Bausch + Lomb And Nicox Announce FDA Approval Of
VYZULTA™ (latanoprostene Bunod Ophthalmic Solution),
November 02, 2017
LAVAL, Quebec and SOPHIA ANTIPOLIS, France, Nov. 2, 2017 /PRNewswire/ —
Valeant Pharmaceuticals International, Inc.’s (NYSE: VRX and
TSX: VRX) wholly owned subsidiary, Bausch + Lomb, a leading global eye health company, and
Nicox S.A. (Euronext Paris: FR0013018124,
COX), an international ophthalmic company, today announced that the U.S.
Food and Drug Administration (FDA) has approved the New
Drug Application (NDA) for VYZULTA™ (latanoprostene bunod ophthalmic solution,
VYZULTA, the first prostaglandin analog with one of its metabolites being nitric oxide (NO), is indicated for the reduction of
intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.
“With today’s approval of VYZULTA, our customers and their patients with glaucoma now
have a new treatment option that can help provide consistent and sustained IOP lowering,
the only modifiable risk factor that can help slow down
the progression of the disease,” said Joseph
C. Papa, chairman and CEO, Valeant. “We expect to make this new advancement available for
those who suffer with glaucoma before the end of the year.”
Following topical administration, VYZULTA, a once daily monotherapy with a dual mechanism
of action, works by metabolizing into two
moieties, latanoprost acid, which primarily works within the uveoscleral pathway
to increase aqueous humor outflow, and butanediol
mononitrate, which releases NO to increase outflow through the trabecular
meshwork and Schlemm’s canal. The most common ocular
adverse events include conjunctival hyperemia, eye irritation, eye pain and
instillation site pain. Increased pigmentation of the iris and
periorbital tissue and growth of eyelashes can occur.
In glaucoma patients, damage to the trabecular meshwork, through which
the majority of the aqueous humor passes, can lead to reduced
drainage and as a result elevated IOP. Lowering IOP, even in patients
with normal baseline levels, can delay, or even prevent damage to optic
nerves, helping to reduce the risk of glaucomatous visual field loss.
“VYZULTA represents the first FDA-approved therapy developed through our proprietary NO-donating research platform,”
said Michele Garufi, chairman and CEO of Nicox. “We look forward to continuing to leverage our
platform in the development of additional innovative
Preclinical studies have shown that NO plays
a role in controlling IOP in
normal eyes by increasing aqueous humor outflow through the
trabecular meshwork and Schlemm’s canal. Studies have also demonstrated that
patients with glaucoma have reduced levels of NO signaling
in their eyes, providing a rationale for the therapeutic value of NO-releasing molecules for patients with open-angle glaucoma or ocular
“The safety and efficacy of VYZULTA has been well-established through multiple clinical studies, which have demonstrated positive results,
including statistically significant differences in IOP lowering compared to timolol and latanoprost,” said Robert N. Weinreb, M.D., chairman and
distinguished professor of Ophthalmology and director, Hamilton Glaucoma Center at the University of California San Diego. “As one
molecule with a dual mechanism of action, VYZULTA™ provides a new treatment option that works to reduce IOP by increasing the outflow
through both the trabecular meshwork and the uveoscleral pathways.”
VYZULTA was licensed on a global basis to Bausch + Lomb from Nicox. As a result of this approval, Nicox will receive $17.5 million from
Bausch + Lomb and will make a $15 million payment to Pfizer under a previous license agreement.
