Wednesday, April 11, 2012

Day 11: Drug Therapy for Cushies Finally Available



Today is the day my Cushie friends and I have been waiting for.  Finally, a drug therapy is available to all of us Cushies stuck in a persistent hypercortisolemic state.  Korlym, the first FDA-approved drug in the United States, is available to patients who need it and want it.

I have been watching the release of this drug closely, and I found what I was looking for today.  This Patient Guide for Korlym outlines all the ins and outs of taking this drug.  

Today, I am happy to share the statement that was music to my ears: 

"We are determined that every patient who could benefit from Korlym will receive it," added Steven Lo, Corcept's Vice President of Commercial Operations. 

If you are a Cushing's patient burdened by the high costs of diagnosis -- lab work, doctor visits, travel -- please be sure to check into SPARK (Support Program for Access and Reimbursement for Korlym). I like to see them making good on that promise that the Veep made. :)

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4/10/12 - Corcept Therapeutics Announces National Product Launch of Korlym(TM) for Patients With Endogenous Cushing's Syndrome
MENLO PARK, CA (Marketwire) 04/10/12

Corcept Therapeutics Incorporated (NASDAQ: CORT) announced today that Korlym™ (mifepristone) 300 mg Tablets is available by prescription nationwide.

On February 17, 2012, the U.S. Food and Drug Administration (FDA) approved Korlym as a once-daily oral medicine to control hyperglycemia secondary to hypercortisolism in adult patients with endogenous Cushing's syndrome who have type 2 diabetes mellitus or glucose intolerance and have failed surgery or are not candidates for surgery. Korlym is the first FDA-approved treatment for this illness.

"After using mifepristone in the company's clinical trial, I am pleased that it will be available for the medical management of my patients with Cushing's syndrome for whom surgery failed," said James W. Findling, M.D., Professor of Medicine, Endocrinology at the Medical College of Wisconsin. "The majority of patients in the trial had very gratifying improvements in the clinical and metabolic manifestations of hypercortisolism."

Korlym is a once daily oral medication. The medicine's FDA-approved labeling instructs physicians to titrate each patient's Korlym dose to clinical efficacy by assessing tolerability and degree of improvement in Cushing's syndrome manifestations. In the first six weeks, these manifestations may include changes in glucose control, anti-diabetic medication requirements, insulin levels and psychiatric symptoms. After two months, assessment may also be based on improvements in cushingoid appearance, acne, hirsutism, striae or decreased body weight, along with further changes in glucose control.

"Korlym offers a new treatment strategy that has the potential to improve the lives of many patients," said Joseph K. Belanoff, M.D., the company's Chief Executive Officer. "We have worked hard to make it available as quickly as possible."
"We are determined that every patient who could benefit from Korlym will receive it," added Steven Lo, Corcept's Vice President of Commercial Operations. "Our specialty pharmacy partner, Curascript, is prepared to dispense medicine. Our Support Program for Access and Reimbursement for Korlym (SPARK) is ready with case managers to help patients navigate their medical insurance coverage and identify the Corcept and charitable foundation support programs available to them."

Physicians and patients seeking more information can visit http://www.korlymspark.com or call 1-855-4Korlym.


About Cushing's SyndromeEndogenous Cushing's syndrome is a rare and life-threatening endocrine disorder that results from long-term exposure to excess levels of the hormone cortisol. This excess is caused by tumors that usually occur in the pituitary or adrenal glands that over-produce, or prompt the over-production of, cortisol.

Although cortisol at normal levels is essential to health, in excess it causes a variety of problems, including glucose intolerance and diabetes, upper body obesity, a rounded face, stretch marks on the skin, an accumulation of fat on the back, thin and easily bruised skin, muscle weakness, bone weakness, persistent infections, high blood pressure, fatigue, irritability, anxiety, psychosis and depression. Women may have menstrual irregularities and facial hair growth, while men may have decreased fertility or erectile dysfunction. More than 70 percent of Cushing's syndrome patients suffer from glucose intolerance or diabetes.

If left untreated, Cushing's syndrome has a five-year mortality rate of 50 percent.


About Korlym™ (mifepristone) 300 mg TabletsKorlym is a once-daily oral medication that blocks the glucocorticoid receptor type II (GR-II) to which cortisol normally binds. By blocking this receptor, Korlym inhibits the effects of excess cortisol in Cushing's syndrome patients. The FDA-approved labeling instructs physicians to titrate each patient's Korlym dose to clinical efficacy by assessing tolerability and degree of improvement in Cushing's syndrome manifestations.

The FDA has designated Korlym as an Orphan Drug, a special status designed to encourage the development of medicines for rare diseases and conditions. Because Korlym is an Orphan Drug, Corcept will have marketing exclusivity for the FDA-approved indication until February 2019.


