ASH 2017: Janssen to Present 40 Abstracts, Including 8 Oral Presentations, with New Data on DARZALEX® (daratumumab), IMBRUVICA® (ibrutinib) and Other Compounds from Robust Portfolio
RARITAN, N.J., Nov. 1, 2017 /PRNewswire/ -- New data for the immunotherapy DARZALEX(®) (daratumumab) and first-in-class BTK inhibitor IMBRUVICA(®) (ibrutinib) are among eight oral presentations from Janssen Research & Development, LLC, to be featured at the 59(th) American Society of Hematology (ASH) Annual Meeting & Exhibition taking place December 9-12, in Atlanta, GA. In total, 40 company-sponsored abstracts for both approved and investigational oncology and cardiovascular compounds have been accepted for presentation. In addition to IMBRUVICA and DARZALEX, data from studies of oral anticoagulant XARELTO(®) (rivaroxaban) and investigational compound imetelstat, and more than 20 investigator-initiated studies for all of these compounds, will be presented.
"This year's ASH meeting promises important updates for approved and investigational compounds across our hematology portfolio," said Peter Lebowitz, M.D., Ph.D., Global Therapeutic Area Head of Oncology, Janssen Research & Development. "Data showing long-term outcomes for DARZALEX and IMBRUVICA, as well as initial compelling results for these therapies and new pipeline products, show our strong focus on developing transformational therapies and our unwavering commitment to people living with blood cancers."
Key company-sponsored data presentations include:
-- DARZALEX: Early data from the Phase 1b PAVO study will be presented on
the tolerability of the subcutaneous delivery of DARZALEX co-formulated
with recombinant human hyaluronidase PH20 in patients with relapsed or
refractory multiple myeloma. Updated safety, efficacy and
pharmacokinetic data for this new investigational delivery method for
DARZALEX will be presented at the meeting.
-- The Phase 1b data will be presented as an oral presentation at 5:15
p.m. ET on Monday, December 11 (Abstract #838).
-- DARZALEX: The first look at results from the Phase 2 CENTAURUS trial
assessing DARZALEX monotherapy for patients with intermediate or
high-risk smoldering multiple myeloma will be presented. Smoldering
multiple myeloma is an asymptomatic precursor stage to multiple myeloma,
where early intervention to delay or prevent the progression to active
disease could benefit patients. These results will serve as the basis of
a Phase 3 study, with enrollment initiating later this year.
-- The Phase 2 data will be presented as an oral presentation at 5:45
p.m. ET on Sunday, December 10 (Abstract #510).
-- DARZALEX: Updated analyses from two pivotal trials will be presented.
Long-term progression-free survival (PFS) data from the Phase 3 POLLUX
trial, which assessed DARZALEX in combination with lenalidomide and
dexamethasone in patients with relapsed or refractory multiple myeloma
who have received at least one prior therapy, will be presented.
Additionally, data from the Phase 3 CASTOR clinical trial will provide a
first look at overall survival for DARZALEX in combination with
bortezomib and dexamethasone in patients with relapsed or refractory
multiple myeloma who have received at least one prior therapy.
-- The updated POLLUX data will be presented as an oral presentation at
2:45 p.m. ET on Monday, December 11 (Abstract #739).
-- The updated CASTOR data will be presented as a poster presentation
from 5:30 - 7:30 p.m. ET on Saturday, December 9 (Abstract #1852).
-- IMBRUVICA: A pooled analysis of 3.5-year follow-up data from Phase 2 and
Phase 3 studies further supports PFS of the first-in-class BTK inhibitor
IMBRUVICA in patients with relapsed or refractory Mantle Cell Lymphoma
(MCL).
-- The pooled analysis will be presented as an oral presentation at
12:00 p.m. ET on Saturday, December 9 (Abstract #151).
-- IMBRUVICA: Results from a Phase 1/2a study evaluating the safety and
efficacy of IMBRUVICA in combination with nivolumab in patients with
relapsed or refractory non-Hodgkin lymphoma or chronic lymphocytic
leukemia will be presented for the first time.
-- The Phase 1/2a data will be presented as an oral presentation at
5:30 p.m. ET on Monday, December 11 (Abstract #833).
-- Imetelstat: Data from the first 32 patients enrolled in Part 1 of an
ongoing Phase 2/3 clinical trial of imetelstat in patients with
transfusion-dependent anemia due to low or intermediate 1 risk
myelodysplastic syndromes (MDS) that is not associated with the deletion
5q cytogenetic abnormality (del[5q]) and who are refractory/resistant to
treatment with an erythropoiesis-stimulating agent (ESA) will be
presented.
-- The Phase 2/3 study will be presented as a poster presentation from
6:00 - 8:00 p.m. ET on Monday, December 11 (Abstract #4256).
-- Imetelstat: Integrated molecular analysis will identify replicative
stress as a sensitizer to imetelstat in Acute Myeloid Leukemia (AML)
cells.
-- The analysis will be presented as an oral presentation at 5:45 p.m.
ET on Monday, December 11 (Abstract #798).
-- XARELTO: Data will be presented evaluating XARELTO for the treatment of
venous thromboembolism (VTE), including economic findings from the
EINSTEIN CHOICE study and efficacy and safety results in people with
cancer-associated VTE. VTE is the second leading cause of death in
people with active cancer.
-- EINSTEIN CHOICE data will be presented as an oral presentation at
2:15 p.m. ET on Saturday, December 9 (Abstract #218).
-- Cancer-associated VTE data will be presented as an oral presentation
at 10:30 a.m. ET on Monday, December 11 (Abstract #625).
