Form 8-K

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, DC 20549

 


FORM 8-K

 


CURRENT REPORT PURSUANT TO SECTION 13 OR 15(d) OF

THE SECURITIES EXCHANGE ACT OF 1934

Date of report (Date of earliest event reported): November 7, 2007

 


Nabi Biopharmaceuticals

(Exact name of registrant as specified in its charter)

 


 

Delaware   000-04829   59-1212264

State or other jurisdiction

of incorporation

  Commission File Number  

IRS Employer

Identification No.

5800 Park of Commerce Boulevard N.W., Boca Raton, FL 33487

(Address of principal executive offices) (Zip code)

(561) 989-5800

(Registrant’s telephone number, including area code)

 


Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions ( see General Instruction A.2. below):

 

¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

¨ Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 



Nabi Biopharmaceuticals

Item 7.01. Regulation FD Disclosure

On the Company’s previously scheduled third quarter financial results conference call held on November 8, 2007, the Company discussed the results of its recently completed Phase IIb proof-of-concept study for NicVAX® (Nicotine Conjugate Vaccine). A press release issued by the Company on November 7, 2007 discussing the results of this study is furnished as Exhibit 99.1 to this Report. On the conference call, the Company reviewed the webcast slides furnished as Exhibit 99.2 and referenced the Study Results Slides posted on the Company’s website and furnished as Exhibit 99.3.

The information in this Item 7.01 shall not be deemed to be “filed” for purposes of Section 18 of the Exchange Act or otherwise subject to the liability of that section, and it shall not be incorporated by reference into any filing under the Securities Act or the Exchange Act, regardless of any general incorporation language in such filing. Furthermore, the furnishing of the information included in this Item 7.01 is not intended to constitute a determination by the registrant that the information is material or that the dissemination of the information is required by Regulation FD.

Item 9.01. Item 9.01. Financial Statements and Exhibits

 

Exhibit

number

 

Description

99.1   NicVAX Press Release
99.2   Webcast Slides
99.3   Study Results Slides

The information included in the exhibits to this Current Report on Form 8-K is furnished pursuant to Items 7.01 and shall not be deemed to be “filed” for purposes of Section 18 of the Exchange Act or otherwise subject to the liability of that section, and shall not be incorporated by reference into any filing under the Securities Act or the Exchange Act, regardless of any general incorporation language in such filing. Furthermore, the furnishing of the information included in these exhibits to this Report is not intended to constitute a determination by the registrant that the information is material or that the dissemination of the information is required by Regulation FD.


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

  Nabi Biopharmaceuticals
Date: November 9, 2007   By:  

/s/ Jordan I. Siegel

    Jordan I. Siegel
    Senior Vice President, Finance and Administration
    Chief Financial Officer and Treasurer


Index of Exhibits

 

Exhibit

number

 

Description

99.1   NicVAX Press Release
99.2   Webcast Slides
99.3   Study Results Slides
NicVAX Press Release

EXHIBIT 99.1

 

LOGO   NEWS RELEASE

Investor Relations

301-770-3099 | www.nabi.com

 

FOR IMMEDIATE RELEASE

Nabi Biopharmaceuticals Announces Successful Completion of NicVAX® Phase 2b Trial;

Drug Shows Statistically Significant Rates of Smoking Cessation

and Continuous Long-Term Smoking Abstinence at 12 Months

Data Presented Today at the American Heart Association Scientific Sessions 2007 in Orlando, Florida

Boca Raton, Florida, November 7, 2007 – Nabi Biopharmaceuticals (NASDAQ: NABI) today announced the successful completion of its Phase 2b trial of NicVAX® (Nicotine Conjugate Vaccine), the company’s innovative and proprietary investigational vaccine being developed to treat nicotine addiction and prevent smoking relapse. The final 12-month data confirm the highly significant trends seen in the previous data at six and nine months for both smoking cessation and long-term smoking abstinence. These data were presented at 9:45 a.m., EST today at the American Heart Association (AHA) Scientific Sessions 2007 in Orlando, Florida by one of the trial’s lead investigators, Dr. Stephen Rennard, Larson Professor of Medicine, University of Nebraska Medical Center.

“I believe data from this trial are very encouraging – for smokers who are trying to quit as well as for the field of smoking cessation vaccines,” said Dr. Rennard. “Only a short time ago, it was difficult to find convincing evidence to link anti-nicotine antibody with smoking cessation. This double-blind, placebo-controlled trial has demonstrated a clinical proof of concept. The data show there is a correlation between antibody level and the ability of patients to quit smoking and remain abstinent over long periods of time. This development is key for the field of smoking cessation research and could have a significant impact on how we treat patients with nicotine addiction.”

