R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747)...

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2008 2008 R&D Meeting R&D Meeting

Transcript of R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747)...

Page 1: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

20082008R&D MeetingR&D Meeting

Page 2: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Achievement of milestones for major projects

Key Milestones Achieved in FY2007Key Milestones Achieved in FY2007

Prasugrel (CS-747, anti-platelet agent) Nov-07 AHA, Proved superiority over current benchmark treatmentsDec-07 FDA filing for 1st indication (ACS-PCI) Brand Name : Effient™Feb-08 NDA filing in Europe 2Q-08 Trials to be started for 2nd indication (ACS-Medical Management)

CS-8663 (anti-hypertensive Amlodipine/Olmesartan combination) Sep-07 FDA approved, Brand Name : AZOR®

⇒ Launched in OctoberSep-07 NDA filed in Europe (28 countries), Brand Name : Sevikar™

⇒ Approvals gradually expected from autumn 2008

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Page 3: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Strategic investment for pipeline expansion

Key Milestones Achieved in FY2007Key Milestones Achieved in FY2007

Rivoglitazone (CS-011, anti-diabetes agent) May-07 First Phase 3 trial launched Aug-07 FDA removed clinical hold regarding of carcinogenicityDec-07 Second Phase 3 trial launched

Denosumab (AMG 162, anti-RANKL antibody) Jul-07 In-licensed from AmgenPhase 3 : bone metastases of cancerPhase 3 in preparation: osteoporosis

2

Page 4: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

The following post-Phase 2 projects are highly prioritized.

Project Project ClassClassPrasugrel (CS-747) Anti-platelet

DU-176b Blood coagulation factor Xa inhibitor

CS-8635 AZOR & HCT Triple Combo, Olme LCM

Rivoglitazone (CS-011) Anti-diabetes, PPAR-gamma agonist

Denosumab (AMG 162) Anti-RANKL antibody

Prioritized Projects (as of Feb-08)Prioritized Projects (as of Feb-08)

3

Page 5: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

PrasugrelPrasugrel (CS-747)

Page 6: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Current StatusCurrent StatusUS submission was made on December 26, 2007

October 26, 2008 PDUFA goal date for standard reviewIf approved, trade name is Effient™ in the US

EU submission was made on February 8, 2008

Post-hoc analysis about TRITON study will be presented at ACC late March, 2008

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Page 7: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Study Design

Double-blind

ACS (STEMI or UA/NSTEMI) & Planned PCIASA

PRASUGREL60 mg LD/ 10 mg MD

CLOPIDOGREL300 mg LD/ 75 mg MD

1o endpoint: CV death, MI, Stroke2o endpoints: CV death, MI, Stroke, Rehosp-Rec Isch

CV death, MI, UTVRStent Thrombosis

Key Substudies: Pharmacokinetic, Genomic

Median duration of therapy - 12 months

N= 13,600

5

Page 8: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

0

5

10

15

0 30 60 90 180 270 360 450

HR 0.81(0.73-0.90)P=0.0004

Prasugrel

Clopidogrel

HR 0.80P=0.0003

HR 0.77P=0.0001

Days

Prim

ary

Endp

oint

(%)

12.1(781)

9.9 (643)

138 events

Primary EndpointPrimary EndpointCV Death,MI,StrokeCV Death,MI,Stroke

NNT= 46

ITT= 13,608ITT= 13,608 LTFU = 14 (0.1%)LTFU = 14 (0.1%)

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Page 9: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

781643

115

58

0

200

400

600

800

1000

1100 Endpoint Events Endpoint Events PreventedPrevented

PostPost--hoc Analysishoc Analysis#

#

Eve

nts

Even

ts

25/1806/189

896896

701701

Clopidogrel Prasugrel

1st EventP=0.0004

AdditionalEvents

Total EventsP<0.0001

-138

-195

ITT N= 13,608 7

Page 10: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

B

OVERALL

No GPIGPI

DESBMS

DMNo DM

>7565-74

<65

FemaleMale

STEMIUA/NSTEMI

0.5 1 2Prasugrel Better Clopidogrel BetterHR

Age

Reduction in risk (%)18

2112

25146

1430

2018

2116

19

21

Pinter = NS

CV Death, MI, StrokeCV Death, MI, StrokeMajor SubgroupsMajor Subgroups

CrCl > 60CrCl < 60 14

19

8

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0

2

4

6

8

0 1 2 3

1

0 30 60 90 180 270 360 450

HR 0.82(0.71-0.96)