A full list of company-sponsored abstracts to be presented at the meeting follows below:
Abstract No. Title Date/Time
------------ ----- ---------
DARZALEX
--------
Oral Presentations
------------------
Abstract #510 Daratumumab monotherapy for patients with Oral Session
intermediate or high-risk smoldering multiple
myeloma (SMM): CENTAURUS, a randomized, Sunday, December 10
open-label, multicenter Phase 2 Study
5:45 p.m. ET
---
Abstract #838 Subcutaneous Delivery of Daratumumab in Patients Oral Session
(pts) with Relapsed or Refractory Multiple
Myeloma
(RRMM): PAVO, an Open-label, Multicenter, Dose Monday, December 11
Escalation Phase 1b Study
5:15 p.m. ET
--- ------------ ------------
Abstract #739 Daratumumab, Lenalidomide, and Dexamethasone Oral Session
(DRd) Versus Lenalidomide and Dexamethasone
(Rd) in Relapsed or Refractory Multiple Myeloma Monday, December 11
(RRMM): Updated Efficacy and Safety Analysis of
POLLUX 2:45 p.m. ET
---
Poster Presentations
--------------------
Abstract #1883 Daratumumab, Lenalidomide, and Dexamethasone Poster Session
(DRd) Versus Lenalidomide and Dexamethasone
(Rd) in Relapsed or Refractory Multiple Myeloma Saturday, December 9
(RRMM) Based on Prior Treatment History, Renal
Function, and Cytogenetic Risk: Subgroup Analyses 5:30 - 7:30 p.m. ET
of POLLUX
--- ---------
Abstract #1852 Daratumumab, bortezomib, and dexamethasone Poster Session
versus bortezomib and dexamethasone for
relapsed/refractory multiple myeloma Saturday, December 9
(RRMM) patients: An update of overall survival in
CASTOR
5:30 - 7:30 p.m. ET
--- ------------------- -------------------
Abstract #1828 Daratumumab in Combination with Lenalidomide Poster Session
and Dexamethasone in Patients with Relapsed or
Relapsed/Refractory Multiple Myeloma (GEN503): Saturday, December 9
Final Results of an Open-label, Phase 1/2 Study
5:30 - 7:30 p.m. ET
--- ------------------- -------------------
Abstract #1869 Daratumumab in Combination with Carfilzomib and Poster Session
Dexamethasone in Patients (pts) With Relapsed
Multiple Myeloma (MMY1001): An Open-label, Saturday, December 9
Phase 1b Study
5:30 - 7:30 p.m. ET
--- ------------------- -------------------
Abstract #2113 Treatment Patterns and Survival Outcomes in Latin Poster Session
American Patients with Newly Diagnosed Multiple
Myeloma: A Retrospective Medical Chart Review Saturday, December 9
Study, 2008-2016
5:30 - 7:30 p.m. ET
--- ------------------- -------------------
Abstract #1879 Interim Safety Analysis of a Phase 2 Randomized Poster Session
Study of Daratumumab (Dara), Lenalidomide (R),
Bortezomib (V), and Dexamethasone (d; Dara?RVd) Saturday, December 9
vs. RVd in Patients (Pts) with Newly Diagnosed
Multiple Myeloma (MM) Eligible for High?Dose 5:30 - 7:30 p.m. ET
Therapy (HDT) and Autologous Stem Cell
Transplantation (ASCT)
--- ---------------------
Abstract #1824 Daratumumab in Combination with Pomalidomide Poster Session
and Dexamethasone for Relapsed and/or
Refractory Multiple Myeloma (RRMM) Patients with Saturday, December 9
>=2 Prior Lines of Therapy: Updated Analysis of
MMY1001 5:30 - 7:30 p.m. ET
--- ------- -------------------
Abstract #1839 Results of an Interim Safety Analysis of a Phase
2 Poster Session
Study of Daratumumab (Dara) plus
Cyclophosphamide, Bortezomib and Saturday, December 9
Dexamethasone (CyBorD) in Previously Untreated
and Relapsed Patients (Pts) with Multiple Myeloma 5:30 - 7:30 p.m. ET
(MM)
--- ---
Abstract #3107 Safety and Efficacy of Daratumumab Monotherapy Poster Session
in Patients with Heavily Pretreated Relapsed and
Refractory Multiple Myeloma: Final Results from Sunday, December 10
GEN501 and SIRIUS
6:00 - 8:00 p.m. ET
--- ------------------- -------------------
Abstract #3100 Daratumumab (DARA) in Combination with Poster Session
Carfilzomib, Lenalidomide, and Dexamethasone
(KRd) in Patients with Newly Diagnosed Multiple Sunday, December 10
Myeloma (MMY1001): Updated Results From an
Open-label, Phase 1b Study 6:00 - 8:00 p.m. ET
--- -------------------------- -------------------
Abstract #3124 Daratumumab in Combination with Lenalidomide Poster Session
Plus Dexamethasone Results in Persistent Natural
Killer (NK) Cells with a Distinct Phenotype and Sunday, December 10
Expansion of Effector Memory T-cells in POLLUX, a
Phase 3 Randomized Study 6:00 - 8:00 p.m. ET
--- ------------------------ -------------------
Abstract #3093 Evaluation of Efficacy Outcomes among Relapsed/ Poster Session
Refractory Multiple Myeloma Treated Patients in a
Real-World Setting Sunday, December 10
6:00 - 8:00 p.m. ET
--- ------------------- -------------------
Abstract #3094 Comparison of Overall Survival Associated with Poster Session
Lenalidomide+Dexamethasone and
Bortezomib+Dexamethasone Among Sunday, December 10
Relapsed/Refractory Multiple Myeloma Patients: A
Matched Analysis of Real World and Clinical Trial 6:00 - 8:00 p.m. ET
Populations (Facilitation)
--- -------------------------
Abstract #3145 Daratumumab, Bortezomib, and Dexamethasone Poster Session
(DVd) Versus Bortezomib and Dexamethasone (Vd)
in Relapsed or Refractory Multiple Myeloma Sunday, December 10
(RRMM): Updated Efficacy and Safety Analysis of
CASTOR 6:00 - 8:00 p.m. ET
--- ------ -------------------
Abstract #3805 Proteomic profiling reveals targetable pathways
in Poster Session
MGUS (SLAMF6, TNFRSF8, TIMP1, TRL2) that
may contribute to disease progression Monday, December 11
6:00 - 8:00 p.m. ET
--- ------------------- -------------------
IMBRUVICA
---------
Oral Presentations
------------------
Abstract #151 Median 3.5-year Follow-Up of Ibrutinib Treatment in Oral Session
Patients with Relapsed/Refractory Mantle Cell
Lymphoma: A Pooled Analysis Saturday, December 9
12:00 p.m. ET
--- --- -------------
Abstract #833 LYM1002: Phase 1/2A Study of Ibrutinib + Oral Session
Nivolumab Safety and Efficacy of Ibrutinib with
Nivolumab Combination in Patients with Relapsed Monday, December 11
Non-Hodgkin Lymphoma or Chronic Lymphocytic
Leukemia 5:30 p.m. ET
--- ---
Poster Presentations
--------------------
Abstract #2770 Comparative effectiveness of single-agent ibrutinib Poster Session
in the RAY trial versus real-world treatment in the
Lyon-Sud database in patients with relapsed or Sunday, December 10
refractory mantle cell lymphoma
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #2783 FL/MZL: Systematic literature review of the clinical Poster Session
efficacy and safety of treatments in the
relapsed/refractory setting for patients with follicular Sunday, December 10
lymphoma or marginal zone lymphoma
6:00 - 8:00 p.m.ET
--- --- ------------------
Abstract #4303 A validated risk model for overall survival in Poster Session
relapsed/refractory chronic lymphocytic leukemia
applicable to patients treated with novel therapies Monday, December 11
and standard of care
6:00 - 8:00 p.m. ET
--- ---
Imetelstat
----------
Oral Presentations
------------------
Abstract #798 Integrated Molecular Analysis Identifies Replicative Oral Session
Stress as Sensitizer to Imetelstat therapy in AML
Monday, December 11
5:45 p.m. ET
--- --- ------------
Poster Presentations
--------------------
Abstract #1654 Imetelstat, a Telomerase Inhibitor, Is Capable of Poster Session
Depleting MF Hematopoietic Stem Cells and
Progenitor Cells Saturday, December 9
5:30 - 7:30 p.m. ET
--- --- -------------------
Abstract #2860 Telomerase Inhibition Impairs Self-renewal of b- Poster Session
catenin Activated Myeloproliferative Neoplasm
Progenitors Sunday, December 10
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #4256 Efficacy and Safety of Imetelstat in RBC Poster Session
Transfusion-Dependent (TD) IPSS Low/Int-1 MDS
Relapsed/Refractory to Erythropoiesis-Stimulating Monday, December 11
Agents (ESA) (IMerge)
6:00 - 8:00 p.m. ET
--- --- -------------------
XARELTO
-------
Oral Presentations
------------------
Abstract #218 Healthcare Cost Impact of Continued Oral Session
Anticoagulation Therapy with Rivaroxaban versus
Aspirin for Prevention of Recurrent Symptomatic Saturday, December 9
Venous Thromboembolism in the EINSTEIN
CHOICE Trial Population 2:15 p.m. ET
--- ----------------------- ------------
Abstract #625 Anticoagulation Therapy in Cancer Patients at Risk Oral Session
of Recurrence of Venous Thromboembolism: Monday, December 11
Results of the select-d pilot trial 10:30 a.m. ET
--- ----------------------------------- -------------
Poster Presentations
--------------------
Abstract #2142 Does Treatment Satisfaction Influence Adherence Poster Session
to Treatment? Impact of AF Patients' Treatment
Satisfaction on Adherence to Oral Anticoagulation Saturday, December 9
Treatment
5:30 - 7:30 p.m. ET
--- --- -------------------
Abstract #1107 The Effect of Rivaroxaban Exposure and Clinical Poster Session
Risk Factors on Efficacy and Safety
Outcomes in Patients with Nonvalvular Atrial Fibrillation Saturday, December 9
5:30 - 7:30 p.m. ET
--- --- -------------------
Abstract #1104 The Effects of Rivaroxaban Exposure and of Poster Session
Clinical Risk Factors on Efficacy and Safety
Outcomes in Patients Treated for Venous Saturday, December 9
Thromboembolism
5:30 - 7:30 p.m. ET
--- --- -------------------
Abstract #2386 A Pooled Analysis of the XALIA and XALIA-LEA Poster Session
Non-Interventional Studies of Rivaroxaban versus
Standard Anticoagulation in Venous Sunday, December 10
Thromboembolism
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #2393 Effectiveness and Safety of Rivaroxaban vs. Poster Session
Warfarin in Patients with Nonvalvular Atrial
Fibrillation and Moderate-to-Severe Chronic Kidney Sunday, December 10
Disease
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #4727 Patient Preferences Regarding Non-Vitamin K Poster Session
Antagonist Oral Anticoagulants for Stroke
Prevention in Atrial Fibrillation Patients - a Discrete Monday, December 11
Choice Experiment
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #4631 VTE Recurrence and Safety of Anticoagulants Poster Session
Among Patients with Cancer Treated for Venous
Thromboembolism Monday, December 11
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #4640 Healthcare Costs Associated with Venous Poster Session
Thromboembolism in Cancer Patients Treated with
Anticoagulants Monday, December 11
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #3717 Effectiveness and Safety of Rivaroxaban in Poster Session
Patients with Cancer-Associated Venous
Thromboembolism Monday, December 11
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #3718 Effects of Rivaroxaban Exposure and of Clinical Poster Session
Risk Factors on Efficacy and Safety Outcomes in
The Prevention of Venous Thromboembolism After Monday, December 11
Elective Hip or Knee Replacement Surgery
6:00 - 8:00 p.m. ET
--- --- -------------------
Abstract #4726 Real-World Adherence to Non-Vitamin K Poster Session
Antagonist Oral Anticoagulants
in Patients with Atrial Fibrillation: Results of an Monday, December 11
International Survey
6:00 - 8:00 p.m. ET
About DARZALEX Injection, for Intravenous Infusion
DARZALEX (daratumumab) injection for intravenous use is the first CD38-directed antibody approved anywhere in the world.[1] CD38 is a surface protein that is highly expressed across multiple myeloma cells, regardless of disease stage.[2] DARZALEX is believed to induce tumor cell death through multiple immune-mediated mechanisms of action, including complement-dependent cytotoxicity (CDC), antibody-dependent cell-mediated cytotoxicity (ADCC) and antibody-dependent cellular phagocytosis (ADCP), as well as through apoptosis, in which a series of molecular steps in a cell lead to its death.[3] A subset of myeloid derived suppressor cells (MDSCs), CD38+ regulatory T cells (Tregs) and CD38+ B cells (Bregs) were decreased by DARZALEX.(3) DARZALEX is being evaluated in a comprehensive clinical development program across a range of treatment settings in multiple myeloma, such as in frontline and relapsed settings.[4](,[5],[6],[7],[8] )Additional studies are ongoing or planned to assess its potential for a solid tumor indication and in other malignant and pre-malignant diseases in which CD38 is expressed, such as smoldering myeloma.[9](,[10],[11] )DARZALEX was the first CD38-directed antibody to receive regulatory approval to treat relapsed or refractory multiple myeloma.[12]