NicVAX® Phase 2b Trial: Key Findings in Final 12 Month Data Set

Optimal NicVAX® Dose and Schedule Identified for Smoking Cessation and Long-Term Abstinence

A statistically significant number of patients treated with the NicVAX® optimal dose (400 micrograms) and schedule (Schedule 2) were able to quit smoking and remained abstinent over the long-term:

 

   

12-Month continuous abstinence: NicVAX® 400 micrograms, Schedule 2 = 16% (8/51), Placebo=6% (6/100), p<0.038 (intent to treat population)

 

   

12-Month continuous abstinence: NicVAX® 200 micrograms, Schedule 2 = 14% (7/50), Placebo=6% (6/100), p<0.056 (intent to treat population)

 

   

For the final 12-month data analysis, this response was calculated using total time after the Target Quit Date, rather than the general study week (which was used in interim data analyses). This conservative and stringent statistical approach yielded statistically significant findings even after a full year.

Anti-Nicotine Antibody Levels Drive Long-Term Smoking Abstinence

 

   

The rate of smoking cessation and ability to achieve long-term abstinence in treated patients was correlated with level of anti-nicotine antibodies at critical time points: The high antibody responder group (top 30% of antibody responders) showed continuous abstinence rates almost three times those of placebo at 12 months.

 

   

These high antibody responders continued to show statistically significant abstinence at 12 months:

 

   

NicVAX®= 16% (10/61) vs. Placebo= 6% (6/100), p<0.032

 

   

Subjects in the therapeutic effect window show a >30% likelihood of achieving at least four months of smoking abstinence and remaining entirely abstinent through 12 months following the first administration of NicVAX®.


Overall Health Benefit – High Antibody Responders Smoked Fewer Cigarettes

Those patients in the NicVAX® group who continued to smoke but who also showed a high antibody response (top third) showed a statistically significant reduction in cigarettes smoked over the full 12 months compared to placebo (p<0.022):

 

   

Using a repeated measures model, vaccinated smokers who failed to quit but showed a high antibody response smoked a median of only 10 cigarettes per day while in the study, compared to their own baseline values of 20 cigarettes per day before treatment.

Safety Trends Continue – NicVAX® Shows No Compensatory Smoking, No Increased Withdrawal

Importantly, there was no evidence of compensatory smoking or increase in withdrawal symptoms observed in NicVAX® patients at any stage of the 12-month trial. NicVAX® continued to be well-tolerated with the placebo and NicVAX® dose groups showing comparable adverse event profiles at each stage of the clinical study.

“We are excited and greatly encouraged by the significant learning which has come from this first efficacy trial of NicVAX.” said Dr. Leslie Hudson, Interim President and Chief Executive Officer of Nabi. “It is important to note that we have seen success in each of the critical parameters of this trial; we know the dimensions of the therapeutic antibody window which will drive continuous abstinence out to a full year, we know the relationship between the psychological and biochemical drives to quit and remain abstinent and, most importantly, we believe we now have the insight to drive a higher rate of response. We will use these encouraging final data to advance our NicVAX partnership discussions and to determine the optimal design for the next step in our clinical trial efforts for this important primary care product candidate.”

About the Phase 2b Study

The Phase 2b study was a double-blind, placebo-controlled and dose-ranging study comprised of 301 patients designed to establish proof of concept and the optimal dose for the Phase 3 program. This study was designed in collaboration with the U.S. Food and Drug Administration and other global regulatory agencies and incorporates the most current clinical trial standards and prevailing protocol design for smoking cessation studies. The trial’s primary endpoint is the rate of carbon monoxide (CO)-confirmed, continuous abstinence from smoking during weeks 19-26 after first vaccination. In May 2007, Nabi announced this trial’s six-month data, which showed that a statistically significant number of patients with in the high anti-nicotine antibody responder group met the trial’s primary endpoint of eight weeks of continuous abstinence between weeks 19-26.

About NicVAX®

NicVAX® is an innovative and proprietary investigational vaccine being developed by Nabi to treat nicotine addiction and prevent smoking relapse. NicVAX® is designed to stimulate the immune system to produce antibodies that bind to nicotine. A nicotine molecule attached to an antibody is too large to cross the blood-brain barrier. Therefore, NicVAX® blocks nicotine from reaching its receptors in the brain and prevents the highly-addictive pleasure sensation experienced by smokers and users of nicotine products. Pre-clinical and previous clinical data, as well as the study reported here, show that NicVAX®’s ability to block nicotine from reaching the brain could help people quit smoking. Because the body’s immune system can be boosted to produce long-lasting antibodies, Nabi believes NicVAX® also could be effective in preventing smoking relapse. Relapse is a significant challenge facing smokers and, with currently-available smoking cessation therapies, relapse rates can be as high as 90% in the first year after a smoker quits.

