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Ironwood and Forest Announce U.S. Availability of LINZESS™ (Linaclotide)



  Ironwood and Forest Announce U.S. Availability of LINZESS™ (Linaclotide)

- New Treatment for Adults with Irritable Bowel Syndrome with Constipation or
      Chronic Idiopathic Constipation Now in Pharmacies Across the U.S.-

Business Wire

CAMBRIDGE, Mass. & NEW YORK -- December 17, 2012

Ironwood Pharmaceuticals, Inc. (NASDAQ: IRWD) and Forest Laboratories, Inc.
(NYSE: FRX) announced today that LINZESS™ (linaclotide) is now available in
pharmacies throughout the United States. The U.S. Food and Drug Administration
(FDA) recently approved LINZESS as a once-daily oral capsule for adult men and
women suffering from irritable bowel syndrome with constipation (IBS-C) or
chronic idiopathic constipation (CIC).

LINZESS is the first and only FDA-approved guanylate cyclase-C (GC-C) agonist
and acts locally in the intestine. For the first time in over six years, a new
prescription option is available for adults with these disorders.

Visit www.linzess.com for more information about LINZESS.

About LINZESS

LINZESS is the first and only guanylate cyclase-C (GC-C) agonist approved by
the FDA for the treatment of both irritable bowel syndrome with constipation
(IBS-C) and chronic idiopathic constipation (CIC) in adults. LINZESS is a
once-daily capsule that helps relieve the abdominal pain and constipation
associated with IBS-C and constipation and hard stools associated with CIC.
The recommended dose is 290 mcg for IBS-C patients and 145 mcg for CIC
patients. LINZESS should be taken at least 30 minutes before the first meal of
the day.

LINZESS is thought to work in two ways based on nonclinical studies. LINZESS
binds to the GC-C receptor locally, within the intestinal epithelium.
Activation of GC-C results in increased intestinal fluid secretion and transit
and a reduction in visceral pain, which is thought to be mediated by decreased
activity of pain-sensing nerves. The clinical relevance of the effect on pain
fibers in nonclinical studies has not been established.

In placebo-controlled Phase III clinical trials of more than 2,800 adults,
LINZESS was shown to reduce abdominal pain in IBS-C patients and increase
bowel movement frequency in both IBS-C patients and CIC patients. Improvement
in abdominal pain and constipation occurred in the first week of treatment and
was maintained throughout the 12-week treatment period. Maximum effect on
abdominal pain was seen at weeks 6-9 and maximum effect on constipation
occurred during the first week. When a subset of LINZESS-treated patients in
the trials were switched to placebo, they reported their symptoms returned
toward pretreatment levels within one week, while placebo-treated patients
switched to LINZESS reported symptom improvements. LINZESS is contraindicated
in pediatric patients up to 6 years of age. The use of LINZESS in pediatric
patients 6 through 17 years of age should be avoided. In nonclinical studies,
administration of a single, clinically relevant adult oral dose of linaclotide
caused deaths in young juvenile mice. LINZESS has not been studied in
pediatric patients. In adults with IBS-C or CIC treated with LINZESS, the most
commonly reported adverse event was diarrhea.

Ironwood and Forest are co-promoting LINZESS in the United States. Linaclotide
was also approved recently by the European Commission for the treatment of
adults in the European Union with IBS-C and will be marketed under the brand
name Constella® through a license agreement between Ironwood and Almirall,
S.A. Ironwood also has partnered linaclotide with Astellas Pharma Inc. for
development and commercialization in Japan and certain other Asian countries
and with AstraZeneca for development and commercialization in China.

About Irritable Bowel Syndrome with Constipation

Irritable bowel syndrome with constipation (IBS-C) is a chronic functional
gastrointestinal disorder that affects as many as 13 million people in the
United States. IBS-C can have a negative impact on daily living; patients
often experience recurring abdominal pain or discomfort, constipation, and
bowel symptoms including hard or lumpy stools in more than 25% of bowel
movements, and soft or watery stools in less than 25% of bowel movements.
There are currently few available therapies approved to treat this disorder.

About Chronic Idiopathic Constipation

Chronic idiopathic constipation (CIC) is a functional gastrointestinal
disorder in which individuals experience infrequent bowel movements (less than
three times per week) for at least three months. Patients who suffer from CIC
may also experience a sensation of incomplete evacuation and hard stools. As
many as 35 million Americans may suffer from symptoms associated with CIC.

Important Safety Information

WARNING: PEDIATRIC RISK
LINZESS is contraindicated in pediatric patients up to 6 years of age. Use
should be avoided in pediatric patients 6 through 17 years of age. In
nonclinical studies, administration of a single, clinically relevant adult
oral dose of linaclotide caused deaths in young juvenile mice.

Contraindications

  * LINZESS is contraindicated in pediatric patients up to 6 years of age.
  * LINZESS is contraindicated in patients with known or suspected mechanical
    gastrointestinal obstruction.