P=0.01

HR 0.80(0.70-0.93)P=0.003

5.6

4.7

6.9

5.6

Days

Prim

ary

Endp

oint

(%)

Prasugrel

Clopidogrel

Prasugrel

Clopidogrel

Loading Dose Maintenance Dose

Timing of BenefitTiming of Benefit(Landmark Analysis)(Landmark Analysis)

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Page 12: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Stent ThrombosisStent Thrombosis(ARC Definite + Probable)(ARC Definite + Probable)

0

1

2

3

0 30 60 90 180 270 360 450

HR 0.48P <0.0001

Prasugrel

Clopidogrel2.4

(142)

74 events

NNT= 77

1.1 (68)

Days

Endp

oint

(%)

Any Stent at Index PCIAny Stent at Index PCIN= 12,844N= 12,844

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Page 13: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

1.8

0.9 0.9

0.10.3

2.4

1.41.1

0.4 0.3

0

2

4

TIMI MajorBleeds

LifeThreatening

Nonfatal Fatal ICH

Bleeding EventsBleeding Events(N=13,457)(N=13,457)

% E

vent

s%

Eve

nts

ARD 0.6%ARD 0.6%HR 1.32HR 1.32P=0.03P=0.03

NNH=167 NNH=167

ClopidogrelClopidogrelPrasugrelPrasugrel

ARD 0.5%ARD 0.5%HR 1.52HR 1.52P=0.01P=0.01

ARD 0.2%ARD 0.2%P=0.23P=0.23

ARD 0%ARD 0%P=0.74P=0.74

ARD 0.3%ARD 0.3%P=0.002P=0.002

ICH in Pts w ICH in Pts w Prior Stroke/TIA Prior Stroke/TIA

(N=518)(N=518)

Clop 0 (0) %Clop 0 (0) %PrasPras 6 (2.3)%6 (2.3)%

(P=0.02)(P=0.02)

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Page 14: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

AntiplateletAntiplateletTherapy in ACSTherapy in ACS

0

108

Placebo APTC CURE TRITON-TIMI 38Single

Antiplatelet RxDual

Antiplatelet RxHigher

IPA

ASA ASA + Clopidogrel ASA +

Prasugrel- 22%

- 20%

- 19%

+ 60% + 38% + 32%

Reductionin

IschemicEvents

Increasein

Major Bleeds

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Page 15: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Net Clinical BenefitNet Clinical BenefitBleeding Risk SubgroupsBleeding Risk Subgroups

OVERALL

>=60 kg

< 60 kg

< 75

>=75

No

Yes

0.5 1 2

PriorStroke / TIA

Age

Wgt

Risk (%)+ 37

-16

-1

-16

+3

-14

-13

Prasugrel Better Clopidogrel BetterHR

Pint = 0.006

Pint = 0.18

Pint = 0.36

PostPost--hoc analysishoc analysis 13

Page 16: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Loading Dose Phase

Maintenance Dose Phase

No PCI

6 hours* Labs, 15 day Events

Coronary Angiography, Post-Angiography Labs

Planned Elective PCIBaseline Laboratory Measures

Prasugrel60 mg

Clopidogrel600 mg

0.5 hour Post Loading Dose Labs

PCI

6 hours*, 18-24 hours Labs

Clopidogrel150 mg x 14 day

Prasugrel10 mg x 14 day

Prasugrel10 mg x 14 day

Clopidogrel150 mg x 14 day 15 day Clinical Events,

Labs†, CROSSOVER

29 day Clinical Events, Labs†

1º EPs: *Loading = 6h IPA (20 µM ADP) ; †Maintenance = 15d or 29d IPA (20 µM ADP)

PRINCIPLEPRINCIPLE TIMITIMI--44: Study Design44: Study DesignStudy Objective: compare the pharmacodynamic response of prasugrel to higher

than approved doses of clopidogrel

Wiviott SD et al. Circulation 2007;116:2923-2932

Page 17: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Hours

IPA

(20

µM A

DP,

%)

Prasugrel 60 mg

***p<0.0001 Prasugrel vs. Clopidogrel

Clopidogrel 600 mg

*********

***

0.5 4 8 12 16 20 240

20

40

60

80

100

62Least square mean (LSM) + standard deviation; IPA=inhibition of platelet aggregation

Primary efficacy endpoint was IPA at 6 hours.

