Efficacy Of Repatha® Across High-Risk Patient Populations Reinforced At ACC.21

Amgen (NASDAQ:AMGN) today announced the presentation of four cardiovascular research abstracts, including final data from the Repatha ® (evolocumab) open label extension trial of patients living with HIV who have high cholesterol, as well as new data from FOURIER evaluating biomarkers of major cardiovascular (CV) events, including complex revascularization procedures. Additional abstracts to be presented include a simulation comparing the impact of different LDL-C guidelines on CV risk reduction, as well as negative control outcomes to assess residual bias when comparing PCSK9 inhibitors to other treatments. These analyses will be presented at the American College of Cardiology's 70th Annual Scientific Session & Expo (ACC.21), May 15-17, 2021 .

The data in HIV confirm the safety and efficacy of Repatha across different patient populations and contribute to Amgen's PROFICIO (Program to Reduce LDL-C and Cardiovascular Outcomes Following Inhibition of PCSK9 In Different POpulations) program of clinical and real-world evidence studies investigating the impact of Repatha on cardiovascular disease. To date, the PROFICIO program consists of 50 clinical trials including more than 47,000 patients worldwide with eight real-world evidence studies ¹ . These studies provide the body of evidence for treatment in a variety of high-risk patients and have contributed to Repatha being approved in more than 75 countries. Notably, Amgen recently passed the milestone of more than one million patients receiving Repatha worldwide ² .

"We're excited to have reached more than one million patients with Repatha ^® – a significant achievement through our unwavering commitment to advancing CV treatment and addressing unmet needs, especially in vulnerable, at-risk populations," said David M. Reese , M.D., executive vice president of Research and Development at Amgen. "Our commitment to helping improve outcomes for CV patients goes beyond developing treatment; it's the guiding force behind our partnerships with leading advocacy organizations on a variety of programs, including the American College of Cardiology (ACC) on the TRANSFORM: ACS program, which aims to initiate lipid lowering treatment sooner to help patients reduce the risk of subsequent CV events."

TRANSFORM: Accelerating Lipid Lowering Post ACS (TRANSFORM: ACS), is a collaboration with ACC and Veradigm which is focused on helping patients with Acute Coronary Syndrome (ACS) receive cholesterol testing in the hospital and guideline-recommended therapies to reduce their LDL-C after discharge. The goal of this program is to improve the rate of lipid panel testing and lipid lowering treatment intensification in ACS patients.

A list of Amgen-sponsored abstracts at ACC.21 can be found online and include:

• Evolocumab Use in Patients with Human Immunodeficiency Virus and Dyslipidemia: Final Results of the Open Label Extension Period (BEIJERINCK) (Moderated Poster, Session 1056-05)
• Biomarker Prediction of Major Coronary Events and Complex Revascularization Procedures in Patients with Stable Atherosclerosis (Oral, Session 910-08)
• Comparison of Achieving 2019 ESC/EAS Versus 2018 ACC/AHA LDL-C Goals for Patients with Atherosclerotic Cardiovascular Disease: A Cardiovascular Risk Simulation from the DA VINCI Study (Poster, Session 2118)
• Use of Negative Control Outcomes to Assess the Comparability of Treatments for Hypercholesterolemia (Poster, Session 2108)

About the Repatha CV Outcomes Trial FOURIER  
FOURIER ( F urther cardiovascular OU tcomes R esearch with PCSK9 I nhibition in Subjects with E levated R isk), a multinational Phase 3 randomized, double-blind, placebo-controlled trial, was designed to evaluate whether treatment with Repatha in combination with statin therapy compared to placebo plus statin therapy reduces CV events. The primary endpoint is the time to CV death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary endpoint is the time to CV death, myocardial infarction or stroke.