NicVAX® Development Progress to Date

In September 2005, Nabi announced that it received a $4.1 million grant from the National Institute on Drug Abuse (NIDA), which is part of the National Institutes of Health. NIDA has also funded, in part, the costs for toxicology testing and earlier clinical trials in the U.S. and contributed scientific and clinical expertise to the program overall. In March 2006, Nabi Biopharmaceuticals announced that NicVAX® had received Fast Track Designation from the FDA, which facilitates the development of products that treat serious diseases where an unmet medical need exists. Nabi Biopharmaceuticals’ intellectual property portfolio for technology related to NicVAX® includes both issued and pending patents in the U.S. In addition, Nabi holds granted patents in 18 European countries, plus patents and pending patent applications in numerous other countries around the world.


About Nabi Biopharmaceuticals

Nabi Biopharmaceuticals leverages its experience and knowledge in powering the immune system to develop and, in certain areas, market products that target serious medical conditions in the areas of hepatitis and transplants, gram positive bacterial infections and nicotine addiction. We are a vertically integrated company with sales of antibodies and other biologics, including Nabi-HB® [Hepatitis B Immune Globulin (Human)], a pipeline of products in various stages of development and a state-of-the-art manufacturing capability. The company operates through two strategic business units: Nabi Biologics and Nabi Pharmaceuticals. Nabi Biologics has responsibility for the company’s protein and immunological products and development pipeline, including Nabi-HB. Nabi Pharmaceuticals is responsible for the NicVAX® (Nicotine Conjugate Vaccine) and StaphVAX® (Staphylococcus aureus Polysaccharide Conjugate Vaccine) development programs. For a complete list of pipeline products, please go to: http://www.nabi.com/pipeline/index.php. In September 2007, Nabi announced that it had entered into a definitive agreement with Biotest AG to sell the Nabi Biologics strategic business unit to Biotest Pharmaceuticals Corporation, including Nabi-HB® [Hepatitis B Immune Globulin (Human)], and other plasma business assets, including Nabi’s state-of-the-art plasma protein production plant, and nine FDA-certified plasma collection centers across the U.S. The acquisition also will include certain of Nabi’s Corporate Shared Services group assets and the company’s Boca Raton, Florida headquarters and other facilities, as well as the assumption of certain liabilities. This transaction is expected to close by the end of the year. The company is headquartered in Boca Raton, Florida. For additional information about Nabi Biopharmaceuticals, please visit our Web site:http://www.nabi.com.

Forward-Looking Statements

Statements in this release that are not strictly historical are forward-looking statements and include statements about the closing of the sale of Nabi Biologics and clinical trials and studies. You can identify these forward-looking statements because they involve our expectations, beliefs, projections, anticipations or other characterizations of future events or circumstances. These forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties that may cause actual results to differ materially from those in the forward-looking statements as a result of any number of factors. These factors include, but are not limited to, risks relating to our ability to: successfully close the sale of the Nabi Biologics SBU to Biotest AG; successfully partner with third parties to fund, develop, manufacture and/or distribute our existing and pipeline products, including NicVAX® and our Gram-positive infections products; obtain successful clinical trial results; our ability to successfully complete our strategic alternatives process; generate sufficient cash flow from sales of products or from milestone or royalty payments to fund our development and commercialization activities; attract and maintain the human and financial resources to commercialize current products and bring to market products in development; depend upon third parties to manufacture or fill our products; achieve approval and market acceptance of our products; expand our sales and marketing capabilities or enter into and maintain arrangements with third parties to market and sell our products; effectively and/or profitability use, or utilize the full capacity of, our vaccine manufacturing facility; manufacture NicVAX® or other products in our own vaccine manufacturing facility; comply with reporting and payment obligations under government rebate and pricing programs; raise additional capital on acceptable terms, or at all; and re-pay our outstanding convertible senior notes when due. Many of these factors are more fully discussed, as are other factors, in the company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006 and our Quarterly Report for the quarters ended June 30, 2007 and March 31, 2007 on Form 10-Q with the Securities and Exchange Commission.

