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.