IMPORTANT SAFETY INFORMATION

WARNING: TERMINATION OF PREGNANCY

See full prescribing information for complete boxed warning.

Mifepristone has potent antiprogestational effects and will result in the termination of pregnancy. Pregnancy must therefore be excluded before the initiation of treatment with Korlym, or if treatment is interrupted for more than 14 days in females of reproductive potential.


Contraindications
  • Pregnancy
  • Use of simvastatin or lovastatin and CYP 3A substrates with narrow therapeutic range
  • Concurrent long-term corticosteroid use
  • Women with history of unexplained vaginal bleeding
  • Women with endometrial hyperplasia with atypia or endometrial carcinoma
Warnings and Precautions
  • Adrenal insufficiency: Patients should be closely monitored for signs and symptoms of adrenal insufficiency.
  • Hypokalemia: Hypokalemia should be corrected prior to treatment and monitored for during treatment.
  • Vaginal bleeding and endometrial changes: Women may experience endometrial thickening or unexpected vaginal bleeding. Use with caution if patient also has a hemorrhagic disorder or is on anti-coagulant therapy.
  • QT interval prolongation: Avoid use with QT interval-prolonging drugs or in patients with potassium channel variants resulting in a long QT interval.
  • Use of Strong CYP3A Inhibitors: Concomitant use can increase mifepristone plasma levels significantly. Use only when necessary and limit mifepristone dose to 300 mg.
Adverse ReactionsMost common adverse reactions in Cushing's syndrome ( ≥ 20%): nausea, fatigue, headache, decreased blood potassium, arthralgia, vomiting, peripheral edema, hypertension, dizziness, decreased appetite, endometrial hypertrophy.


To report suspected adverse reactions, contact Corcept Therapeutics at 1-855-844-3270 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.


Drug Interactions
  • Drugs metabolized by CYP3A: Administer drugs that are metabolized by CYP3A at the lowest dose when used with Korlym.
  • CYP3A inhibitors: Caution should be used when Korlym is used with strong CYP3A inhibitors. Limit mifepristone dose to 300 mg per day when used with strong CYP3A inhibitors.
  • CYP3A inducers: Do not use Korlym with CYP3A inducers.
  • Drugs metabolized by CYP2C8/2C9: Use the lowest dose of CYP2C8/2C9 substrates when used with Korlym.
  • Drugs metabolized by CYP2B6: Use of Korlym should be done with caution with bupropion and efavirenz.
  • Hormonal contraceptives: Do not use with Korlym.
Use in Specific Populations
  • Nursing mothers: Discontinue drug or discontinue nursing.
Please see the accompanying full Prescribing Information including boxed warning atwww.corcept.com/prescribinginfo.pdf
Please see the accompanying Medication Guide at www.corcept.com/medicationguide.pdf


About Corcept Therapeutics IncorporatedCorcept is a pharmaceutical company engaged in the discovery, development and commercialization of drugs for the treatment of severe metabolic and psychiatric disorders. Korlym, a first generation GR-II antagonist, is the company's first FDA-approved medication. The company has a portfolio of new selective GR-II antagonists that block the effects of cortisol but not progesterone. Corcept owns an extensive intellectual property portfolio covering the use of GR-II antagonists, including mifepristone, in the treatment of a wide variety of psychiatric and metabolic disorders. The company also holds composition of matter patents for its selective GR-II antagonists.

Statements made in this news release, other than statements of historical fact, are forward-looking statements. Forward-looking statements are subject to a number of known and unknown risks and uncertainties that might cause actual results to differ materially from those expressed or implied by such statements. For example, there can be no assurances that clinical results will be predictive of real-world use, or regarding the pace of Korlym's acceptance by physicians and patients, the reimbursement decisions of government or private insurance payers, the effects of rapid technological change and competition, the protections afforded by Korlym's Orphan Drug Designation or by Corcept's other intellectual property rights, and the cost, pace and success of Corcept's other product development efforts. These and other risks are set forth in the Company's SEC filings, all of which are available from our website (http://www.corcept.com) or from the SEC's website (www.sec.gov). We disclaim any intention or duty to update any forward-looking statement made in this news release.

Investor Contact:
Charles Robb
Chief Financial Officer
Corcept Therapeutics Incorporated
650-688-8783

Media Contact:
Alyson Kuritz
Communications Strategies, Inc.
973-635-6669

Source: Corcept Therapeutics

Day 10: New Report Outlines Korlym's Success for Cushies

Data Published in Premiere Endocrinology Journal Shows Korlym Provides Significant Clinical Improvement in Patients with Endogenous Cushing's Syndrome