Wiviott SD et al. Circulation 2007;116:2923-2932

Primary Endpoint: Loading Dose Phase IPAPrimary Endpoint: Loading Dose Phase IPAHighly significant differences emerged throughout the LD phase

Page 18: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

• Well-tolerated and no TIMI major bleeds observed in either treatment arm during the study period.

Least square mean (LSM) + standard deviation; IPA=inhibition of platelet aggregation15 29

Prasugrel 10 mg

Clopidogrel 150 mg***p<0.0001 Prasugrel vs. Clopidogrel

Days0

20

40

60

80

100

IPA

(20

µM A

DP,

%)

*** ***

Prasugrel 10 mg

Clopidogrel 150 mg

Wiviott SD et al. Circulation 2007;116:2923-2932

Maintenance Dose Phase IPAMaintenance Dose Phase IPASubstantially and statistically significantly greater platelet inhibition with prasugrel

Page 19: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Purpose: to expand the prasugrel indicationPurpose: to expand the prasugrel indication

• ACC/AHA and ESC guidelines1 endorse an early invasive strategy with prompt coronary angiography and revascularization in UA/NSTEMI patients with intermediate to high-risk features

• Despite this recommendation, observational studies show that nearly 50% of subjects with UA/NSTEMI do not undergo catheterization and/or revascularization procedures during initial hospitalization2

• Furthermore, prognosis for medically managed patients, excludingthose with insignificant CAD, is poor compared to those treated with early revascularization3

1 Anderson 2007; Bassand 20072 Goldberg 2004, Carruthers 2005; Roe 2005; Mandelzweig 2006; Tricoci 20063 Fox 2007 17

Page 20: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

TTaaRRgetedgeted platelet platelet IInhibition to nhibition to ccLLarifyarify the the OOptimal ptimal stratestrateGGyy to to medicallmedicallYY managed managed

AAcute cute CCoronary oronary SSyndromesyndromes

• Double-blind, parallel-arm, active control study• To evaluate safety and efficacy of prasugrel against clopidogrel in

reducing the risk of cardiovascular death, heart attack or stroke in UA/NSTEMI patients who are to be medically managed without planned revascularization

• About 10,300 patients, 800 hospital, 35 countries• Duke Clinical Research Institute (Dr. Magnus Ohman)

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Page 21: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

MedMed--High Risk UA/NSTEMI ACS High Risk UA/NSTEMI ACS Management decision Management decision ≤≤ 7 days after presentation7 days after presentation

PCI or CABGPCI or CABG(performed or planned(performed or planned

for Index Event)for Index Event)

INELIGIBLEELIGIBLE

Medication OnlyMedication Only

N ~ 10,300

Study PopulationStudy Population

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Page 22: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

RivoglitazoneRivoglitazone (CS-011)

Page 23: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Potent selective PPAR-gamma agonistSuperior efficacy to pioglitazoneEarly onset of therapeutic benefitsFavorable lipid profile

TG reductions and HDL-C increases, similar to or better than pioglitazoneNo significant increase in LDL-C

Equivalent safety profiles to pioglitazoneHemodilution, weight gain and edema Adequate safety margins on animal carinogenecity studiesNo indication of liver toxicity

Over 12,000 patients to be studied with careful monitoring of safety and efficacy

Product Profile of RivoglitazoneProduct Profile of Rivoglitazone

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Page 24: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Target Product ProfileTarget Product ProfileIndication for treatment of type 2 diabetes

MonotherapyCombination use with other classes of agents

Significantly superior efficacy to pioglitazoneAt top dose, glycemic benefits 20 to 30% greater than with pio 45mg

Safety profile generally similar to pioglitazoneEdema and fluid retentionCV outcomes

Favorable lipid data included in the product labelTG reductions and HDL increases; no significant effect on LDL-C

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Page 25: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

2007 – 20102011

2007 – 20082009 – 20112011

Development TimelineDevelopment TimelineUS / EU

Ph3 NDA / MPP

JPN / AsianPh2Ph3 NDA

22

Page 26: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Summary of Rivoglitazone Ph2 StudySummary of Rivoglitazone Ph2 Study

