Upsher-Smith Laboratories Research On Qudexy XR (topiramate) Extended-Release Capsules Highlighted At the 2015 American Academy of Neurology Annual Meeting

WASHINGTON, April 21, 2015 /PRNewswire/ -- Upsher-Smith Laboratories, Inc. (Upsher-Smith) presented data from a 52-week, open-label extension study (PREVAIL OLE) showing that Qudexy XR (topiramate) extended-release capsules offered a long-term adjunctive treatment option with a favorable tolerability profile for a high proportion of patients with refractory partial-onset seizures (POS). In a separate presentation, researchers also reported that when Qudexy XR capsules were opened and sprinkled onto soft food, they remained bioequivalent to intact capsules, making them a useful alternative for patients with swallowing difficulties. These results were presented at the American Academy of Neurology's (AAN) Annual Meeting in Washington, DC on April 18-25, 2015.  Qudexy XR, a once-daily, broad-spectrum antiepileptic drug specifically engineered to deliver a smooth pharmacokinetic profile, is an extended-release formulation of topiramate studied in a Phase 3, randomized, double-blind, placebo-controlled trial (PREVAIL) and the only extended-release topiramate formulation to have been approved by the Food and Drug Administration (FDA) for administration via the sprinkle method.

The PREVAIL OLE study of Qudexy XR enrolled 96.8% of participants who completed the original Phase 3 PREVAIL trial and had a completion rate of 70%. New individual neurocognitive / neuropsychiatric treatment-emergent adverse events (TEAEs) were reported in <3% of patients, with the exception of aphasia (5.2%) and depression (3.8%).

Data from a study evaluating an alternative administration method for Qudexy XR was also presented. In a Phase 1, randomized, single-dose crossover study (n=36) of Qudexy XR, researchers compared pharmacokinetic parameters when Qudexy XR was administered as an intact capsule to those when the capsule was opened and the beads were sprinkled onto soft food. AUC and C_max were bioequivalent between Qudexy XR beads sprinkled onto soft food and the intact capsule (90% CI: AUC_0-0.98-1.05; C_max 1.03-1.14). Median T_max was between 10-14 hours. In separate in vitro experiments, Qudexy XR beads were successfully passed through >/= 14 French G-/J-tubes.  

"We are pleased that favorable data continues to emerge from the comprehensive clinical trials of Qudexy XR," said Steve Chung, M.D., Professor of Neurology at Banner University Medical Center, Phoenix and trial investigator. "The Phase 3 PREVAIL trial demonstrated that Qudexy XR met its primary and secondary endpoints for efficacy, and the open-label extension study supports the favorable safety profile and long-term use of Qudexy XR. This scientific data, combined with its dosing flexibility, substantiates the use of Qudexy XR as a potential treatment option for patients with seizure disorders."

Abstracts of the poster presentations can be found at www.aan.com.  To schedule an interview with an investigator, please contact Daina Basile at dbasile@klcpr.com.

About Qudexy XR

Qudexy XR is indicated as initial monotherapy in patients 10 years of age and older with Partial Onset Seizures (POS) or primary generalized tonic-clonic seizures. It is also approved as an adjunctive therapy in patients two years of age or older with POS, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome. Qudexy XR is the only extended-release topiramate product that is FDA-approved to be administered by carefully opening the capsule and sprinkling the entire contents onto a spoonful of soft food.  All strengths of Qudexy XR may be administered by this sprinkle method. This makes it the only extended-release topiramate product approved for patients who experience challenges swallowing whole capsules or tablets. 