About Multiple Myeloma
Multiple myeloma is an incurable blood cancer that occurs when malignant plasma cells grow uncontrollably in the bone marrow.[13](,[14]) Refractory cancer occurs when a patient's disease is resistant to treatment or in the case of multiple myeloma, patients progress within 60 days of their last therapy.[15](,[16] )Relapsed cancer means the disease has returned after a period of initial, partial or complete remission.[17] Globally, it is estimated that 124,225 people were diagnosed and 87,084 died from the disease in 2015.[18](,[19]) While some patients with multiple myeloma have no symptoms at all, most patients are diagnosed due to symptoms, which can include bone fracture or pain, low red blood counts, fatigue, calcium elevation, kidney problems or infections.[20]
IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS - None
WARNINGS AND PRECAUTIONS
Infusion Reactions - DARZALEX can cause severe infusion reactions. Approximately half of all patients experienced a reaction, most during the first infusion. Infusion reactions can also occur with subsequent infusions. Nearly all reactions occurred during infusion or within 4 hours of completing an infusion. Prior to the introduction of post-infusion medication in clinical trials, infusion reactions occurred up to 48 hours after infusion. Severe reactions have occurred, including bronchospasm, hypoxia, dyspnea, hypertension, laryngeal edema and pulmonary edema. Signs and symptoms may include respiratory symptoms, such as nasal congestion, cough, throat irritation, as well as chills, vomiting and nausea. Less common symptoms were wheezing, allergic rhinitis, pyrexia, chest discomfort, pruritus, and hypotension.
Pre-medicate patients with antihistamines, antipyretics, and corticosteroids. Frequently monitor patients during the entire infusion. Interrupt infusion for reactions of any severity and institute medical management as needed. Permanently discontinue therapy for life-threatening (Grade 4) reactions. For patients with Grade 1, 2, or 3 reactions, reduce the infusion rate when re-starting the infusion.
To reduce the risk of delayed infusion reactions, administer oral corticosteroids to all patients following DARZALEX infusions. Patients with a history of chronic obstructive pulmonary disease may require additional post-infusion medications to manage respiratory complications. Consider prescribing short- and long-acting bronchodilators and inhaled corticosteroids for patients with chronic obstructive pulmonary disease.
Interference with Serological Testing - Daratumumab binds to CD38 on red blood cells (RBCs) and results in a positive Indirect Antiglobulin Test (Indirect Coombs test). Daratumumab-mediated positive indirect antiglobulin test may persist for up to 6 months after the last daratumumab infusion. Daratumumab bound to RBCs masks detection of antibodies to minor antigens in the patient's serum. The determination of a patient's ABO and Rh blood type are not impacted. Notify blood transfusion centers of this interference with serological testing and inform blood banks that a patient has received DARZALEX. Type and screen patients prior to starting DARZALEX.
Neutropenia - DARZALEX may increase neutropenia induced by background therapy. Monitor complete blood cell counts periodically during treatment according to manufacturer's prescribing information for background therapies. Monitor patients with neutropenia for signs of infection. DARZALEX dose delay may be required to allow recovery of neutrophils. No dose reduction of DARZALEX is recommended. Consider supportive care with growth factors.
Thrombocytopenia - DARZALEX may increase thrombocytopenia induced by background therapy. Monitor complete blood cell counts periodically during treatment according to manufacturer's prescribing information for background therapies. DARZALEX dose delay may be required to allow recovery of platelets. No dose reduction of DARZALEX is recommended. Consider supportive care with transfusions.
Interference with Determination of Complete Response - Daratumumab is a human IgG kappa monoclonal antibody that can be detected on both, the serum protein electrophoresis (SPE) and immunofixation (IFE) assays used for the clinical monitoring of endogenous M-protein. This interference can impact the determination of complete response and of disease progression in some patients with IgG kappa myeloma protein.
Adverse Reactions - In patients who received DARZALEX in combination with lenalidomide and dexamethasone, the most frequently reported adverse reactions (incidence >=20%) were: neutropenia (92%), thrombocytopenia (73%), upper respiratory tract infection (65%), infusion reactions (48%), diarrhea (43%), fatigue (35%), cough (30%), muscle spasms (26%), nausea (24%), dyspnea (21%) and pyrexia (20%). The overall incidence of serious adverse reactions was 49%. Serious adverse reactions were pneumonia (12%), upper respiratory tract infection (7%), influenza (3%) and pyrexia (3%).
In patients who received DARZALEX in combination with bortezomib and dexamethasone, the most frequently reported adverse reactions (incidence >=20%) were: thrombocytopenia (90%), neutropenia (58%), peripheral sensory neuropathy (47%), infusion reactions (45%), upper respiratory tract infection (44%), diarrhea (32%), cough (27%), peripheral edema (22%), and dyspnea (21%). The overall incidence of serious adverse reactions was 42%. Serious adverse reactions were upper respiratory tract infection (5%), diarrhea (2%) and atrial fibrillation (2%).
In patients who received DARZALEX as monotherapy, the most frequently reported adverse reactions (incidence >=20%) were: neutropenia (60%), thrombocytopenia (48%), infusion reactions (48%), fatigue (39%), nausea (27%), back pain (23%), pyrexia (21%), cough (21%), and upper respiratory tract infection (20%). Serious adverse reactions were reported in 51 (33%) patients. The most frequent serious adverse reactions were pneumonia (6%), general physical health deterioration (3%), and pyrexia (3%).