Eligible patients with high cholesterol (LDL-C ≥70 mg/dL or non-high-density lipoprotein cholesterol [non-HDL-C] ≥100 mg/dL) and clinically evident ASCVD at more than 1,300 study locations around the world were randomized to receive Repatha subcutaneous 140 mg every two weeks or 420 mg monthly plus effective statin dose; or placebo subcutaneous every two weeks or monthly plus effective statin dose. Optimized statin therapy was defined as at least atorvastatin 20 mg or equivalent daily with a recommendation for at least atorvastatin 40 mg or equivalent daily where approved. The study was event-driven and continued until at least 1,630 patients experienced a key secondary endpoint.

FOURIER is part of Amgen's PROFICIO ( P rogram to R educe LDL-C and cardiovascular O utcomes F ollowing I nhibition of P C SK9 I n different p O pulations) program of clinical studies investigating the impact of Repatha on LDL-C and CVD across multiple populations at high CV risk, including those managed by statins, statin-intolerant patients, those with genetic disorders and patients with atherosclerosis. To date, the PROFICIO program consists of 50 trials including more than 43,000 patients worldwide.

About BEIJERINCK Study Design  
Evolocuma B   E ffect on LDL-C Lower I ng in Sub JE cts with Human Immunodeficiency Vi R us and IN creased Cardiovascular Ris K (BEIJERINCK) is a double-blind, randomized, placebo-controlled study designed to evaluate the efficacy and safety of 420 mg once-monthly treatment with evolocumab in HIV+ patients with hyperlipidemia or mixed dyslipidemia over 24 weeks. The study enrolled 467 adults with known HIV infection who have received stable HIV therapy for six months or more prior to randomization and have also been treated with maximally tolerated lipid-lowering therapy for four weeks or longer prior to randomization. Both background therapies were not expected to change during the duration of study participation. Statin-intolerant patients were also eligible for the study. Evolocumab-treated patients who completed the 24-week double-blind treatment period were enrolled in an open-label period through the end of the study at week 52.

About Amgen in the Cardiovascular Therapeutic Area  
Building on more than three decades of experience in developing biotechnology medicines for patients with serious illnesses, Amgen is dedicated to addressing important scientific questions to advance care and improve the lives of patients with cardiovascular disease, the leading cause of morbidity and mortality worldwide. ³ Amgen's research into cardiovascular disease, and potential treatment options, is part of a growing competency at Amgen that utilizes human genetics to identify and validate certain drug targets. Through its own research and development efforts, as well as partnerships, Amgen is building a robust cardiovascular portfolio consisting of several approved and investigational molecules in an effort to address a number of today's important unmet patient needs, such as elevated lipids, including high cholesterol and Lp(a), and heart failure.

About Amgen  
Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. This approach begins by using tools like advanced human genetics to unravel the complexities of disease and understand the fundamentals of human biology.

Amgen focuses on areas of high unmet medical need and leverages its biologics manufacturing expertise to strive for solutions that improve health outcomes and dramatically improve people's lives. A biotechnology pioneer since 1980, Amgen has grown to be the world's largest independent biotechnology company, has reached millions of patients around the world and is developing a pipeline of medicines with breakaway potential.

For more information, visit www.amgen.com and follow us on www.twitter.com/amgen .

About Repatha (evolocumab)  
Repatha is a human monoclonal antibody that inhibits proprotein convertase subtilisin/kexin type 9 (PCSK9). Repatha binds to PCSK9 and inhibits circulating PCSK9 from binding to the low-density lipoprotein (LDL) receptor (LDLR), preventing PCSK9-mediated LDLR degradation and permitting LDLR to recycle back to the liver cell surface. By inhibiting the binding of PCSK9 to LDLR, Repatha increases the number of LDLRs available to clear LDL from the blood, thereby lowering LDL-C levels. ⁴

Repatha is approved in more than 75 countries, including the U.S., Japan , Canada , Australia , China and in all 28 countries that are members of the European Union. Applications in other countries are pending.