About Upsher-Smith's PREVAIL and PREVAIL OLE Studies

The PREVAIL OLE study was an open-label extension of PREVAIL, which was a global Phase 3 study designed to evaluate the safety and efficacy of Qudexy XR (USL255) as adjunctive therapy in patients with refractory partial-onset seizures (n=249) using a randomized, double-blind, placebo-controlled, parallel-group methodology. 96.8% of participants who completed PREVAIL enrolled in PREVAIL OLE (n=210). Participants underwent a 3-week, blinded-conversion phase, during which patients previously randomized to placebo in PREVAIL were titrated to 200 mg/d Qudexy XR, and those randomized to 200 mg/d of Qudexy XR in PREVAIL were given matching placebo. The conversion phase was followed by a 52-week open-label treatment phase.  After completing 11 weeks of treatment, changes were allowed in Qudexy XR dosage (in 50 mg/wk increments to a maximum of 400 mg/d) and to concomitant antiepileptic drugs (AEDs).

To learn more about the original PREVAIL study, see www.clinicaltrials.gov(NCT01142193).  Additional information concerning the open-label extension study, PREVAIL OLE, can be found by searching NCT0119086 at www.clinicaltrials.gov or by contacting Upsher-Smith Medical Affairs at 1-800-654-2299.

About Epilepsy

Epilepsy is a medical condition that is characterized by recurrent seizures. More than two million people in the U.S. are estimated to be affected by epilepsy, with about 150,000 new cases of epilepsy diagnosed each year.1  Epilepsy can be associated with profound physical, psychological and social consequences that negatively impact people's lives.

About Upsher-Smith

Upsher-Smith Laboratories, Inc., founded in 1919, is a growing pharmaceutical company dedicated to its mission of Advancing Pharmacotherapy. Improving Life. With capabilities ranging from early-stage research to delivering on-market products, Upsher-Smith is committed to offering quality products that enable people to live life to its greatest potential. Upsher-Smith's approach to product development and partnering has resulted in a broad range of both branded and generic therapeutic solutions to address patients' needs. The Company has a particular focus on developing therapies for people living with central nervous system (CNS) conditions, such as seizure disorders, and has a robust pipeline of promising CNS compounds in various stages of development. For more information, visit www.upsher-smith.com.

INDICATIONS FOR QUDEXY XR

Qudexy XR (topiramate) extended-release capsules is a prescription medicine used to treat certain types of seizures (partial-onset seizures and primary generalized tonic-clonic seizures) in adults and children 10 years of age and older, and with other medicines to treat certain types of seizures (partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome) in adults and children 2 years and older.

IMPORTANT SAFETY INFORMATION FOR QUDEXY XR

Do not take Qudexy XR if you have metabolic acidosis and are also taking metformin (e.g., Glucophage®).

Qudexy XR can cause serious side effects including: Eye problems. Serious eye problems include blurred vision, sudden decrease in vision with or without eye pain and redness, and a blockage of fluid that may cause increased pressure in the eye (secondary angle closure glaucoma). If left untreated, these can lead to permanent vision loss. Decreased sweating and increased body temperature (fever). People, especially children, should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition. Increased acid level in your blood (metabolic acidosis). This may or may not cause symptoms. Symptoms may include feeling tired, decreased appetite, change in heartbeat, or trouble thinking clearly. If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may harm your baby if you are pregnant. High blood ammonia levels. High ammonia in the blood can affect mental activities, slow alertness, cause tiredness, or cause vomiting. This can also happen when Qudexy XR is taken with a medicine called valproic acid (e.g., Depakene® and Depakote®). Kidney stones. Drink plenty of fluids when taking Qudexy XR to decrease your chances of getting kidney stones. Low body temperature. Taking Qudexy XR when you are also taking valproic acid may cause a drop in body temperature to less than 95°F, tiredness, confusion, or coma. Effects on thinking and alertness. Qudexy XR may affect how you think, and can cause confusion, and problems with concentration, attention, memory, or speech. Qudexy XR may cause depression or mood problems, tiredness, and sleepiness. Dizziness or loss of muscle coordination. Call your healthcare provider right away if you have any of the above symptoms.

