Treatment of ADHD
Shire plc announced today that the U.S. Food and Drug Administration (FDA) approved DAYTRANA (methylphenidate transdermal system), the first and only non-oral medication for the treatment of attention deficit hyperactivity disorder (ADHD). DAYTRANA, a once daily transdermal patch formulation of methylphenidate, will be available in 10 mg, 15 mg, 20 mg and 30 mg dosage strengths.
"The approval of DAYTRANA is important news for ADHD patients, their families and healthcare providers. In addition to being the only patch treatment for ADHD, it offers a convenient option to deliver medicine for those diagnosed with ADHD," said Shire Chief Executive Officer Matthew Emmens. "The addition of DAYTRANA to Shire's portfolio reaffirms our position as the market leader in ADHD."
Shire and Noven Pharmaceuticals, Inc. submitted an amended New Drug Application (NDA) for DAYTRANA to the FDA in June of last year. DAYTRANA is licensed globally to Shire by Noven and will be available in pharmacies in the U.S. in mid 2006.
The efficacy of DAYTRANA was established in two controlled clinical trials in children aged 6 to 12 years old with ADHD. DAYTRANA combines methylphenidate, a medication with a 50-year history of use, with Noven's patented DOT Matrix transdermal technology. This transdermal delivery system delivers medication directly through the skin into the bloodstream, and is designed to provide consistent, smooth drug release throughout the day. The patch is designed to stay on during the normal daily activities of a child, including swimming, exercising, and bathing. Because DAYTRANA is a patch, physicians can manage the duration of its effect and potential side effects by having the patient wear the patch for a shorter time period than the recommended 9 hour wear time on a given day. In clinical trials, wearing a DAYTRANA patch for 9 hours provided a duration of effect of 12 hours.
"The FDA's approval of DAYTRANA offers an important new option in the treatment of ADHD in children," said Robert Findling, MD, lead investigator and Professor of Psychiatry; Director, Division of Adolescent and Child Psychiatry, Case Western University. "DAYTRANA has been shown to be effective and generally well tolerated in clinical studies, and offers ADHD treatment in the convenient form of a patch."
As part of the agreement between Shire and Noven for DAYTRANA, Shire completed an upfront payment to Noven of $25 million in 2003, and may make separate milestone payments up to $125 million; $50 million will be paid dictated by this FDA approval and $75 million conditioned upon the achievement of certain sales targets.
DAYTRANA Significantly Controls ADHD Symptoms
Data from phase II and phase III clinical trials demonstrated statistically significant improvements in the primary and secondary endpoints analyzed for children treated with DAYTRANA compared to children treated with placebo.
The phase II analog classroom study included 79 children with ADHD. The patch was worn for nine hours, and efficacy was assessed throughout the day for 12 hours. DAYTRANA demonstrated statistically significant improvement over placebo on the measures tested. Behavior, which was measured using the Swanson, Kotkin, Agler, M-Flynn, and Pelham-Deportment (SKAMP-D) scale, was improved with DAYTRANA overall (mean score 3.2 for DAYTRANA versus 8.0 for placebo) and at all time points assessed up to and including 12 hours post-application (P < .01). The mean number of math problems attempted by children taking DAYTRANA on the Permanent Product Measure of Performance (PERMP) scale was significantly more than those taking placebo (P <.0001) and this same group also completed more math problems correctly than did those taking placebo (P <.0001).
In the phase III naturalistic trial with 270 participants, investigators found that DAYTRANA worn for nine hours reduced the children's overall symptoms of ADHD, compared to a placebo (P < .0001), as measured by scores on the ADHD Rating Scale-IV (ADHD-RS-IV). By the study's end, mean ADHD-RS-IV scores declined 56% (24.2 points) from baseline for children treated with DAYTRANA versus a decline of 25 % (10.3) for those treated with placebo (P < .0001). ADHD-RS assesses 18 individual symptoms of ADHD as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision