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Soluble Ferric Pyrophosphate (SFP)

Phase III asset available from Rockwell Medical
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Opportunity:

Rockwell Medical (NASDAQ: RMTI) is currently exploring Global out-licensing opportunities for its proprietary late stage drug candidate Soluble Ferric Pyrophosphate (SFP).  Rockwell is seeking partners to share in the global clinical, regulatory and commercialization expenses for SFP.  All territories, formulations and indications are available for discussion.  Formulations and indications for potential use include; hemodialysis, peritoneal dialysis, oral dose delivery both OTC and Rx, total parenteral nutrition (TPN) and IV delivery for the Oncology and GI markets. 

About Rockwell Medical:

Rockwell Medical is a fully-integrated biopharmaceutical company targeting end-stage renal disease (ESRD) and chronic kidney disease (CKD) with innovative products and services for the treatment of iron deficiency, secondary hyperparathyroidism and hemodialysis. Rockwell is an established manufacturer and leader in delivering high-quality hemodialysis concentrates/dialysates to dialysis providers and distributors in the U.S. and abroad. Rockwell has three manufacturing and distribution facilities in the United States.

About SFP:

Soluble Ferric Pyrophosphate (SFP), Rockwell’s lead late-stage drug compound, delivers iron to the bone marrow of dialysis patients in a non-invasive, physiologic manner via dialysate during their regular dialysis treatment. In order to prevent or treat anemia, sufficient availability of iron and erythropoietin must be present in the bone marrow to generate healthy red blood cells.  In completed dialysis clinical trials to date, SFP has demonstrated that it can safely deliver iron to the bone marrow. SFP is currently in ongoing Phase 3 clinical studies (CRUISE-1 and CRUISE-2) to address an estimated $600M U.S. and $1B global dialysis market.

SFP is a unique iron compound that is delivered to the hemodialysis patient via dialysate replacing the 5-7mg of iron lost during a dialysis treatment. SFP is introduced into the sodium bicarbonate concentrate that subsequently is mixed into dialysate. Once in the dialysate, SFP crosses the dialyzer membrane and enters the bloodstream where it immediately binds to apo-transferrin and is taken to the bone marrow. SFP mimics the way dietary iron is handled in the human body. In completed clinical trials to date, SFP has demonstrated that it can safely deliver iron and maintain hemoglobin levels, while decreasing ESA use without any increase in iron stores. For a demonstration of SFP's unique mechanism of action in delivering iron via dialysate, please view the animation video at http://www.rockwellmed.com/collateral/documents/english-us/mode-of-action.html.


Recently Reported ESA Sparing Data from PRIME Study:

WIXOM, Mich., Feb. 4, 2013 /PRNewswire/ -- Rockwell Medical (RMTI), a fully-integrated biopharmaceutical company targeting end-stage renal disease (ESRD) and chronic kidney disease (CKD) with innovative products and services for the treatment of iron deficiency, secondary hyperparathyroidism and hemodialysis, announced successful topline results from the PRIME clinical study of Soluble Ferric Pyrophosphate (SFP), its investigational iron-delivery drug currently in Phase 3 clinical studies for the treatment of iron deficiency in hemodialysis patients. The PRIME study demonstrated that regular administration of SFP-iron via dialysate reduced the usage of erythropoietin stimulating agents (ESAs) during hemodialysis by 35% while maintaining iron balance and maximizing iron delivery.

Study Design

The PRIME study was a nine-month, prospective, randomized, placebo-controlled, double-blinded, multi-center study in United States that randomized 108 patients equally to dialysate containing SFP-iron versus conventional dialysate. A total of 103 patients received blinded study drug (52 SFP, 51 Placebo; modified ITT population). In each group, 11 subjects discontinued prematurely. Discontinuations due to adverse events were 2 in SFP and 3 in placebo. The reasons for the remaining discontinuations were similar between treatment groups. The baseline hemoglobin was similar in both groups (10.9 g/dL SFP and 11.1 g/dL placebo). In all study patients, ESA doses were titrated to maintain hemoglobin in a target range of 9.5 to 11.5 g/dL according to an algorithm managed by an independent centralized anemia management group. At the end of treatment, the hemoglobin value in the SFP group was 10.5 g/dL and 10.4 g/dL in the placebo group. Intravenous (IV) iron was administered as needed to treat iron deficiency.

Primary Endpoint

The primary objective of the study was to determine whether regular administration of SFP via dialysate reduced the requirement for ESA dose by maintaining iron balance and optimizing iron delivery. The primary endpoint was the percent change in ESA dose from baseline to end of treatment (final two weeks of treatment period). Baseline ESA dose was similar between SFP (9448 U/wk) and placebo (9049 U/wk). In the modified ITT population, at the end of the study, ESA dose in the SFP arm was 10557 U/wk and placebo was 13345 U/wk. After adjusting for differences in baseline hemoglobin, the SFP arm required 35% less ESA dose compared to placebo. The difference between the two groups was statistically significant (p=0.034). The ESA sparing effect from SFP was observed without an increase in serum ferritin or transferrin saturation. A total of 32 patients received rescue IV iron, 20 in placebo and 12 in SFP. Further analysis of the complete data set is ongoing and the Company plans to submit PRIME data results for presentation at a major medical meeting later in 2013.

Dr. Raymond Pratt, Chief Medical Officer of Rockwell Medical stated, "We are very excited about the results of this well-run study. The 11 microgram/dL SFP dose delivered sufficient iron without increasing iron stores while greatly reducing ESA dose. The safety profile of SFP was similar to placebo and was well tolerated. In this study, a 37% higher ESA dose was needed in the placebo arm to maintain hemoglobin compared to the SFP arm, but in the Phase 3 CRUISE efficacy studies the ESA dose is kept constant, unable to be titrated, over the 12-month study period. The PRIME results support our belief that SFP will demonstrate efficacy in the Phase 3 CRUISE clinical studies by maintaining hemoglobin in the SFP arm while hemoglobin decreases in the placebo arm."

Mr. Robert L. Chioini, Chairman, CEO and President of Rockwell stated, "We are extremely pleased with the results of the PRIME study. We believe that SFP's unique ability to treat iron deficiency while dramatically reducing the need for ESA, without increasing iron stores, strengthens SFP's potential to become the market leading iron therapy treatment for CKD-HD patients. SFP's ability to substantially reduce ESA use in the treatment of anemia should translate into significant cost savings in dialysis care while potentially lowering the serious risks associated with the dosing of ESAs. We sincerely thank the study investigators and coordinators, and our clinical team for a well-conducted PRIME study, and we look forward to the upcoming efficacy results from the Phase 3 CRUISE studies, which are expected to read-out in the 2nd-half of this year."

In addition to delivering SFP via dialysate, Rockwell has developed and completed early testing for IV and Oral SFP formulations.  These additional formulations are expected to expand the use of SFP into the oral OTC/Rx, total parenteral nutrition (TPN) and IV Oncology and GI markets.  These formulations require additional clinical studies for regulatory commercial marketing approval, and combined market opportunity for these SFP line extensions may exceed $4B worldwide. 

 


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