Like other antiepileptic drugs, Qudexy XR may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Before you take Qudexy XR, tell your healthcare provider if you have or have had depression, mood problems, or suicidal thoughts or behavior. Call a healthcare provider right away if you have thoughts about suicide or dying; have attempted to commit suicide; have new or worsening depression or anxiety; feel agitated or restless; experience panic attacks, trouble sleeping (insomnia), or new or worsening irritability; feel or act aggressive, angry, or violent; act on dangerous impulses; have an extreme increase in activity and talking (mania); or experience other unusual changes in behavior or mood.

Before taking Qudexy XR, tell your healthcare provider about any other medical conditions, including if you have had depression, mood problems, or suicidal thoughts or behavior; have kidney problems, kidney stones, or are getting kidney dialysis; have a history of metabolic acidosis (too much acid in the blood); have liver problems; have weak, brittle or soft bones (osteomalacia, osteoporosis, osteopenia, or decreased bone density); have lung or breathing problems; have eye problems, especially glaucoma; have diarrhea; have a growth problem; are on a diet high in fat and low in carbohydrates, which is called a ketogenic diet; are having surgery; are pregnant or plan to become pregnant; or if you are breastfeeding. The medicine in Qudexy XR (topiramate) passes into your breast milk. It is not known if the medicine, topiramate, that passes into breast milk can harm your baby. Talk to your healthcare provider about the best way to feed your baby if you take Qudexy XR.

Qudexy XR can harm your unborn baby. All women of childbearing age should talk to their healthcare providers about possible alternative treatments. If you take Qudexy XR during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. If the decision is made to use Qudexy XR, you should use effective birth control (contraception) unless you are planning to become pregnant. Tell your healthcare provider right away if you become pregnant while taking Qudexy XR.

The most common side effects include tingling of the arms and legs (paresthesia), irregular movements of the eyes (nystagmus), loss of appetite, nausea or indigestion, a change in the way foods taste, diarrhea, weight loss, nervousness, and upper respiratory tract infection. These are not all the possible side effects of Qudexy XR. For more information, ask your healthcare provider or pharmacist.

Tell your healthcare provider about any other medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Qudexy XR and other medicines may affect each other causing side effects. Especially tell your healthcare provider if you take metformin (e.g., Glucophage); valproic acid (e.g., Depakene or Depakote); any medicines that impair or decrease your thinking, concentration, or muscle coordination; birth control pills; medicines used to prevent seizures; or any other carbonic anhydrase inhibitors. Qudexy XR may make your birth control pills less effective.

Do not stop Qudexy XR without first talking to a healthcare provider. If you have epilepsy and you stop taking Qudexy XR suddenly, you may have seizures that do not stop. Your healthcare provider will tell you how to stop taking Qudexy XR slowly.

Do not drink alcohol while taking Qudexy XR. Qudexy XR and alcohol can cause serious side effects such as severe sleepiness and dizziness and an increase in seizures.

Do not drive a car, swim, climb, or operate heavy machinery until you know how Qudexy XR affects you. Qudexy XR can slow your thinking and motor skills, and may affect vision. Even when taking Qudexy XR, some patients with epilepsy will continue to have unpredictable seizures.

If you are unable to swallow Qudexy XR capsules whole, the medicine may be sprinkled on a spoonful of soft food like applesauce. Do not store the food and medicine mixture to use later or crush or chew the food and medicine mixture before swallowing.

This safety information is not all-inclusive. For additional important information, talk to your healthcare provider and read the Medication Guide for Qudexy XR. You can also visit www.upsher-smith.com or call 1-888-650-3789.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please see full Prescribing Information at www.QudexyXR.com.

Qudexy is a trademark of Upsher-Smith Laboratories, Inc.  All other marks are owned by their respective owners.

Reference

1. Epilepsy.com. Available at: http://www.epilepsy.com/learn/epilepsy-statistics.  Accessed  March 17, 2015.

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SOURCE Upsher-Smith Laboratories, Inc.