MENLO PARK, CA--(Marketwire -04/09/12)- Corcept Therapeutics Incorporated (NASDAQ: CORT - News), a pharamceutical company engaged in the discovery, development and commercialization of drugs for the treatment of severe metabolic and psychiatric diorders, today announced the results of its phase 3 SEISMIC trial published in The Journal of Clinical Endocrinology and Metabolism (JCEM) demonstrated that refractory Cushing's syndrome patients receiving Korlym (mifepristone) experienced significant clinical improvement.
The U.S. Food and Drug Administration (FDA) recently approved Korlym as a once-daily oral medicine to control hyperglycemia secondary to hypercortisolism in adult patients with endogenous Cushing's syndrome who have type 2 diabetes mellitus or glucose intolerance and have failed surgery or are not candidates for surgery. Korlym is the first FDA-approved therapy for endogenous Cushing's syndrome.
"The recently published SEISMIC study showed that Korlym significantly improved diabetes control (blood glucose levels, insulin sensitivity and Hemoglobin A1C), promoted weight loss and decreases in waist circumference, and improved body composition, mood and cognition in patients with Cushing's syndrome," said Maria Fleseriu, M.D., F.A.C.E., Director Northwest Pituitary Center, Oregon Health & Science University, Associate Professor of Medicine & Neurological Surgery, a principal investigator in the study. "Although clinically significant adrenal insufficiency is a potential side effect of glucocorticoid receptor antagonism, it was uncommon during this study."
"Glucocorticoid receptor antagonism with Korlym offers a new and exciting approach to control the clinical manifestations of this severe, debilitating disease," Dr. Fleseriu added. "The side effect profile over 6 months is well characterized and manageable with close follow-up."
Physicians and patients seeking more information can visit http://www.korlymspark.com.
The Commercialization of Korlym
Corcept's guiding principle is that every patient who is prescribed Korlym will receive it.
[blogger emphasis]  Our mission is to get medicine to patients who need it," said Joseph K. Belanoff, M.D., the company's Chief Executive Officer. "Corcept's Support Program for Access and Reimbursement for Korlym (SPARK) will provide patients with a case manager who can help them navigate their medical coverage on a case by case basis and identify the Corcept support programs available to them."
The SEISMIC StudyFifty Cushing's syndrome patients were enrolled in the study. Forty-three had Cushing's disease (an ACTH-producing tumor of the pituitary gland), of which 42 had prior surgery, four patients had ectopic ACTH-producing tumors and three had adrenal cancer. Of the 29 patients enrolled in the study who were glucose intolerant, 60% (p < 0.0001) met the study's primary endpoint, defined as a 25% or greater reduction in blood sugar level on a standard oral glucose tolerance test from baseline to 24 weeks. In these patients there was a continued improvement in glucose tolerance measured at each of the evaluations at week 6, 10, and 16, as well as at week 24. Of the 12 patients taking insulin at baseline, seven cut their daily dose by at least 50%. There was also a statistically significant reduction in mean HbA1c over the course of the study, from 7.43% at baseline to 6.29% at study conclusion (p < 0.001). Of the twelve patients who had an HbA1c over 7% at baseline (mean = 8.5%), nine achieved an HbA1c below 7%, including six who achieved an HbA1c of 6% or below.
All patients were evaluated on the key secondary endpoint of "global clinical improvement" as determined by an independent data review board's evaluation of eight clinical areas -- glucose, blood pressure, lipids, weight and body composition, appearance, strength, bone, psychiatric and quality of life measures. Eighty-seven percent of the patients (p < 0.0001) were judged to have made significant clinical improvement by the data review board.
The study examined patients' weight gain/loss during the 24-week trial, with over half of study participants experiencing weight loss of at least 5%, compared to baseline (p < 0.001). Patients demonstrated a mean reduction in waist circumference compared to baseline -- 6.8 cm in women and 8.4 cm for men (p < 0.001 for each gender). [That's 2.7 inches in women and 3.3 inches in men.  This really is significant. High cortisol will prevent your body from losing weight, no matter your exercise or diet regimen.  To me, this really means that the medication stops the body from recognizing there is cortisol swirling around up in there. That's good news for a Cushie.]
Side-effects observed in the phase 3 study were consistent with the safety profile of Korlym's active ingredient, mifepristone. The majority of adverse events were considered to be mild or moderate, with fatigue and nausea being the ones most commonly reported.
Approximately 90% of the patients who completed the study chose to continue as part of Corcept's extension study. [patients seem to be happy with the drug therapy]
About Cushing's SyndromeEndogenous Cushing's syndrome is a rare and life-threatening endocrine disorder that results from long-term exposure to excess levels of the hormone cortisol. This excess is caused by tumors that usually occur in the pituitary or adrenal glands that over-produce, or prompt the over-production of, cortisol. Although cortisol at normal levels is essential to health, in excess it causes a variety of problems, including glucose intolerance and diabetes, upper body obesity, a rounded face, stretch marks on the skin, an accumulation of fat on the back, thin and easily bruised skin, muscle weakness, bone weakness, persistent infections, high blood pressure, fatigue, irritability, anxiety, psychosis and depression. Women may have menstrual irregularities and facial hair growth, while men may have decreased fertility or erectile dysfunction. More than 70 percent of Cushing's syndrome patients suffer from glucose intolerance or diabetes.
If left untreated, Cushing's syndrome has a five-year mortality rate of 50 percent. [WOW. I have never seen this statistic. So sad.]
About Korlym™ (mifepristone) 300 mg TabletsKorlym is a once-daily oral medication that blocks the glucocorticoid receptor type II (GR-II) to which cortisol normally binds. By blocking this receptor, Korlym inhibits the effects of excess cortisol in Cushing's syndrome patients.
The FDA-approved labeling instructs physicians to titrate each patient's Korlym dose to clinical efficacy by assessing tolerability and degree of improvement in Cushing's syndrome manifestations. In the first six weeks, these manifestations may include changes in glucose control, anti-diabetic medication requirements, insulin levels and psychiatric symptoms. After two months, assessment may also be based on improvements in cushingoid appearance, acne, hirsutism, striae or decreased body weight, along with further changes in glucose control.
The FDA has designated Korlym as an Orphan Drug, a special status designed to encourage the development of medicines for rare diseases and conditions. Because Korlym is an Orphan Drug, Corcept will have marketing exclusivity for the FDA-approved indication until February 2019.
IMPORTANT SAFETY INFORMATION
 
