Portola Pharmaceuticals Provides Update on Bevyxxa

SOUTH SAN FRANCISCO, Calif., Nov. 21, 2017 (GLOBE NEWSWIRE) -- Portola Pharmaceuticals, Inc. ^® (NASDAQ: PTLA ) today announced that the U.S. Food and Drug Administration (FDA) has extended the review period for the Company’s Prior Approval Supplement (PAS) for Bevyxxa® (betrixaban) to allow the agency time to review the entire submission. The FDA informed the Company today that it will respond to the PAS request to change the current manufacturing release specification within the standard 60-day extension period. No additional information was requested at this time. The new action date is January 30, 2018.

“As we communicated earlier this month, we’ve made good progress with the FDA and have established an agreement in principle on the change to our product release specification that would allow for the release and distribution of current product inventory. We also noted that the agency might need additional time to review our submission,” said Bill Lis, chief executive officer of Portola. “While the FDA completes its review, the momentum within the medical community is building. We continue our commercial and medical education activities in anticipation of a potential launch by February 2018, and remain committed to getting Bevyxxa to patients who may benefit from this important and potentially life-saving new therapy.”

Approved by the FDA on June 23, 2017, Bevyxxa is the first and only anticoagulant for hospital and extended duration prophylaxis (35 to 42 days) of VTE in adult patients hospitalized for an acute medical illness who are at risk for thromboembolic complications due to moderate or severe restricted mobility and other risk factors for VTE. 

Important U.S. Safety Information for Bevyxxa (betrixaban) capsules

INDICATION Bevyxxa is indicated for the prophylaxis of venous thromboembolism (VTE) in adult patients hospitalized for an acute medical illness who are at risk for thromboembolic complications due to moderate or severe restricted mobility and other risk factors for VTE.

LIMITATIONS OF USE The safety and effectiveness of Bevyxxa have not been established in patients with prosthetic heart valves because this population has not been studied.

SELECT IMPORTANT SAFETY INFORMATION

WARNING: SPINAL/EPIDURAL HEMATOMA EPIDURAL OR SPINAL HEMATOMAS MAY OCCUR IN PATIENTS TREATED WITH BEVYXXA WHO ARE RECEIVING NEURAXIAL ANESTHESIA OR UNDERGOING SPINAL PUNCTURE. THE RISK OF THESE EVENTS MAY BE INCREASED BY THE USE OF IN ‑ DWELLING EPIDURAL CATHETERS OR THE CONCOMITANT USE OF MEDICAL PRODUCTS AFFECTING HEMOSTASIS. THESE HEMATOMAS MAY RESULT IN LONG-TERM OR PERMANENT PARALYSIS. CONSIDER THESE RISKS WHEN SCHEDULING PATIENTS FOR SPINAL PROCEDURES.

CONTRAINDICATIONS

• Active pathological bleeding 
• Severe hypersensitivity reaction to Bevyxxa 

WARNINGS AND PRECAUTIONS   Risk of Bleeding

• Bevyxxa increases the risk of bleeding and can cause serious and potentially fatal bleeding 
• Concomitant use of drugs affecting hemostasis increases the risk of bleeding. These include aspirin and other antiplatelet agents, other anticoagulants, heparin, thrombolytic agents, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs) 
• Advise patients of signs and symptoms of blood loss and to report them immediately or go to an emergency room
• Promptly evaluate any signs or symptoms of blood loss and consider the need for blood replacement 
• Discontinue Bevyxxa in patients with active pathological bleeding 
• There is no established way to reverse the anticoagulant effect of Bevyxxa, which can be expected to persist for at least 72 hours after the last dose 
• It is unknown whether hemodialysis removes Bevyxxa 
• Protamine sulfate, vitamin K, and tranexamic acid are not expected to reverse the anticoagulant activity of Bevyxxa 

