg/day by week 24. Rituxan was administered at a dose of 1000 mg via intravenous (IV) infusion on day 1 and 15, with a repeat administration on days 168 and 182. MMF was administered at a dose of 2 grams orally daily (starting at 1 g/day on day 1 and titrated to achieve a goal of 2 g/day by week 2). The primary endpoint at week 52 was the percentage of participants who achieved sustained complete remission without experiencing treatment failure. Sustained complete remission was defined as achieving healing of lesions with no new active lesions (i.e., Pemphigus Disease Area Index activity score of 0) while on 0 mg/day prednisone or equivalent, and maintaining this response for at least 16 consecutive weeks, during the 52-week treatment period. Secondary endpoints were cumulative oral corticosteroid dose, number of disease flares, time to sustained complete remission, time to disease flare and health-related quality of life, as measured by the Dermatology Life Quality Index.
What is Pemphigus Vulgaris
Pemphigus vulgaris is an autoimmune, blistering disease affecting the skin and mucous membranes. This rare, potentially life-threatening condition accounts for up to 80% of cases of pemphigus, a group of autoimmune disorders which affect 30,000 to 40,000 people in the United States.
What autoimmune diseases does Rituxan treat?
Adults with Rheumatoid Arthritis (RA): with another prescription medicine called methotrexate, to reduce the signs and symptoms of moderate to severe active RA, after treatment with at least one other medicine called a tumor necrosis factor (TNF) antagonist has been used and did not work well enough.
People with Granulomatosis with Polyangiitis (GPA) (Wegener’s Granulomatosis) and Microscopic Polyangiitis (MPA) ages 2 years and above: with glucocorticoids.
Adults with Pemphigus Vulgaris (PV): to treat moderate to severe PV.