HbA1cBoth 2 and 3 mg rivoglitazone showed significantly greater HbA1cplacebo-corrected decreases from baseline than pioglitazone 45 mg

TG and HDL-CRivoglitazone showed greater TG reductions and HDL-C increases than pioglitazone 45 mg

Results to be presented at scientific conference(s) in 2008

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Page 27: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Olmesartan FranchiseOlmesartan Franchise

Page 28: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Olmesartan FranchiseOlmesartan FranchiseCS-8663 (Combination drug with Amlodipine)

Sep. 2007 Approved in the US, Brand name:AZOR®

Sep. 2007 NDA filed in Europe (28 countries), Brand name:Sevikar™⇒ Approvals gradually expected from autumn 2008

CS-8635 (Combination drug with Amlodipine and Hydrochlorothiazide)Phase 3 trials planned in the US

CS-866AZ (Combination drug with Azelnidipine*)Phase 3 trials ongoing in Japan

* Azelnidine is marketed in Japan as brand name of Calblock

CS-866DM (New indication for diabetic nephropathy)Phase 3 trials ongoing in Japan

CS-866CMB (Combination drug with Hydrochlorothiazide)

24

Page 29: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Status of CS-8635Status of CS-8635Development concept

Triple combination will maximize the sales of Olmesartan franchise and key opportunity for growthNext step for patients who are on either an ARB / HCTZ or CCB / ARB and need additional blood pressure reduction

Target Indication: Treatment of hypertension

Region: US

Development Stage: Phase 3 planned

NDA Submission: 2009

25

Page 30: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Status of CS-866AZStatus of CS-866AZDevelopment concept

Maximize the sales of Olmesartan and Calblock as one of LCM strategiesFixed dose combination of ARB and CCB which are most frequently co-administered in Japan for hypertension treatment

Target Indication: 2nd line therapy for hypertensive patients who responded poorly to Olmetec or Calblocktreatment

Region: Japan

Development Stage: Phase 3

NDA Submission: 2009

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Page 31: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Development conceptAdditional indication of Olmesartan as one of LCM strategiesEvaluate the composite renal endpoints* as primary endpoint in ORIENT study

Target Indication: Diabetic nephropathy with type 2 diabetesRegion: Japan

Development Stage: Phase 3

NDA Submission: 2009

*:Doubling of serum creatinine (Scr), Onset of ESRD (Scr>

Status of CS-866DMStatus of CS-866DM

5 mg/dL, dialysis, kidney transplantation), Death

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Page 32: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

ROADMAP StudyROADMAP Study

ROADMAPROADMAP

Normal Microalbuminuria Proteinuria Proteinuria Normal Microalbuminuria Proteinuria Proteinuria ESRDESRD

IDNTIDNT

RENAALRENAAL

IRMA 2IRMA 2

MARVALMARVAL

ORIENTORIENT

Stage 1 Stage 1 PrePre

Stage 2 Stage 2 MildMild

Stage 3 Stage 3 ModerateModerate

Stage 4 Stage 4 SevereSevere

Stage 5 Stage 5 In dialysisIn dialysis

Originality; Diabetic Nephropathy and Outcome StudiesThe subject condition of ROADMAP is normal renal function

Daiichi Sankyo

Other companies

Trials sponsored by

Page 33: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

ROADMAP StudyROADMAP StudyThe ROADMAP study will establish whether olmesartan can prevent microalbuminuria in patients with type 2 diabetes, and whether this signifies vascular protection

First study to examine whether an ARB can prevent or delay the onset of microalbuminuria

Randomized, double-blind, placebo-controlled, multicentre, multinational, parallel-group trial of olmesartan 40 mg/day vs. placebo

4,400 patients with Type-2 diabetes mellitus and normoalbuminuria with at least 1 cardiovascular risk factor

Study Schedule Started Nov. 2004Recruitment ended Jun. 2006 Clinical phase to end 2011Study report 2012

29

Page 34: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Olmesartan Lifecycle ManagementOlmesartan Lifecycle Management

Japan

<Mono><Mono>

US

Europe

Phase 2Phase 2 Phase 3Phase 3

CS-866DM(diabetic nephropathy)

MarketingMarketing

Benicar

Olmetec

Olmetec

NDA filedNDA filed

Japan

<Combo><Combo>

US

Europe

Phase 2Phase 2

CS-866CMB(with HCTZ)