Spinal/Epidural Anesthesia or Puncture

• When neuraxial anesthesia (spinal/epidural anesthesia) or spinal/epidural puncture is employed, patients treated with antithrombotic agents for prevention of thromboembolic complications are at risk of developing an epidural or spinal hematoma which can result in long-term or permanent paralysis 
• Do not remove an epidural catheter earlier than 72 hours after the last administration of Bevyxxa. The next Bevyxxa dose is not to be administered earlier than 5 hours after the removal of the catheter. If traumatic puncture occurs, delay the administration of Bevyxxa for 72 hours 
• Monitor patients frequently for signs and symptoms of neurological impairment (e.g., numbness or weakness of the legs, bowel or bladder dysfunction). If neurological compromise is noted, urgent diagnosis and treatment is necessary 
• Prior to neuraxial intervention, consider the potential benefit versus the risk in anticoagulated patients or in patients to be anticoagulated for thromboprophylaxis 

Use in Patients with Severe Renal Impairment

• Patients with severe renal impairment (CrCl ≥ 15 to < 30 mL/min computed by Cockcroft-Gault) taking Bevyxxa may have an increased risk of bleeding events 
• Reduce dose of Bevyxxa, monitor patients closely, and promptly evaluate any signs or symptoms of blood loss in these patients 

Use in Patients on Concomitant P-glycoprotein (P-gp) Inhibitors

• Patients on concomitant P-gp inhibitors with Bevyxxa may have an increased risk of bleeding 
• Reduce dose of Bevyxxa in patients receiving or starting concomitant P-gp inhibitors, monitor patients closely, and promptly evaluate any signs or symptoms of blood loss in these patients 
• Avoid use of Bevyxxa in patients with severe renal impairment receiving concomitant P‑gp inhibitors 

ADVERSE REACTIONS

• The most common adverse reactions with Bevyxxa were related to bleeding (> 5%) 

USE IN SPECIFIC POPULATIONS   Hepatic Impairment

• Bevyxxa has not been evaluated in patients with hepatic impairment, because these patients may have intrinsic coagulation abnormalities 
• Bevyxxa is not recommended in patients with hepatic impairment 

Please see additional Important Safety Information and full Prescribing Information, including the Boxed Warning at Bevyxxa.com

About Portola Pharmaceuticals, Inc. Portola Pharmaceuticals is a biopharmaceutical company developing product candidates that could significantly advance the fields of thrombosis and other hematologic diseases. The Company’s first medicine Bevyxxa ^® (betrixaban), an oral, once-daily Factor Xa inhibitor, was approved by the U.S. Food and Drug Administration in June 2017. The company is also working to advance two clinical programs for andexanet alfa, a recombinant protein designed to reverse the anticoagulant effect in patients treated with an oral or injectable Factor Xa inhibitor; and cerdulatinib, a SYK/JAK inhibitor in development to treat hematologic cancers. Portola's partnered program is focused on developing selective SYK inhibitors for inflammatory conditions. For more information, visit  http://www.portola.com and follow the Company on Twitter @Portola_Pharma.

Forward-Looking Statements This announcement contains forward-looking statements, including statements relating to Portola Pharmaceuticals’ expectations regarding the anticipated product availability of Bevyxxa. These statements are subject to significant risks and uncertainties and actual results could differ materially from those projected. Portola Pharmaceuticals cautions investors not to place undue reliance on the forward-looking statements contained in this release. These risks and uncertainties include, without limitation, risks and uncertainties related to regulatory review and our manufacturing and distribution strategy. There can be no assurance that Portola Pharmaceuticals will be able to make Bevyxxa commercially available on our anticipated timeline. Risks and uncertainties relating to Portola Pharmaceuticals and its business can be found in the “Risk Factors” section of Portola Pharmaceuticals’ Quarterly Report on Form 10-Q for the third quarter of 2017, which was filed with the SEC on November 9, 2017. Portola Pharmaceuticals undertakes no duty or obligation to update any forward-looking statements contained in this release as a result of new information, future events or changes in Portola Pharmaceuticals’ expectations.