In patients who received DARZALEX in combination with pomalidomide and dexamethasone, the most frequent adverse reactions (>20%) were infusion reactions (50%), diarrhea (38%), constipation (33%), nausea (30%), vomiting (21%), fatigue (50%), pyrexia (25%), upper respiratory tract infection (50%), muscle spasms (26%), back pain (25%), arthralgia (22%), dizziness (21%), insomnia (23%), cough (43%) and dyspnea (33%). The overall incidence of serious adverse reactions was 49%. Serious adverse reactions reported in >=5% patients included pneumonia (7%).
DRUG INTERACTIONS
Effect of Other Drugs on daratumumab: The coadministration of lenalidomide, pomalidomide or bortezomib with DARZALEX did not affect the pharmacokinetics of daratumumab.
Effect of Daratumumab on Other Drugs: The coadministration of DARZALEX with bortezomib did not affect the pharmacokinetics of bortezomib.
About IMBRUVICA
IMBRUVICA (ibrutinib) was one of the first therapies to receive U.S. approval after having received the FDA's Breakthrough Therapy Designation. IMBRUVICA works by blocking a protein called Bruton's tyrosine kinase (BTK). The BTK protein transmits important signals that tell B cells to mature and produce antibodies and is needed by specific cancer cells to multiply and spread.[21] IMBRUVICA targets and blocks BTK, inhibiting the survival and spread of cancer cells, and impacting signaling associated with other serious conditions. For more information, visit www.IMBRUVICA.com.
Additional Information about IMBRUVICA(® )
INDICATIONS
IMBRUVICA(®) is indicated to treat adults with:
-- Chronic lymphocytic leukemia (CLL)/Small lymphocytic lymphoma (SLL)
-- Chronic lymphocytic leukemia (CLL)/Small lymphocytic lymphoma (SLL) with
17p deletion
-- Waldenström's macroglobulinemia (WM)
-- Mantle cell lymphoma (MCL) patients who have received at least one prior
therapy
-- Accelerated approval was granted for this indication based on
overall response rate. Continued approval for this indication may be
contingent upon verification and description of clinical benefit in
a confirmatory trial.
-- Marginal zone lymphoma (MZL) patients who require systemic therapy and
have received at least one prior anti-CD20-based therapy
-- Accelerated approval was granted for this indication based on
overall response rate. Continued approval for this indication may be
contingent upon verification and description of clinical benefit in
a confirmatory trial.
-- Chronic Graft-Versus-Host-Disease (cGVHD) patients who failed one or
more lines of systemic therapy
IMPORTANT SAFETY INFORMATION
WARNINGS AND PRECAUTIONS
Hemorrhage: Fatal bleeding events have occurred in patients treated with IMBRUVICA(®). Grade 3 or higher bleeding events (intracranial hemorrhage [including subdural hematoma], gastrointestinal bleeding, hematuria, and post-procedural hemorrhage) have occurred in up to 6% of patients. Bleeding events of any grade, including bruising and petechiae, occurred in approximately half of patients treated with IMBRUVICA(®).
The mechanism for the bleeding events is not well understood.
IMBRUVICA(®) may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and patients should be monitored for signs of bleeding.
Consider the benefit-risk of withholding IMBRUVICA(®) for at least 3 to 7 days pre- and post-surgery depending upon the type of surgery and the risk of bleeding.
Infections: Fatal and non-fatal infections (including bacterial, viral, or fungal) have occurred with IMBRUVICA(®) therapy. Grade 3 or greater infections occurred in 14% to 29% of patients. Cases of progressive multifocal leukoencephalopathy (PML) and Pneumocystis jirovecii pneumonia (PJP) have occurred in patients treated with IMBRUVICA(®). Consider prophylaxis according to standard of care in patients who are at increased risk for opportunistic infections.
Monitor and evaluate patients for fever and infections and treat appropriately.
Cytopenias: Treatment-emergent Grade 3 or 4 cytopenias including neutropenia (range, 13 to 29%), thrombocytopenia (range, 5 to 17%), and anemia (range, 0 to 13%) based on laboratory measurements occurred in patients with B-cell malignancies treated with single agent IMBRUVICA(®). Monitor complete blood counts monthly.
Atrial Fibrillation: Atrial fibrillation and atrial flutter (range, 6 to 9%) have occurred in patients treated with IMBRUVICA(®), particularly in patients with cardiac risk factors, hypertension, acute infections, and a previous history of atrial fibrillation. Periodically monitor patients clinically for atrial fibrillation. Patients who develop arrhythmic symptoms (e.g., palpitations, lightheadedness) or new onset dyspnea should have an ECG performed. Atrial fibrillation should be managed appropriately, and if it persists, consider the risks and benefits of IMBRUVICA(®) treatment and follow dose modification guidelines.
Hypertension: Hypertension (range, 6 to 17%) has occurred in patients treated with IMBRUVICA(®) with a median time to onset of 4.6 months (range, 0.03 to 22 months). Monitor patients for new onset hypertension or hypertension that is not adequately controlled after starting IMBRUVICA(®). Adjust existing anti-hypertensive medications and/or initiate anti-hypertensive treatment as appropriate.
Second Primary Malignancies: Other malignancies (range, 3 to 16%) including non-skin carcinomas (range, 1 to 4%) have occurred in patients treated with IMBRUVICA(®). The most frequent second primary malignancy was non-melanoma skin cancer (range, 2 to 13%).
Tumor Lysis Syndrome: Tumor lysis syndrome has been infrequently reported with IMBRUVICA(®) therapy. Assess the baseline risk (e.g., high tumor burden) and take appropriate precautions. Monitor patients closely and treat as appropriate.
Embryo-Fetal Toxicity: Based on findings in animals, IMBRUVICA(®) can cause fetal harm when administered to a pregnant woman. Advise women to avoid becoming pregnant while taking IMBRUVICA(®) and for 1 month after cessation of therapy. If this drug is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to a fetus. Advise men to avoid fathering a child during the same time period.
ADVERSE REACTIONS
B-cell malignancies: The most common adverse reactions (>=20%) in patients with B-cell malignancies (MCL, CLL/SLL, WM and MZL) were thrombocytopenia (62%), neutropenia (61%), diarrhea (43%), anemia (41%), musculoskeletal pain (30%), rash (30%), bruising (30%), nausea (29%), fatigue (29%), hemorrhage (22%), and pyrexia (21%).