----------------------------------------------------------------------------
 WARNING: TERMINATION OF PREGNANCY

 See full prescribing information for complete boxed warning.

 Mifepristone has potent antiprogestational effects and will result in the
 termination of pregnancy. Pregnancy must therefore be excluded before the
 initiation of treatment with Korlym, or if treatment is interrupted for
 more than 14 days in females of reproductive potential.
----------------------------------------------------------------------------
Contraindications
  • Pregnancy
  • Use of simvastatin or lovastatin and CYP 3A substrates with narrow therapeutic range
  • Concurrent long-term corticosteroid use
  • Women with history of unexplained vaginal bleeding
  • Women with endometrial hyperplasia with atypia or endometrial carcinoma
Warnings and Precautions
  • Adrenal insufficiency: Patients should be closely monitored for signs and symptoms of adrenal insufficiency.
  • Hypokalemia: Hypokalemia should be corrected prior to treatment and monitored for during treatment.
  • Vaginal bleeding and endometrial changes: Women may experience endometrial thickening or unexpected vaginal bleeding. Use with caution if patient also has a hemorrhagic disorder or is on anti-coagulant therapy.
  • QT interval prolongation: Avoid use with QT interval-prolonging drugs or in patients with potassium channel variants resulting in a long QT interval.
  • Use of Strong CYP3A Inhibitors: Concomitant use can increase mifepristone plasma levels significantly. Use only when necessary and limit mifepristone dose to 300 mg.
Adverse ReactionsMost common adverse reactions in Cushing's syndrome ( ≥ 20%): nausea, fatigue, headache, decreased blood potassium, arthralgia, vomiting, peripheral edema, hypertension, dizziness, decreased appetite, endometrial hypertrophy.
To report suspected adverse reactions, contact Corcept Therapeutics at 1-855-844-3270 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Drug Interactions
  • Drugs metabolized by CYP3A: Administer drugs that are metabolized by CYP3A at the lowest dose when used with Korlym.
  • CYP3A inhibitors: Caution should be used when Korlym is used with strong CYP3A inhibitors. Limit mifepristone dose to 300 mg per day when used with strong CYP3A inhibitors.
  • CYP3A inducers: Do not use Korlym with CYP3A inducers.
  • Drugs metabolized by CYP2C8/2C9: Use the lowest dose of CYP2C8/2C9 substrates when used with Korlym.
  • Drugs metabolized by CYP2B6: Use of Korlym should be done with caution with bupropion and efavirenz.
  • Hormonal contraceptives: Do not use with Korlym.
Use in Specific Populations
  • Nursing mothers: Discontinue drug or discontinue nursing.
Please see the accompanying full Prescribing Information including boxed warning atwww.corcept.com/prescribinginfo.pdf
Please see the accompanying Medication Guide atwww.corcept.com/medicationguide.pdf
About Corcept Therapeutics IncorporatedCorcept is a pharmaceutical company engaged in the discovery, development and commercialization of drugs for the treatment of severe metabolic and psychiatric disorders. Korlym, a first generation GR-II antagonist, is the company's first FDA-approved medication. The company has a portfolio of new selective GR-II antagonists that block the effects of cortisol but not progesterone. Corcept owns an extensive intellectual property portfolio covering the use of GR-II antagonists, including mifepristone, in the treatment of a wide variety of psychiatric and metabolic disorders. The company also holds composition of matter patents for its selective GR-II antagonists.