United Therapeutics to Present Tyvaso DPI™ BREEZE Clinical Data at the European Respiratory Society International Congress 2021

SILVER SPRING, Md. and RESEARCH TRIANGLE PARK, N.C., Aug. 24, 2021 /PRNewswire/ -- United Therapeutics Corporation (Nasdaq: UTHR) today announced it will present data from a clinical trial studying Tyvaso DPI™ (treprostinil) in patients with pulmonary arterial hypertension (PAH) at the European Respiratory Society (ERS) International Congress 2021, which will be held virtually from September 5-8, 2021.

Data from the BREEZE study of Tyvaso DPI, a dry powder inhaled formulation of treprostinil, will be presented in a poster session on September 6, 2021. The BREEZE study enrolled 51 subjects on a stable regimen of Tyvaso® Inhalation Solution who were transitioned to Tyvaso DPI at a corresponding treprostinil dose.

The primary objective of the study was to evaluate the safety and tolerability of Tyvaso DPI during a three-week treatment phase in PAH patients previously treated with Tyvaso Inhalation Solution. Top line data showing the BREEZE study met its primary objective were released in January 2021.

Secondary objectives highlighted at the congress will include: (1) change in six-minute walk distance (6MWD); (2) patient satisfaction with and preference for inhaled treprostinil devices; and (3) patient-reported PAH symptoms and impact (PAH-SYMPACT®). Each objective was assessed at study entry when patients were using Tyvaso Inhalation Solution and after three weeks using Tyvaso DPI.

Additional pharmacokinetic (PK) data from the BREEZE and healthy volunteer studies will be presented at future medical congresses.

"We look forward to presenting important new data that serve as the basis of our pending New Drug Application for Tyvaso DPI," said Leigh Peterson, Ph.D., Senior Vice President, Product Development, at United Therapeutics. "If approved by the FDA, Tyvaso DPI will provide a more convenient formulation of inhaled treprostinil that may increase prostacyclin accessibility." 

Details for the poster presentation at ERS 2021 are as follows:

Title: BREEZE: Open-label, Clinical Study to Evaluate the Safety and Tolerability of a Treprostinil Dry Powder inhaler in Patients with Pulmonary Arterial Hypertension Currently using TyvasoLead Author: Leslie Spikes, M.D.

The poster will be available on the United Therapeutics Pipeline website following the conclusion of the congress.

About PAH

Also known as World Health Organization (WHO) Group 1 Pulmonary Hypertension, PAH is life-threatening high blood pressure in the arteries of the lungs, affecting the ability of the heart and lungs to work properly in afflicted patients. PAH is a serious, progressive disease for which there is no known cure.

About Tyvaso DPI

Tyvaso DPI™ is an investigational drug-device combination therapy comprised of a dry powder formulation of treprostinil and a small, portable, dry powder inhaler. If approved, Tyvaso DPI is expected to provide a more convenient method of administration compared with traditional nebulized Tyvaso® therapy. United Therapeutics has developed Tyvaso DPI under a collaboration and license agreement with MannKind Corporation (Nasdaq: MNKD). Tyvaso DPI incorporates the dry powder formulation technology and Dreamboat® inhalation device technology used in MannKind's Afrezza® (insulin human) Inhalation Powder product, which was approved by the FDA in 2014.

United Therapeutics and MannKind are also developing BluHale®, a Bluetooth-connected accessory for the Tyvaso DPI inhaler with a companion mobile application intended to help the patient track information about inhaler use.

United Therapeutics has submitted a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) seeking approval of Tyvaso DPI to treat patients with PAH and pulmonary hypertension associated with interstitial lung disease. FDA action on the NDA is anticipated in October 2021.

About TYVASO® (treprostinil) Inhalation Solution

INDICATION TYVASO (treprostinil) is a prostacyclin mimetic indicated for the treatment of:

• Pulmonary arterial hypertension (PAH; WHO Group 1) to improve exercise ability. Studies establishing effectiveness predominately included patients with NYHA Functional Class III symptoms and etiologies of idiopathic or heritable PAH (56%) or PAH associated with connective tissue diseases (33%). The effects diminish over the minimum recommended dosing interval of 4 hours; treatment timing can be adjusted for planned activities. While there are long-term data on use of treprostinil by other routes of administration, nearly all controlled clinical experience with inhaled treprostinil has been on a background of bosentan (an endothelin receptor antagonist) or sildenafil (a phosphodiesterase type 5 inhibitor). The controlled clinical experience was limited to 12 weeks in duration.
• Pulmonary hypertension associated with interstitial lung disease (PH-ILD; WHO Group 3) to improve exercise ability. The study establishing effectiveness predominately included patients with etiologies of idiopathic interstitial pneumonia (IIP) (45%) inclusive of idiopathic pulmonary fibrosis (IPF), combined pulmonary fibrosis and emphysema (CPFE) (25%), and WHO Group 3 connective tissue disease (22%).

IMPORTANT SAFETY INFORMATION

WARNINGS AND PRECAUTIONS

• TYVASO is a pulmonary and systemic vasodilator. In patients with low systemic arterial pressure, TYVASO may produce symptomatic hypotension.
• TYVASO inhibits platelet aggregation and increases the risk of bleeding.
• Co-administration of a cytochrome P450 (CYP) 2C8 enzyme inhibitor (e.g., gemfibrozil) may increase exposure (both Cmax and AUC) to treprostinil. Co-administration of a CYP2C8 enzyme inducer (e.g., rifampin) may decrease exposure to treprostinil. Increased exposure is likely to increase adverse events associated with treprostinil administration, whereas decreased exposure is likely to reduce clinical effectiveness.

DRUG INTERACTIONS/SPECIFIC POPULATIONS

• The concomitant use of TYVASO with diuretics, antihypertensives, or other vasodilators may increase the risk of symptomatic hypotension.
• Human pharmacokinetic studies with an oral formulation of treprostinil (treprostinil diolamine) indicated that co-administration of the cytochrome P450 (CYP) 2C8 enzyme inhibitor, gemfibrozil, increases exposure (both Cmax and AUC) to treprostinil. Co-administration of the CYP2C8 enzyme inducer, rifampin, decreases exposure to treprostinil. It is unclear if the safety and efficacy of treprostinil by the inhalation route are altered by inhibitors or inducers of CYP2C8.
• Limited case reports of treprostinil use in pregnant women are insufficient to inform a drug-associated risk of adverse developmental outcomes. However, pulmonary arterial hypertension is associated with an increased risk of maternal and fetal mortality. There are no data on the presence of treprostinil in human milk, the effects on the breastfed infant, or the effects on milk production.
• Safety and effectiveness in pediatric patients have not been established.
• Across clinical studies used to establish the effectiveness of TYVASO in patients with PAH and PH–ILD, 268 (47.8%) patients aged 65 years and over were enrolled. The treatment effects and safety profile observed in geriatric patients were similar to younger patients. In general, dose selection for an elderly patient should be cautious, reflecting the greater frequency of hepatic, renal, or cardiac dysfunction, and of concomitant diseases or other drug therapy.

ADVERSE REACTIONS

• Pulmonary Arterial Hypertension (WHO Group 1)In a 12-week, placebo-controlled study (TRIUMPH I) of 235 patients with PAH (WHO Group 1 and nearly all NYHA Functional Class III), the most common adverse reactions seen with TYVASO in ≥4% of PAH patients and more than 3% greater than placebo in the placebo-controlled study were cough (54% vs 29%), headache (41% vs 23%), throat irritation/pharyngolaryngeal pain (25% vs 14%), nausea (19% vs 11%), flushing (15% vs