Phase 3Phase 3

CS-8635(CS-8663 + HCTZ)

CS-866CMB(with HCTZ)

CS-866AZ(with Calblock)

MarketingMarketing

Benicar HCTAZOR

Olmetec Plus

NDA filedNDA filed

Sevikar (CS-8663)(with Amlodipine)

30

Page 35: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

DU-176bDU-176b

Page 36: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Target Profile and Positioning of DU-176bTarget Profile and Positioning of DU-176b

Not inferior to warfarin in VTE / NVAFEfficacy

Not inferior to warfarinLow incidence of bleeding

NoFood Effects

Safety and tolerabilityand tolerability

VTENVAFIndications

NoMonitoring

Once daily dosingDosage RegimenDU-176bAttributes

- Liver Toxicity

- Bleeding

No hepatotoxicity

31

Page 37: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Protocol of Ph2b Studies in THR & TKRProtocol of Ph2b Studies in THR & TKRPrimary objective

Assess the efficacy of DU-176b in the prevention of VTE vs. dalteparin (THR) or placebo (TKR)

Patient populationPatient undergo elective THR / TKR

DesignRandomized, double-blind

First dosing6 to 8 hours after surgery (THR), 6 to 24 hours after surgery (TKR)

Treatment period7 to 10 days (THR), 11-14 days (TKR)

Number of patients750 (THR), 410 (TKR)

THR: total hip replacementTKR: total knee replacement

32

Page 38: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Summary of Ph2b Results in THR & TKRSummary of Ph2b Results in THR & TKRDose-dependent inhibition of VTE incidence

THR 15 mg – 90 mg qd, superior to dalteparin (US/EU)TKR 5 mg – 60 mg qd, superior to placebo (Japan)

Low incidence of major bleeding, including at doses with very effective VTE inhibition

Favorable PK/PD profile

Possible QD (once daily) regimen

Results to be presented at scientific conference(s) in 2008

33

Page 39: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Protocol of Ph2b Studies in AFProtocol of Ph2b Studies in AFPrimary objective

Evaluation of safety of DU-176b vs. warfarin

Patient populationPatients with non-valvular AF

DesignRandomized, double-blind, active-controlled, DU-176b and open-label warfarin study

Treatment period3 months treatment

Number of patients1,000 (US/EU), 500 (Japan)

34

Page 40: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Indication Current statusVTE prophylaxis Phase 2b studies completed

VTE prophylaxis / treatment Phase 3 planned

NVAF in US/EU Phase 2bPatients enrolment completed

NVAF in Japan Phase 2bPatients enrolment completed

NVAF Phase 3 planned

Multiple Chronic Indication StrategyMultiple Chronic Indication Strategy

35

Page 41: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

DU-176bDU-176bNo hepatotoxicity signals in pre-clinical including toxicogenomics and clinical studies

Phase 2b studies in patients with total hip replacement and total knee replacement completed and patients with atrial fibrillation are ongoing globally

Favorable balance of efficacy versus bleeding in studies to date

Phase 3 NVAF study planned to be started in 3Q 2008

Significant market opportunity but with competitors

Best in Class Inhibitor of Blood Coagulation Factor Xa

Best in Class Inhibitor of Blood Coagulation Factor Xa

36

Page 42: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

DenosumabDenosumab (AMG 162)

Page 43: R&D Meeting 2008€¦ · Prioritized Projects (as of Feb-08)(as of Feb-08) 3. Prasugrel (CS-747) Current Status US submission was made on December 26, 2007 zOctober 26, 2008 PDUFA

Denosumab (Dmab) is a fully human monoclonal antibody that specifically targets the receptor activator of nuclear factor kappa B ligand (RANKL), a key mediator of the resorptive phase of bone remodeling.

Dmab is being studied across a range of conditions, including osteoporosis, treatment-induced bone loss, rheumatoid arthritis, bone metastases, and multiple myeloma.

On July 11, 2007, Amgen and Daiichi Sankyo announced a collaboration and license agreement for the development and commercialization of Dmab in Japan.