Indications  
Repatha is indicated:

• In adults with established cardiovascular disease to reduce the risk of myocardial infarction, stroke, and coronary revascularization
• As an adjunct to diet, alone or in combination with other low-density lipoprotein cholesterol (LDL-C) lowering therapies, in adults with primary hyperlipidemia, including heterozygous familial hypercholesterolemia (HeFH) to reduce LDL-C
• As an adjunct to other LDL-C-lowering therapies in patients with homozygous familial hypercholesterolemia (HoFH), to reduce LDL-C

The safety and effectiveness of Repatha have not been established in pediatric patients with HoFH who are younger than 13 years old or in pediatric patients with primary hyperlipidemia.

Important U.S. Safety Information

• Contraindication: Repatha is contraindicated in patients with a history of a serious hypersensitivity reaction to evolocumab or any of the excipients in Repatha ^® . Serious hypersensitivity reactions including angioedema have occurred in patients treated with Repatha.
  
  
• Hypersensitivity Reactions: Hypersensitivity reactions, including angioedema, have been reported in patients treated with Repatha. If signs or symptoms of serious hypersensitivity reactions occur, discontinue treatment with Repatha, treat according to the standard of care, and monitor until signs and symptoms resolve.
  
  
• Adverse Reactions in Primary Hyperlipidemia: The most common adverse reactions (>5% of patients treated with Repatha and more frequently than placebo) were: nasopharyngitis, upper respiratory tract infection, influenza, back pain, and injection site reactions.
  
  From a pool of the 52-week trial and seven 12-week trials: Local injection site reactions occurred in 3.2% and 3.0% of Repatha-treated and placebo-treated patients, respectively. The most common injection site reactions were erythema, pain, and bruising. Hypersensitivity reactions occurred in 5.1% and 4.7% of Repatha-treated and placebo-treated patients, respectively. The most common hypersensitivity reactions were rash (1.0% versus 0.5% for Repatha and placebo, respectively), eczema (0.4% versus 0.2%), erythema (0.4% versus 0.2%), and urticaria (0.4% versus 0.1%).
  
  
• Adverse Reactions in the Cardiovascular Outcomes Trial: The most common adverse reactions (>5% of patients treated with Repatha and more frequently than placebo) were: diabetes mellitus (8.8% Repatha, 8.2% placebo), nasopharyngitis (7.8% Repatha, 7.4% placebo), and upper respiratory tract infection (5.1% Repatha, 4.8% placebo).
  
  Among the 16,676 patients without diabetes mellitus at baseline, the incidence of new-onset diabetes mellitus during the trial was 8.1% in patients treated with Repatha compared with 7.7% in patients that received placebo.
  
• Adverse Reactions in HoFH: In a 12-week study in 49 patients, the adverse reactions that occurred in at least two patients treated with Repatha and more frequently than placebo were: upper respiratory tract infection, influenza, gastroenteritis, and nasopharyngitis. In an open-label extension study in 106 patients, including 14 pediatric patients, no new adverse reactions were observed.
  
  
• Immunogenicity: Repatha is a human monoclonal antibody. As with all therapeutic proteins, there is potential for immunogenicity with Repatha.

Please contact Amgen Medinfo at 800-77-AMGEN (800-772-6436) or 844-REPATHA (844-737-2842) regarding Repatha availability or find more information, including full Prescribing Information , at www.amgen.com and www.Repatha.com .

Amgen Forward-Looking Statements  
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CONTACT: Amgen, Thousand Oaks
Michael Strapazon , 805-313-5553 (media)
Megan Fox , 805-447-1423 (media)
Arvind Sood , 805-447-1060 (investors)

References  
^[1] Amgen Data on File. 2021.
^[2] Amgen Data on File. 2021.
^[3] World Health Organization. Cardiovascular diseases (CVDs) fact sheet. https://www.who.int/mediacentre/factsheets/fs317/en/ . Accessed September 2020 .
^[4] Repatha Prescribing Information; Amgen, Thousand Oaks, CA , 2018.

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SOURCE Amgen