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BTG plc: Full Results of VarisolveR US Phase II Safety Study to be Presented
at ACP
Results confirm that treatment with Varisolve® does not cause cerebral
injury
London, UK, 7 November 2008: BTG plc (LSE: BGC), the life sciences company,
announces that the full results of the US phase II safety study of Varisolve®
are being presented today at the American College of Phlebology (ACP) 22nd
Annual Congress. The results confirm that treatment with Varisolve® in subjects
with right-to-left (R-L) cardiac shunts, which may allow residual bubbles
following treatment to enter the cerebral arterial circulation, does not cause
cerebral injury.
Principal investigator Kathleen Gibson, MD, of Lake Washington Vascular
Surgeons, commented:
“There is increasing interest in using foam sclerosant to treat varicose veins,
because of the many benefits to patients including the speed of treatment and no
requirement for general or tumescent anaesthesia. However, concerns have been
raised relating to the potential risk of cerebral gas embolisation, particularly
in patients who have a right-to-left cardiac shunt that may allow residual
bubbles from the foam to enter the arterial circulation. This study found no
evidence of any injury to the brain, retina or heart following treatment with
the proprietary Varisolve® polidocanol microfoam in patients with cardiac
shunts. These results should not be generalised to other foams, such as
air-based foams that have high nitrogen content and are insoluble in blood.”
Louise Makin, chief executive officer of BTG, said: “It was very important for
the future development and commercial potential of Varisolve® to demonstrate no
subclinical effects following treatment in the brains of people with a cardiac
shunt. Having removed this uncertainty, we have been able to press ahead with
confidence both with partnering discussions and with the pilot phase III trials,
in anticipation of the pivotal phase III trials that are planned to begin around
mid-2009.”
Dr Gibson’s oral presentation, Proprietary Polidocanol Endovenous Microfoam
Bubble Embolization Does Not Cause Cerebral Injury, will describe the
multi-centre phase II safety study. Eligible patients were screened for the
presence of a R-L shunt and if positive were given a baseline diffusion-weighted
brain MRI scan. Patients were then treated with Varisolve® and monitored for 60
minutes following treatment using Transcranial Doppler (TCD) to detect bubbles
entering the middle cerebral artery (MCA). Additional safety evaluations
included blood oximetry, cardiac markers and electrocardiograms. Patients with
detected MCA bubbles had follow-up diffusion-weighted brain MRI scans 24 hours
and 28 days after treatment, neurological and visual field examinations plus
other routine assessments. The study objective was to treat and follow up 50
patients with detected MCA bubbles.
Of 82 patients treated, 73% (60) had detection of MCA bubbles and all had at
least one post-treatment MRI. No new MRI lesions or abnormal findings in the
neurological and visual field examinations were detected in any patients, and
none had any evidence of cardiac ischaemia.
Sapheno-femoral junction reflux was eliminated in 94% of patients at one month,
and 88% had occlusion of the great saphenous vein. Adverse events were generally
mild and transient and were consistent with previous experience with Varisolve®.
In a second oral presentation at ACP entitled Neurological and Visual Symptoms
Following Treatment of the Saphenous Veins with Two Formulations of Polidocanol
Endovenous Microfoam, Janet Rush, MD, BTG’s Head of US Regulatory & Medical
Affairs, will describe the characteristics of the Varisolve® microfoam before
and following its reformulation to minimise residual gas bubbles. Dr Rush will
also compare clinical experience and results from studies of the original
formulation (7% nitrogen) and the new formulation (0.01-0.8% nitrogen). She will
conclude that of 534 patients treated with the original formulation, one patient
(who had a cardiac shunt) had potentially clinically concerning neurological
symptoms, while there have been no clinically concerning neurological or visual
symptoms in any of the 106 patients treated with the new formulation.
A third oral presentation, by David Wright, MB, FRCS, BTG’s Vice President of
Medical Affairs, entitled A Single-Center Pilot Study of Polidocanol Endovenous
Microfoam (PEM) Treatment to Evaluate Presence and Durability of Gas Emboli
Using Echocardiography, will explore the relative echocardiographic appearances
of the original and new formulations of Varisolve®, with the objective of
determining whether nitrogen ingress can “stabilise” small bubbles thereby
causing them to persist in the circulatory system. Twenty patients were
randomised to receive treatment with the original or new formulation of
Varisolve®, and 10 additional patients were also randomised to pre-breathe
oxygen or not. This was to explore whether pre-breathing oxygen would de-nitrogenate
the blood sufficiently to prevent any stabilisation of the bubbles that might
occur.
Dr Wright will conclude that all patients receiving endovenous microfoam
ablation treatment have right sided cardiac bubbles. He will also conclude that
the echocardiographic appearance is unaltered by elimination of nitrogen, and
that pre-breathing with oxygen does not change the presence of bubbles.
Treatment of the varicose veins was successful with all 35 patients (including 5
training patients) having occlusion of the great saphenous vein and elimination
of reflux at 28 days.
In addition to the oral presentations, Gregory Suplick, BTG’s Vice President of
Clinical Development, will present two poster presentations entitled Patient
Recruitment Strategies and Referrals Associated with a Multicenter Phase II
Study of Patients with GSV Incompetence and Patient Pre-Qualification Tools Used
to Recruit Patients for a Multicenter Phase II Study of Patients with GSV
Incompetence.
For further information contact:
BTG
Andy Burrows, Director of Investor Relations
+44 (0)20 7575 1741; mobile: +44 (0)7990 530605
Christine Soden, Chief Financial Officer
+44 (0)20 7575 1591
Financial Dynamics
Ben Atwell
+44 (0)20 7831 3113
About BTG
BTG in-licenses, develops and commercialises pharmaceuticals and has a broad
pipeline of development programmes targeting neurological and other disorders
including varicose veins. The company also has a substantial and growing revenue
stream of milestone payments and royalties from out-licensed products. BTG
operates from offices in London, Philadelphia and Osaka. For further
information, visit: www.btgplc.com .
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