Warnings and Precautions

Pediatric Risk

  * LINZESS is contraindicated in pediatric patients up to 6 years of age. In
    nonclinical studies, deaths occurred within 24 hours in young juvenile
    mice (1 to 3 week-old mice; approximately equivalent to human pediatric
    patients less than 2 years of age) following administration of one or two
    daily oral doses of linaclotide.
  * Use of LINZESS should be avoided in pediatric patients 6 through 17 years
    of age. Linaclotide did not cause deaths in older juvenile mice
    (approximately equivalent to humans age 12 to 17 years). Although there
    were no deaths in older juvenile mice, given the deaths in young juvenile
    mice and the lack of clinical safety and efficacy data in pediatric
    patients, use of LINZESS should be avoided in pediatric patients 6 through
    17 years of age.

Diarrhea

  * Diarrhea was the most common adverse reaction of LINZESS-treated patients
    in the pooled IBS-C and CIC double-blind placebo-controlled trials. Severe
    diarrhea was reported in 2% of LINZESS-treated patients. The incidence of
    diarrhea was similar in the IBS-C and CIC populations.
  * Patients should be instructed to stop LINZESS if severe diarrhea occurs
    and to contact their healthcare provider, who should consider dose
    suspension.

Adverse Reactions

  * In IBS-C clinical trials, the most common adverse reactions in
    LINZESS-treated patients (incidence ≥2% and greater than placebo) were
    diarrhea (20% vs 3% placebo), abdominal pain (7% vs 5%), flatulence (4% vs
    2%), headache (4% vs 3%), viral gastroenteritis (3% vs 1%) and abdominal
    distension (2% vs 1%).
  * In CIC clinical trials, the most common adverse reactions in
    LINZESS-treated patients (incidence ≥2% and greater than placebo) were
    diarrhea (16% vs 5% placebo), abdominal pain (7% vs 6%), flatulence (6% vs
    5%), upper respiratory tract infection (5% vs 4%), sinusitis (3% vs 2%)
    and abdominal distension (3% vs 2%).

Drug Interactions

No drug-drug interaction studies have been conducted with LINZESS. Linaclotide
and its active metabolite are not measurable in plasma following
administration of the recommended clinical doses; hence, no systemic drug-drug
interactions or drug interactions mediated by plasma protein binding of
linaclotide or its metabolite are anticipated

Linaclotide does not interact with the cytochrome P450 enzyme system based on
the results of in vitro studies. In addition, linaclotide is neither a
substrate nor an inhibitor of the efflux transporter P-glycoprotein (P-gp).

About Ironwood Pharmaceuticals

Ironwood Pharmaceuticals (NASDAQ: IRWD) is an entrepreneurial pharmaceutical
company dedicated to the art and science of great drugmaking. Ironwood is
located in Cambridge, Mass. To learn more, visit www.ironwoodpharma.com.

About Forest Laboratories, Inc.

Forest Laboratories’ (NYSE: FRX) longstanding global partnerships and track
record developing and marketing pharmaceutical products in the United States
have yielded its well-established central nervous system and cardiovascular
franchises and innovations in anti-infective and respiratory,
gastrointestinal, and pain management medicine. The Company’s pipeline, the
most robust in its history, includes product candidates in all stages of
development across a wide range of therapeutic areas. The Company is
headquartered in New York, NY. To learn more, visit www.FRX.com.

Except for the historical information contained herein, this release contains
forward-looking statements within the meaning of the Private Securities
Litigation Reform Act of 1995. These statements involve a number of risks and
uncertainties, including the potential sales of LINZESS in the United States
and of Constella in the European Union, the target patient populations in the
United States for LINZESS, the potential reimbursement for LINZESS in the
United States, the post approval development strategy for LINZESS, the
acceptance and demand for new pharmaceutical products, the impact of
competitive products and pricing, the timely development and launch of new
products, and the risk factors listed from time to time in each of Forest’s
and Ironwood’s Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q,
and other SEC filings. Neither Forest nor Ironwood undertakes any obligation
to update these forward-looking statements to reflect events or circumstances
occurring after this press release. These forward-looking statements speak
only as of the date of this press release. All forward-looking statements are
qualified in their entirety by this cautionary statement.

Photos/Multimedia Gallery Available:
http://www.businesswire.com/multimedia/home/20121217005366/en/

Multimedia
Available:http://www.businesswire.com/cgi-bin/mmg.cgi?eid=50509001&lang=en

Contact:

Forest Laboratories, Inc.
Frank J. Murdolo, 212-224-6714
Vice President - Investor Relations
media.relations@frx.com
or
Ironwood Pharmaceuticals, Inc.
Media Relations:
Lisa Buffington, 617-374-5103
lbuffington@ironwoodpharma.com
or
Investor Relations:
Meredith Kaya, 617-374-5082
mkaya@ironwoodpharma.com
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