The most common Grade 3 or 4 adverse reactions (>=5%) in patients with B-cell malignancies (MCL, CLL/SLL, WM and MZL) were neutropenia (39%), thrombocytopenia (16%), and pneumonia (10%).
Approximately 6% (CLL/SLL), 14% (MCL), 11% (WM) and 10% (MZL) of patients had a dose reduction due to adverse reactions. Approximately 4%-10% (CLL/SLL), 9% (MCL), and 9 % (WM [6%] and MZL [13%]) of patients discontinued due to adverse reactions.
cGVHD: The most common adverse reactions (>=20%) in patients with cGVHD were fatigue (57%), bruising (40%), diarrhea (36%), thrombocytopenia (33%), muscle spasms (29%), stomatitis (29%), nausea (26%), hemorrhage (26%), anemia (24%), and pneumonia (21%).
The most common Grade 3 or 4 adverse reactions (>=5%) reported in patients with cGVHD were fatigue (12%), diarrhea (10%), neutropenia (10%), pneumonia (10%), sepsis (10%), hypokalemia (7%), headache (5%), musculoskeletal pain (5%), and pyrexia (5%).
Twenty-four percent of patients receiving IMBRUVICA(®) in the cGVHD trial discontinued treatment due to adverse reactions. Adverse reactions leading to dose reduction occurred in 26% of patients.
DRUG INTERACTIONS
CYP3A Inducers: Avoid coadministration with strong CYP3A inducers.
CYP3A Inhibitors: Dose adjustment may be recommended.
SPECIFIC POPULATIONS
Hepatic Impairment (based on Child-Pugh criteria): Avoid use of IMBRUVICA(®) in patients with moderate or severe baseline hepatic impairment. In patients with mild impairment, reduce IMBRUVICA(®) dose.
Please see Full Prescribing Information: https://www.imbruvica.com/prescribing-information.
About Imetelstat
Imetelstat (GRN163L; JNJ-63935937) is a potent and specific inhibitor of telomerase that is administered by intravenous infusion. This first-in-class compound is a specially designed and modified short oligonucleotide, which targets and binds directly with high affinity to the active site of telomerase. Imetelstat has not been approved for marketing by any regulatory authority. Janssen entered into an exclusive worldwide license and collaboration agreement with Geron Corporation (Nasdaq: GERN) in November 2014 to develop and commercialize imetelstat, an investigational telomerase inhibitor.
WHAT IS XARELTO(®)?
XARELTO(®) is a prescription medicine used to reduce the risk of stroke and blood clots in people with atrial fibrillation, not caused by a heart valve problem. For patients currently well managed on warfarin, there is limited information on how XARELTO(®) and warfarin compare in reducing the risk of stroke.
XARELTO(®) is also a prescription medicine used to treat deep vein thrombosis (DVT) and pulmonary embolism (PE), and to reduce the risk of blood clots happening again in people who continue to be at risk for DVT or PE after receiving treatment for blood clots for at least 6 months.
XARELTO(®) is also a prescription medicine used to reduce the risk of forming a blood clot in the legs and lungs of people who have just had knee or hip replacement surgery.
IMPORTANT SAFETY INFORMATION
WHAT IS THE MOST IMPORTANT INFORMATION I SHOULD KNOW ABOUT XARELTO(®)?
-- For people taking XARELTO(®) for atrial fibrillation:People with atrial
fibrillation (an irregular heart beat) are at an increased risk of
forming a blood clot in the heart, which can travel to the brain,
causing a stroke, or to other parts of the body. XARELTO(®) lowers your
chance of having a stroke by helping to prevent clots from forming. If
you stop taking XARELTO(®), you may have increased risk of forming a
clot in your blood.Do not stop taking XARELTO(®) without talking to the
doctor who prescribes it for you. Stopping XARELTO(®) increases your
risk of having a stroke.If you have to stop taking XARELTO(®), your
doctor may prescribe another blood thinner medicine to prevent a blood
clot from forming.
-- XARELTO(®) can cause bleeding, which can be serious, and rarely may
lead to death. This is because XARELTO(®) is a blood thinner medicine
(anticoagulant) that reduces blood clotting. While you take XARELTO(®)
you are likely to bruise more easily, and it may take longer for
bleeding to stop.You may have a higher risk of bleeding if you take
XARELTO(®) and take other medicines that increase your risk of
bleeding, including:
-- Aspirin or aspirin-containing products
-- Non-steroidal anti-inflammatory drugs (NSAIDs)
-- Warfarin sodium (Coumadin(®), Jantoven(®))
-- Any medicine that contains heparin
-- Clopidogrel (Plavix(®))
-- Selective serotonin reuptake inhibitors (SSRIs) or serotonin
norepinephrine reuptake inhibitors (SNRIs)
-- Other medicines to prevent or treat blood clots
Tell your doctor if you take any of these medicines. Ask your doctor or pharmacist if you are not sure if your medicine is one listed above.
Call your doctor or get medical help right away if you develop any of these signs or symptoms of bleeding:
-- Unexpected bleeding or bleeding that lasts a long time, such as:
-- Nosebleeds that happen often
-- Unusual bleeding from gums
-- Menstrual bleeding that is heavier than normal, or vaginal bleeding
-- Bleeding that is severe or you cannot control
-- Red, pink, or brown urine
-- Bright red or black stools (looks like tar)
-- Cough up blood or blood clots
-- Vomit blood or your vomit looks like "coffee grounds"
-- Headaches, feeling dizzy or weak
-- Pain, swelling, or new drainage at wound sites
-- Spinal or epidural blood clots (hematoma): People who take a blood
thinner medicine like XARELTO(®), and have medicine injected into their
spinal and epidural area, or have a spinal puncture, have a risk of
forming a blood clot that can cause long-term or permanent loss of the
ability to move (paralysis). Your risk of developing a spinal or
epidural blood clot is higher if:
-- A thin tube called an epidural catheter is placed in your back to
give you certain medicine
-- You take NSAIDs or a medicine to prevent blood from clotting
-- You have a history of difficult or repeated epidural or spinal
punctures
-- You have a history of problems with your spine or have had surgery
on your spine
If you take XARELTO® and receive spinal anesthesia or have a spinal puncture, your doctor should watch you closely for symptoms of spinal or epidural blood clots. Tell your doctor right away if you have back pain, tingling, numbness, muscle weakness (especially in your legs and feet), or loss of control of the bowels or bladder (incontinence).