RANK: Receptor activator for nuclear factor kappa B

What is Denosumab (AMG 162)What is Denosumab (AMG 162)

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Proposed Mechanism of Action for DmabProposed Mechanism of Action for Dmab

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Development OverviewDevelopment OverviewDevelopment StageIndication Dose

US/EU Japan

Ph.3

Ph.3

Ph.2

Oncology(Bone Metastasis) 120 mg every month SC Ph.3

Osteoporosis 60 mg every 6 months SC Ph.3 preparing

Rheumatoid Arthritis60-180 mg every 6 months SC(TBD)

-

Generally well tolerated; adverse events were similar among Dmab, placebo, and alendronate groups

No neutralizing antibodies observed

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Effect of 4 Years of Dmab Treatment on Lumbar Spine BMDEffect of 4 Years of Dmab Treatment on Lumbar Spine BMD

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Data TimingPhase 3 HALT prostate cancer H2 ’08 - data in housePhase 3 PMO fracture study H2 ’08 - data in house

HALT: hormone-ablative therapy

Phase 3 head-to-head study vs alendronate met primary and all secondary endpoints

Denosumab showed approximately 40% greater increases in bone mineral density as compared to alendronateDenosumab and alendronate exhibited similar safety profiles

Completed phase 3 breast SRE study enrollment

Continue to expect robust data set in 2008

Recent Outcomes and Upcoming EventsRecent Outcomes and Upcoming Events

SRE: skeletal related events

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Ph 1 study: CompletedPostmenopausal womenPK/PD study

Ph 2 study: CompletedA randomized, double-blind, placebo-controlled, dose response study of Dmab in Japanese postmenopausal osteoporosis subjectsDose: 14, 60 and 100mg SC once every 6 monthsPrimary endpoints

Percent change of lumbar spine BMD at month 12Safety profile

Phase 2 PMO study met both primary and secondary endpoints

Ph 3 study: In preparation

Development Plan (JPN) - Osteoporosis -Development Plan (JPN) - Osteoporosis -

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Development Plan (JPN) - Bone Metastasis -Development Plan (JPN) - Bone Metastasis -Ph 1 study: Completed

Breast cancer patients with bone metastasis

Ph 3 multinational studies including Japan: OngoingA randomized, double-blind, multicenter study of Dmab compared with Zoledronic Acid (Zometa®) in the treatment of bone metastases in subjects with advanced breast cancer

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Oncology FranchiseOncology Franchise

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Oncology FranchiseOncology FranchiseAMG 162 Denosumab (Phase 3)

Human monoclonal antibody that targets RANK Ligand (an essential mediator of cells that break down bone)

CS-1008 (Phase 2)A humanized version TRA-8, a murine agonistic monoclonal antibody raised against human death receptor 5 (DR5)

CS-7017 (Phase 1)Antitumor PPAR-gamma activator

DE-766 Nimotuzumab (Phase 1)Humanized monoclonal antibody against the epidermal growth factor receptor

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A humanized version TRA-8, a murine agonistic Mab raised against human death receptor 5 (DR5)

DR5 is rarely expressed in normal tissues, expected to show selective activity against tumor cells

Induces apoptosis of tumor cells expressing DR5 on the cell surfaceAnti-cancer effect from pre-clinical studies

Human cancer cell lines in vitroTumor-bearing mice in vivo

Good safety profile in pre-clinical studiesDevelopment timeline

IND: Dec 2005Phase 2 start: 3Q 2007

CDC: Complement-dependent cytotoxicity

ADCC: Antibody dependent cell-mediated cytotoxicity

Apoptosis

Apoptosis Signal

Conventional antibodies

CS-1008

DR5

CDC: Complement-dependent cytotoxicity

ADCC: Antibody dependent cell-mediated cytotoxicity

Apoptosis

Apoptosis Signal

Conventional antibodies

CS-1008

DR5

CS-1008

DR5

CS-1008CS-1008

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CS-7017CS-7017Antitumor PPAR-gamma activator

Positive correlation between PPAR-gamma activation and inhibition against colony formation of tumor cells in vitro

Inhibits growth of tumor cells in vitro without killing those cellsExpected to be less toxic compared to standard chemotherapeutics

Effective against human tumor-implanted in vivo models

Could be used either alone or in combination with otherchemotherapeutic agents

Phase 1 study is ongoing in US

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Nimotuzumab DE-766Nimotuzumab DE-766Humanized Mab to epidermal growth factor receptor (EGFR)Target indication; tumors expressing EGFR