VYZULTA™ COMPREHENSIVE CLINICAL TRIALS
VYZULTA™ vs. Timolol Study: Non-Inferior & Superior to Timolol 0.5% (32% Mean Diurnal IOP Reduction)
The efficacy and safety of VYZULTA were evaluated in two randomized, multi-center, double-masked, parallel-group Phase 3 studies, APOLLO
and LUNAR, comparing VYZULTA with timolol maleate ophthalmic solution 0.5% in subjects (N=831) with open-angle glaucoma or ocular
hypertension. The primary objective of these studies was to demonstrate that the mean IOP reduction over 3 months of treatment with
VYZULTA once daily (QD) in the evening was non-inferior to timolol 0.5% twice daily (BID). A secondary objective was to demonstrate the
superiority of VYZULTA QD to timolol 0.5% BID. In both studies, VYZULTA met the primary efficacy endpoint. VYZULTA also demonstrated
significantly greater IOP lowering than timolol 0.5% throughout the day at 3 months of treatment resulting in a reduction in mean diurnal
IOP of 32% from baseline. The most common ocular adverse events included conjunctival hyperemia (6%), eye irritation (4%), eye pain
(3%), and instillation site pain (2%). No unexpected safety concerns were raised as a result of any of the ocular sign assessments or vital
VYZULTA™ vs. Latanoprost Study: Greater Mean IOP Reduction vs. Latanoprost
In the Phase 2 VOYAGER study, designed to identify the appropriate dose of VYZULTA for the reduction of IOP in addition to assessing
safety and efficacy, 413 patients across 23 sites in the United States and Europe were randomized to receive either latanoprostene bunod
(various concentrations) or Xalatan (latanoprost ophthalmic solution 0.005%) once a day in the evening for 28 days. Two of the four doses
tested, including the FDA approved dose for VYZULTA (latanoprostene bunod ophthalmic solution), 0.024%, showed greater IOP reduction
compared with Xalatan (latanoprost ophthalmic solution 0.005%), with the differences reaching 1.23 mm Hg (p=0.005) for VYZULTA. In
addition, 68.7% of subjects treated with the FDA approved dose for VYZULTA (latanoprostene bunod ophthalmic solution), 0.024%,
compared to 47.5% of subjects treated with Xalatan (latanoprost ophthalmic solution 0.005%), achieved a mean diurnal IOP ≤18 mm Hg
52-Week Safety Study: VYZULTA™ Reduced Mean IOP to 14.4 mm Hg in Subjects with Mean Low Baseline IOP of 19.6 mm Hg
The long-term safety of VYZULTA was assessed in JUPITER, a single-arm, multicenter, open-label Phase 3 study of one-year duration in
Japanese subjects (N=130) with open-angle glaucoma (including normotensive, pigmentary and pseudoexfoliative glaucoma) or ocular
hypertension. The efficacy endpoints of the JUPITER study were to evaluate the absolute IOP level and its reduction from baseline over a 52-
week period. The mean baseline IOP in the study eye in the JUPITER study was 19.6 mm Hg. Treatment with VYZULTA resulted in a 22%
mean reduction in IOP at Week 4 which was sustained through Week 52. Mean IOP was 14.4 mm Hg at Week 52 representing a 26%
reduction from baseline in the study eye. The most common ocular adverse events were conjunctival hyperemia, growth of eyelashes, iris
pigmentation, blepharal pigmentation, eye irritation, and eye pain.
24-hour IOP Lowering Study: VYZULTA Demonstrated Better 24-hour IOP Control than Timolol
Another study, CONSTELLATION, compared the effect of VYZULTA dosed QD with timolol maleate ophthalmic solution 0.5% dosed BID in
reducing IOP measured over a 24-hour period in subjects with open-angle glaucoma or ocular hypertension (N=25). The results of this
randomized, single-center, open-label, 2-month crossover study demonstrated that VYZULTA lowered IOP over 24-hours, with a
significantly greater nocturnal IOP reduction vs. timolol (p<0.004). The study also compared ocular perfusion pressure (OPP) in VYZULTA treated subjects vs. timolol-treated subjects over a 24-hour period. VYZULTA improved daytime OPP vs. baseline (p<0.001) and nocturnal
OPP vs. timolol 0.5% (p=0.01).
Important Risk Information about VYZULTA
INDICATION AND USAGE
VYZULTA™ (latanoprostene bunod ophthalmic solution), 0.024% is a prostaglandin analog indicated for the reduction of intraocular
pressure in patients with open-angle glaucoma or ocular hypertension.
IMPORTANT SAFETY INFORMATION
Increased pigmentation of the iris, periorbital tissue (eyelid), and eyelashes can occur. Iris pigmentation is likely to be permanent
Gradual changes to eyelashes, including increased length, increased thickness, and number of eyelashes, may occur. These changes are
usually reversible upon treatment discontinuation
Most common ocular adverse reactions with incidence ≥2% are conjunctival hyperemia (6%), eye irritation (4%), eye pain (3%), and
instillation site pain (2%)
Please see full prescribing information at www.bausch.com/vyzulta.