-- XARELTO(®) is not for people with artificial heart valves.Do not take
XARELTO(®) if you:
-- Currently have certain types of abnormal bleeding. Talk to your doctor
before taking XARELTO(®) if you currently have unusual bleeding.
-- Are allergic to rivaroxaban or any of the ingredients of XARELTO(®).
Before taking XARELTO(®), tell your doctor about all your medical
conditions, including if you:
-- Have ever had bleeding problems
-- Have liver or kidney problems
-- Are pregnant or plan to become pregnant. It is not known if XARELTO(®)
will harm your unborn baby.
-- Tell your doctor right away if you become pregnant during treatment
with XARELTO(®). Taking XARELTO(®) while you are pregnant may
increase the risk of bleeding in you or in your unborn baby.
-- If you take XARELTO(®) during pregnancy, tell your doctor right
away if you have any signs or symptoms of bleeding or blood loss.
See "What is the most important information I should know about
XARELTO(®)?" for signs and symptoms of bleeding.
-- Are breastfeeding or plan to breastfeed. XARELTO(®) may pass into your
breast milk. You and your doctor should decide if you will take
XARELTO(®) or breastfeed.
Tell all of your doctors and dentists that you are taking XARELTO(®). They should talk to the doctor who prescribed XARELTO(®) for you before you have any surgery, medical or dental procedure.
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some of your other medicines may affect the way XARELTO(®) works. Certain medicines may increase your risk of bleeding. See "What is the most important information I should know about XARELTO(®)?"
HOW SHOULD I TAKE XARELTO(®)?
-- Take XARELTO(®) exactly as prescribed by your doctor.
-- Do not change your dose or stop taking XARELTO(®) unless your doctor
tells you to.
-- Your doctor may change your dose if needed.
-- If you take XARELTO(®) for:
-- Atrial Fibrillation:
-- Take XARELTO(®) 1 time a day with your evening meal.
-- If you miss a dose of XARELTO(®), take it as soon as you
remember on the same day. Take your next dose at your regularly
scheduled time.
-- Blood clots in the veins of your legs or lungs:
-- Take XARELTO(®) 1 or 2 times a day as prescribed by your
doctor.
-- For the 15-mg and 20-mg doses, XARELTO(®) should be taken with
food.
-- For the 10-mg dose, XARELTO(®) may be taken with or without
food.
-- Take your XARELTO(®) dose(s) at the same time each day.
-- If you miss a dose:
-- If you take the 15-mg dose of XARELTO(®) 2 times a day (a
total of 30 mg of XARELTO(®) in 1 day): Take XARELTO(®) as
soon as you remember on the same day. You may take 2 doses
at the same time to make up for the missed dose. Take your
next dose at your regularly scheduled time.
-- If you take XARELTO(®) 1 time a day: Take XARELTO(®) as
soon as you remember on the same day. Take your next dose at
your regularly scheduled time.
-- Hip or knee replacement surgery:
-- Take XARELTO(®) 1 time a day with or without food.
-- If you miss a dose of XARELTO(®), take it as soon as you
remember on the same day. Take your next dose at your regularly
scheduled time.
-- If you have difficulty swallowing the XARELTO(® )tablet whole, talk to
your doctor about other ways to take XARELTO(®).
-- Your doctor will decide how long you should take XARELTO(®).
-- Your doctor may stop XARELTO(®) for a short time before any surgery,
medical or dental procedure. Your doctor will tell you when to start
taking XARELTO(®) again after your surgery or procedure.
-- Do not run out of XARELTO(®). Refill your prescription for XARELTO(®)
before you run out. When leaving the hospital following a hip or knee
replacement, be sure that you have XARELTO(®) available to avoid
missing any doses.
-- If you take too much XARELTO(®), go to the nearest hospital emergency
room or call your doctor right away.
WHAT ARE THE POSSIBLE SIDE EFFECTS OF XARELTO(®)?
-- See "What is the most important information I should know about
XARELTO(®)?"
Call your doctor for medical advice about side effects. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088. You may also report side effects to Janssen Pharmaceuticals, Inc., at 1-800-JANSSEN (1-800-526-7736).
Please see full Prescribing Information, including Boxed Warnings, and Medication Guide.
Trademarks are those of their respective owners.
About the Janssen Pharmaceutical Companies
At the Janssen Pharmaceutical Companies of Johnson & Johnson, we are working to create a world without disease. Transforming lives by finding new and better ways to prevent, intercept, treat and cure disease inspires us. We bring together the best minds and pursue the most promising science. We are Janssen. We collaborate with the world for the health of everyone in it. Learn more at www.janssen.com. Follow us at www.twitter.com/JanssenUS and www.twitter.com/JanssenGlobal.
Cautions Concerning Forward-Looking Statements
This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 regarding the continued study and development of DARZALEX® (daratumumab), IMBRUVICA® (ibrutinib) and XARELTO® (rivaroxaban), The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Janssen Research & Development, LLC, any of the other Janssen Pharmaceutical Companies and/or Johnson & Johnson. Risks and uncertainties include, but are not limited to: challenges inherent in product research and development, including uncertainty of clinical success and obtaining regulatory approvals; uncertainty of commercial success for new products or new indications; manufacturing difficulties or delays; competition, including technological advances, new products and patents attained by competitors; challenges to patents; changes in behavior and spending patterns of purchasers of health care products and services; product efficacy or safety concerns resulting in product recalls or regulatory action; changes to applicable laws and regulations, including global health care reforms; and trends toward health care cost containment. A further list and description of these risks, uncertainties and other factors can be found in Johnson & Johnson's Annual Report on Form 10-K for the fiscal year ended January 1, 2017, including under "Item 1A. Risk Factors," its most recently filed Quarterly Report on Form 10-Q, including in the section captioned "Cautionary Note Regarding Forward-Looking Statements," and the company's subsequent filings with the Securities and Exchange Commission. Copies of these filings are available online at www.sec.gov, www.jnj.com or on request from Johnson & Johnson. Neither the Janssen Pharmaceutical Companies nor Johnson & Johnson undertakes to update any forward-looking statement as a result of new information or future events or developments.