Glioma, NSCLC, Esophagus, Gastric, Colorectal, etcCombination therapy (with radiotherapy and/or chemotherapy)Superior safety in terms of skin rash and comparable efficacy to other EGFR Mabs

Best-in-Class among EGFR antibodiesDevelopment timeline

Phase 1 study in Japan: ongoingPhase 2 start: 2Q 2008

Current Status in Other CountriesHead & Neck cancer: Approved in Cuba, India, South America countries etc.Nasopharyngeal carcinomas: Approved in China, CubaGlioma: Approved in Cuba, Argentina and Ukraine

Phase 3 study is ongoing in Germany

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Closing RemarksClosing Remarks

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Daiichi Sankyo R&D Strategy Vision StatementDaiichi Sankyo R&D Strategy Vision Statement

As a Global Pharma Innovator, Daiichi Sankyo R&D will discover and develop value added first-in-class and

best-in-class therapies expanding on our legacy of quality and innovation to improve

patient health and raise global standards for disease treatment and prevention

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ThromboticDisorders

Autoimmune Disorders / RA

MalignantNeoplasm

DiabetesMellitusCore Disease Areas

Franchise Areas

Hyperlipidemia /Atherosclerosis

Hypertension BacterialInfections

Therapeutic Area PrioritizationTherapeutic Area Prioritization

49

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hypertension

COPD

MRSAIBD IBS

lung cancer

breast cancer

strokestomach cancer

prostate cancer

colon canceruterine fibroid

uterine cancerliver cancer

bed sore

atopic dermatitispsora

asthma

allergic rhinitis

depression

anxiety neurosis

schizophrenia

vasculardementia

Alzheimer

benign prostatic hypertrophy

endometriosisnephrosis

overactive bladder syndrome

gout

rheumatic arthritis

osteoporosis

osteoarthrosis

SLE

epilepsia

Parkinson's disease

sleep apnea syndrome

multiple sclerosis chronic renal failure

chronic glomerulonephritis

stress urinary incontinence

AIDS

chronic hepatitis C

chronic hepatitis B

tuberculosis

glaucoma

age-related macular degeneration

diabetic neuropathy

diabetic retinopathy

diabetic nephropathy

diabetes mellitus

hyperlipidemia

peptic ulcer

functional gastrointestinal disorder

hepatic cirrhosis

brain hemorrhage

heart failurearrhythmia myocardial infarction

angina

leukemia

Results of Questionnaire to PhysiciansResults of Questionnaire to PhysiciansContrib

ution o

f Dru

gs

in

Contrib

ution o

f Dru

gs

in

Medic

al Tre

atm

ent

Medic

al Tre

atm

ent

Medical SatisfactionMedical Satisfaction

MalignantNeoplasm

Diabetes

Thrombotic Disorder

AutoimmuneDisorders / RA

Hypertension

InfectionsHyperlipidemia

Japan Human Health Sciences Foundation; Investigation of Japan fundamental technology report -View of medical treatment needs in 2015, (2005)

Correlation between Medical Satisfaction and Contribution of DrugsCorrelation between Medical Satisfaction and Contribution of Drugs

50

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Malignant Neoplasm

Core Disease Areas

Franchise Areas

Autoimmune Disorders / RA

Hyperlipidemia /Atherosclerosis

Therapeutic Area PrioritizationTherapeutic Area Prioritization

DiabetesMellitus

ThromboticDisorders

Hypertension

High Unmet Medical NeedsNovel products with high efficacy and good safety based on our excellent science and technologies

Bacterial InfectionsRelatively Low Unmet Medical Needs because of good therapeutics including our products : Olmetec / Benicar, Cravit / Levaquin, Mevalotin / Pravachol, etc.Products with improved usefulness for patients by developing combination drugs, additional formulations, and others.

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We make the impossible possibleand make the incurable curable

~ Our Challenge ~

We make the impossible possibleWe make the impossible possibleand make the incurable curableand make the incurable curable

~ Our Challenge ~~ Our Challenge ~

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Contact address regarding this material

DAIICHI SANKYO CO., LTD.Corporate Communications Department

TEL: +81-3-6225-1126FAX: +81-3-6225-1132

Each numerical value regarding the future prospect in this material is derived from our judgment and assumptions based on the currently available information and may include risk and uncertainty. For this reason, the actual performance data, etc. may differ from the prospective value.