Nicox S.A. (Euronext Paris: FR0013018124, COX) is an international ophthalmic company developing innovative solutions to help maintain
vision and improve ocular health. By leveraging its proprietary expertise in NO donation and other technologies, the Company is developing
an extensive portfolio of novel drug candidates that target multiple ophthalmic conditions, including glaucoma. Nicox currently has two
products with approved NDAs, VYZULTA (latanoprostene bunod ophthalmic solution), 0.024%, licensed worldwide to Bausch + Lomb,
and ZERVIATE (cetirizine ophthalmic solution) 0.24% licensed in the U.S. to Eyevance. In addition, its promising drug-candidate pipeline
includes clinical stage assets based both on its proprietary NO-donating research platform and on the repurposing of existing molecules as
well as a next-generation of stand-alone NO donors and exploratory novel NO-donating compounds with the potential to offer novel
approaches to treat a range of ophthalmic conditions. Nicox is headquartered in Sophia Antipolis, France, is listed on Euronext Paris
(Compartment B: Mid Caps; Ticker symbol: COX) and is part of the CAC Healthcare, CAC Pharma & Bio and Next 150 indexes. For more
information on Nicox, its products or pipeline, please visit: www.nicox.com.
About Bausch + Lomb
Bausch + Lomb, a Valeant Pharmaceuticals International, Inc. company, is a leading global eye health organization that is solely focused on
protecting, enhancing and restoring people’s eyesight. Its core businesses include over-the-counter supplements, eye care products,
ophthalmic pharmaceuticals, contact lenses, lens care products, ophthalmic surgical devices and instruments. Bausch + Lomb develops,
manufactures and markets one of the most comprehensive product portfolios in our industry, which is available in more than 100 countries.
Valeant Pharmaceuticals International, Inc. (NYSE/TSX: VRX) is a multinational specialty pharmaceutical company that develops,
manufactures and markets a broad range of pharmaceutical products primarily in the areas of dermatology, gastrointestinal disorders, eye
health, neurology and branded generics. More information about Valeant can be found at www.valeant.com.
This press release may contain forward-looking statements which may generally be identified by the use of the words “anticipates,”
“expects,” “intends,” “plans,” “should,” “could,” “would,” “may,” “will,” “believes,” “estimates,” “potential,” “target,” or “continue” and
variations or similar expressions. These statements are based upon the current expectations and beliefs of the management of Valeant and
Nicox and are subject to certain risks and uncertainties that could cause actual results to differ materially from those described in the
forward-looking statements. These risks and uncertainties include, but are not limited to, risks and uncertainties discussed in Valeant’s most
recent annual or quarterly report and detailed from time to time in Valeant’s other filings with the Securities and Exchange Commission and
the Canadian Securities Administrators, which factors are incorporated herein by reference. Readers are cautioned not to place undue
reliance on any of these forward-looking statements. These forward-looking statements speak only as of the date hereof. Neither Valeant
nor Nicox undertakes any obligation to update any of these forward-looking statements to reflect events or circumstances after the date of
this press release or to reflect actual outcomes, unless required by law.
1. Vyzulta™ [prescribing information]. Bridgewater, NJ: Bausch & Lomb Incorporated; 2017.
2. Weinreb RN, Scassellati Sforzolini B, Vittitow J, Liebmann J. Latanoprostene bunod 0.024% versus Timolol maleate 0.5% in subjects with
open-angle glaucoma or ocular hypertension: the APOLLO study. Ophthalmology. 2016;123(5):965-973.
3. Medeiros FA, Martin KR, Peace J, et al. Comparison of latanoprostene bunod 0.024% and timolol maleate 0.5% in open-angle glaucoma or
ocular hypertension: the LUNAR study. Am J Ophthalmol. 2016;168:250-259.
4. Kaufman PL. Latanoprostene bunod ophthalmic solution 0.024% for IOP lowering in glaucoma and ocular hypertension. Expert Opin
5. Weinreb RN, Ong T, Scassellati Sforzolini B, et al. A randomised, controlled comparison of latanoprostene bunod and latanoprost 0.005%
in the treatment of ocular hypertension and open angle glaucoma: the VOYAGER study. Br J Ophthalmol. 2015;99:738-745.
6. Kawase K, Vittitow JL, Weinreb RN, Araie M for the Jupiter Study Group. Long-term safety and efficacy of latanoprostene bunod 0.024%
in Japanese subjects with open-angle glaucoma or ocular hypertension: the JUPITER Study. Adv Ther. 2016;33:1612-1627.
7. Liu J, Slight JR, Vittitow JL, et al. Efficacy of latanoprostene bunod 0.024% compared with timolol 0.5% in lowering intraocular pressure
over 24 hours. Am J Ophthalmol. 2016;169:249-257.
877-281-6642 (toll free)
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+44 7860 361 746
T +33 (0)1 44 71 94 98
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