(1) Janssen Biotech, Inc. "Janssen Submits Application to U.S. FDA to Expand Indication for Daratumumab (DARZALEX®)." Issued August 17, 2016.
(2) Fedele G et al. CD38 Ligation in Peripheral Blood Mononuclear Cells of Myeloma Patients Induces Release of Protumorigenic IL-6 and Impaired Secretion of IFN Cytokines and Proliferation. Mediators Inflamm. 2013;2013:564687.
(3) DARZALEX Prescribing Information, June 2017.
(4) Janssen Research & Development, LLC. A Study Comparing Daratumumab, Lenalidomide, and Dexamethasone With Lenalidomide and Dexamethasone in Relapsed or Refractory Multiple Myeloma. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000-[cited 2016 Nov 11]. Available at: https://clinicaltrials.gov/ct2/show/NCT02076009?term=mmy3003&rank=1 NLM Identifier: NCT02136134.
(5) Janssen Research & Development, LLC. Addition of Daratumumab to Combination of Bortezomib and Dexamethasone in Participants With Relapsed or Refractory Multiple Myeloma. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000-[cited 2016 Nov 11]. Available at: https://clinicaltrials.gov/ct2/show/NCT02136134?term=mmy3004&rank=1 NLM Identifier: NCT02076009.
(6) Janssen Research & Development, LLC. A Study to Evaluate Daratumumab in Transplant Eligible Participants With Previously Untreated Multiple Myeloma (Cassiopeia). In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000-[cited 2016 Nov 11]. Available at: https://clinicaltrials.gov/ct2/show/NCT02541383?term=mmy3006&rank=2 NLM Identifier: NCT02541383.
(7) Janssen Research & Development, LLC. A Study of Combination of Daratumumab and Velcade (Bortezomib) Melphalan-Prednisone (DVMP) Compared to Velcade Melphalan-Prednisone (VMP) in Participants With Previously Untreated Multiple Myeloma In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000-[cited 2016 Nov 11]. Available at: https://clinicaltrials.gov/ct2/show/NCT02195479?term=mmy3007&rank=1 Identifier: NCT02195479.
(8) Janssen Research & Development, LLC. Study Comparing Daratumumab, Lenalidomide, and Dexamethasone With Lenalidomide and Dexamethasone in Participants With Previously Untreated Multiple Myeloma. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000-[cited 2016 Nov 11]. Available at: https://clinicaltrials.gov/ct2/show/NCT02252172?term=mmy3008&rank=1Identifier: NCT02252172.
(9) Janssen Research & Development, LLC. "Janssen Announces the Initiation of Two Studies Evaluating Daratumumab (DARZALEX®) and Atezolizumab in Multiple Myeloma and Solid Tumor." Issued March 21, 2016.
(10) Janssen Research & Development, LLC. A Study to Evaluate 3 Dose Schedules of Daratumumab in Participants With Smoldering Multiple Myeloma In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000-[cited 2016 Nov 11]. Available at: https://clinicaltrials.gov/ct2/show/NCT02316106?term=smm2001&rank=1 Identifier: NCT02316106.
(11) Janssen Research & Development, LLC. An Efficacy and Safety Proof of Concept Study of Daratumumab in Relapsed/Refractory Mantle Cell Lymphoma, Diffuse Large B-Cell Lymphoma, and Follicular Lymphoma In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000-[cited 2016 Nov 11]. Available at: https://clinicaltrials.gov/ct2/show/NCT02413489?term=lym2001&rank=1 Identifier: NCT02413489.
(12) Janssen Biotech, Inc. "DARZALEX (daratumumab) Approved by U.S. FDA: First Human Anti-CD38 Monoclonal Antibody Available for the Treatment of multiple Myeloma." Issued November 16, 2015.
(13 )Kumar, SK et al. Leukemia. 2012 Jan; 26(1):149-57.
(14) American Cancer Society. "Multiple Myeloma Overview." Available at: http://www.cancer.org/cancer/multiplemyeloma/detailedguide/multiple-myeloma-what-is-multiple-myeloma. May 2017.
(15) National Cancer Institute. "NCI Dictionary of Cancer Terms: Refractory." Available at: https://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=350245. Accessed November 2015.
(16) Richardson, et al. "The Treatment of Relapsed and Refractory Multiple Myeloma." ASH Education Book January 1, 2007 vol. 2007 no. 1 317-323.
(17) National Cancer Institute. "NCI Dictionary of Cancer Terms: Relapsed." Available at: https://www.cancer.gov/publications/dictionaries/cancer-terms?CdrID=45866. Accessed November 2015.
(18) GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide: Number of New Cancers in 2015. Available at: http://globocan.iarc.fr/old/burden.asp?selection_pop=224900&Text-p=World&selection_cancer=17270&Text-c=Multiple+myeloma&pYear=3&type=0&window=1&submit=%C2%A0Execute. Accessed May 2017.
(19) GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide: Number of Cancer Deaths in 2015. Available at: http://globocan.iarc.fr/old/burden.asp?selection_pop=224900&Text-p=World&selection_cancer=17270&Text-c=Multiple+myeloma&pYear=3&type=1&window=1&submit=%C2%A0Execute. Accessed May 2017.
(20) American Cancer Society. "How is Multiple Myeloma Diagnosed?" Available at: http://www.cancer.org/cancer/multiplemyeloma/detailedguide/multiple-myeloma-diagnosis. Accessed November 2015.
(21) Genetics Home Reference. Isolated growth hormone deficiency. Available from: http://ghr.nlm.nih.gov/condition/isolated-growth-hormone-deficiency. Accessed April 2017.
Media Inquiries:
Satu Kaarina Glawe
Mobile: +49 172 294 6264
Megan Farina
Mobile: 1-610-724-1079
Investor Relations:
Lesley Fishman
Phone: 1-732-524-3922
U.S. Medical Inquiries:
(DARZALEX, XARELTO and imetelstat):
1-800-526-7736
(IMBRUVICA -
Pharmacyclics/AbbVie):
1-877-877-3536
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