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Acurox™ Tablets

Acurox™ Tablets, our lead product candidate with Aversion Technology, is an orally administered immediate-release tablet containing oxycodone HCl as the sole active analgesic ingredient, a sub therapeutic amount of niacin, and a unique composition of functional inactive ingredients. Acurox™ Tablets will have an anticipated indication for treating acute moderate to moderately severe pain and will also have anticipated features to discourage or deter the most common methods of misuse and abuse including (i) intravenous injection of dissolved tablets, (ii) nasal snorting of crushed tablets and (iii) intentional swallowing of excess quantities of tablets.  Acurox™ Tablets are being developed pursuant to an active investigational new drug application (“IND”) on file with the FDA.  We and King intend to file a 505(b)(2) NDA for Acurox™ Tablets.  The FDA has confirmed in writing to us that the proposed NDA would qualify for a Section 505(b)(2) submission.   

Technical and Pre-Clinical Development Program and Regulatory Affairs Strategy

The technical and pre-clinical development program and regulatory strategy and status for Acurox™ Tablets are summarized below. At this stage, we can not provide any assurance that FDA will not require additional pre-clinical studies not listed below, or revise the Acurox™ Tablets regulatory requirements prior to their acceptance for filing of a 505(b)(2) NDA submission for Acurox™ Tablets.

     Technical and Pre-Clinical Development

 Status and Expectations

Formulation development

Complete

Pilot bioequivalence study

Complete

Pivotal oxycodone HCl extraction study

Complete

Tablet stability for NDA submission

Testing in process.  24 month real time data demonstrates stability acceptable for NDA submission

Toxicology studies

Not required per FDA written guidance to the Company

                 Regulatory Affairs Strategy

                               Status and Expectations

Investigational New Drug Application (IND)

Active

End of Phase II meeting with FDA

Complete

Factorial design clinical studies

Not required per FDA written guidance to Company

Phase III pivotal clinical trial

A single phase III efficacy and safety trial is required per FDA written guidance to Company

Type of regulatory submission for U.S. regulatory approval and commercial distribution in the U.S.

Acurox™ Tablets are eligible for submission as a 505(b)(2) NDA per FDA written guidance to Company

505(b)(2) NDA submission

Anticipate before end of 2008

Clinical Development Program

The clinical development program for Acurox Tablets is summarized below.  At this stage, the Company cannot provide any assurance that FDA will not require additional clinical studies prior to their acceptance for filing of a 505(b)(2) NDA submission for Acurox Tablets

Clinical Studies to Evaluate Pharmacokinetics in Normal Subjects

Status and Expectations

     AP-ADF-104

Phase I: Bioequivalence to non Aversion® Technology Reference Listed Drug

Final study report complete.  Acurox Tablets are bioequivalent to Reference Listed Drug

     AP-ADF-108

Phase I: Single dose linearity and food effect

Summary report complete. Acurox Tablets demonstrate single dose linearity. Absorption is delayed by food.

     AP-ADF-109

Phase I: Multi-dose linearity

Subject enrollment complete

 

Clinical Studies to Evaluate Niacin Dose Response in Normal Subjects

Status and Expectations

     AP-ADF-101

Phase I: Niacin dose response (0-75mg)

Final study report complete

     AP-ADF-103

Phase II: Repeat dose safety and tolerability

Final study report complete

     AP-ADF-107

Phase II: Niacin dose-response (0-600mg)

Final study report complete

 

Clinical Studies to Evaluate Tolerability of Nasal Snorting and Excess Oral Dose in Subjects with a History of Opioid Abuse

Status and Expectations

    AP-ADF-106

Phase I: Evaluate effects of nasal snorting in subjects with history of snorting and nasal drug abuse

Expect subject enrollment to commence in Q2-08

    AP-ADF-102

Phase II: Evaluate relative dislike of oxycodone HCl/niacin versus oxycodone alone

Final study report complete

    AP-ADF-111

Phase II: Evaluate abuse liability of oxycodone HCl/niacin versus oxycodone alone 

Subject enrollment commenced in Q1-08

 

Clinical Studies to Evaluate Efficacy and Safety in Patients with Acute Moderate to Severe Pain

Status and Expectations

    AP-ADF-105

Phase III: Pivotal efficacy and safety 

Special Protocol Assessment (SPA) agreed by FDA. Patient enrollment in progress. Top-line clinical trial results expected by July 2008. Anticipated final clinical study report by  H2-08

 

Estimated Timing for submission of a 505(b)(2) NDA for Acurox™ Tablets

In September, 2007 we began enrolling patients in clinical Study AP-ADF-105, our pivotal phase III efficacy and safety study being conducted pursuant to a Special Protocol Assessment agreed with the FDA (see description of this study under the link “Study AP-ADF-105”).  We expect to submit our 505(b)(2) NDA for Acurox™ Tablets to the FDA in the second half of 2008. At the time of NDA submission we intend to request a priority review of the application by the FDA.  The FDA has publicly indicated a willingness to consider such action for product candidates incorporating abuse deterrence features.  No assurance however can be provided that the FDA will grant a priority review of our 505(b)(2) NDA submission. 

 

Expectations for Acurox™ Tablets Product Labeling

In the U.S., every product approved for commercialization pursuant to an NDA must be marketed in accordance with its FDA approved indications and associated product labeling.  The FDA has provided written guidance to us stating that an indication for abuse deterrence must be supported by data from two adequate and well-controlled clinical trials.  We do not intend to seek an indication for abuse deterrence for Acurox™ Tablets.  Instead, we are seeking an indication for Acurox™ Tablets for treatment of moderate to moderately severe pain.  The FDA has also provided written guidance to us stating that language regarding abuse deterrence (as opposed to an indication for abuse deterrence), which is supported by rigorous, scientific data, may be placed into appropriate sections of the Acurox™ Tablet product label.  In this regard, we intend to seek FDA approval of language in the Acurox™ Tablet product label describing the physical characteristics of the product and likely results if attempts are made to dissolve tablets in solvents suitable for intravenous injection, and/or snort crushed tablets, and/or swallow excess quantities of tablets.  We believe this product labeling strategy will provide a viable promotional platform for the commercialization of Acurox™ Tablets and other product candidates utilizing Aversion® Technology.  At this stage there can be no assurances that our product labeling strategy for Acurox™ Tablets will be successful or that FDA approved product labeling, if any, will provide a viable commercialization platform.

 

 
   
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