Webcast Slides
NicVAX™
NicVAX™
Nicotine Conjugate Vaccine
Nicotine Conjugate Vaccine
Relationship of Anti-Nicotine
Relationship of Anti-Nicotine
Antibody Levels to Abstinence:
Antibody Levels to Abstinence:
Final Phase 2b Trial Results at 12 Months
Final Phase 2b Trial Results at 12 Months
November 8, 2007
November 8, 2007
Exhibit 99.2


2
Forward Looking Statements
Forward Looking Statements
Certain matters Nabi will discuss today consist of forward-looking statements
made pursuant to the safe harbor provisions of the Private Securities
Litigation Reform Act of 1995 relating to, among other things, Nabi’s
expectations concerning the company’s commercial and regulatory strategy
and business and financial outlook.  These forward-looking statements are
not guarantees of future performance and are subject to a variety of risks and
uncertainties that could cause actual results to differ materially from the
results contemplated thereby.  Any forward-looking statements made by Nabi
should be considered in light of the risks and uncertainties contained in our
filings with the Securities and Exchange Commission.  Many of these factors
are
more
fully
discussed,
as
are
other
factors,
in
the
company's
Annual
Report on Form 10-K for the fiscal year ended December 31, 2006 and
Quarterly Reports on Form 10-Q with the Securities and Exchange
Commission.  You are cautioned not to place undue reliance on these
forward-looking statements, which speak only as of today. Nabi undertakes
no obligation to update or revise the information provided herein, whether as
the
result
of
new
information,
future
events
or
circumstances
or
otherwise.


3
NicVAX Phase 2b Trial Design
NicVAX Phase 2b Trial Design
Multi-center, randomized, double-blind, placebo
Multi-center, randomized, double-blind, placebo
controlled study in smokers who want to quit smoking
controlled study in smokers who want to quit smoking
Primary endpoint at 6-months: 8 weeks continuous abstinence in
Primary endpoint at 6-months: 8 weeks continuous abstinence in
antibody-stratified population
antibody-stratified population
301 heavy smokers
301 heavy smokers
Average of 24 cigarettes per day; no smoker less than 15 per day
Average of 24 cigarettes per day; no smoker less than 15 per day
2 doses (400 µg and 200 µg) vs. placebo
2 doses (400 µg and 200 µg) vs. placebo
2 schedules for each dose:
2 schedules for each dose:
Schedule 1: 4 injections over 6 months
Schedule 1: 4 injections over 6 months
Schedule 2: 5 injections over 6 months
Schedule 2: 5 injections over 6 months
Point prevalence and continuous abstinence rates
Point prevalence and continuous abstinence rates
At 6 and 12 months
At 6 and 12 months


4
Primary and Secondary
Primary and Secondary
Abstinence Measures
Abstinence Measures
Target Quit Date
Target Quit Date
8 week
abstinence
immediately
prior to 6
months
Continuous abstinence to 6 months
6
Months
12
Primary End Point
Continuous abstinence to 12 months
Secondary End Point


5
12-Month Continuous Abstinence
12-Month Continuous Abstinence
14%
14%
(n=7/50)
(n=7/50)
p=0.056
p=0.056
16%
16%
(n=8/51)
(n=8/51)
p=0.038
p=0.038
Schedule 2
Schedule 2
6%                       
6%                       
(n=3/50)                   
(n=3/50)                   
p=0.88
p=0.88
NicVAX         
NicVAX         
200 µg
200 µg
6%
6%
(n=6/100)
(n=6/100)
Placebo
Placebo
6%                       
6%                       
(n=3/50)                    
(n=3/50)                    
p=0.96
p=0.96
NicVAX         
NicVAX         
400 µg
400 µg
Schedule 1
Schedule 1


6
Antibody Response by Treatment Arm
Antibody Response by Treatment Arm
0
2
4
6
8
10
12
14
16
18
20
22
24
26
28
30
32
34
36
38
40
42
44
46
48
50
52
Study Week
200 µg/Schedule 1
400 µg/Schedule 1
200 µg/Schedule 2
400 µg/Schedule 2


7
Exceeding the Effect Threshold Drives
Exceeding the Effect Threshold Drives
Greater Abstinence
Greater Abstinence
Intent to Treat Population
6%        
6%        
(n=6/98)
(n=6/98)
11%
11%
(n=2/19)
(n=2/19)
p=0.37
p=0.37
22%
22%
(n=6/27)
(n=6/27)
p=0.011
p=0.011
12-Month
12-Month
Continuous
Continuous
Abstinence Rates
Abstinence Rates
NicVAX 400 µg
NicVAX 400 µg
Below Threshold
Below Threshold
at
at
TQD
TQD
Placebo
Placebo
NicVAX 400 µg
NicVAX 400 µg
Above Threshold
Above Threshold
at
at
TQD
TQD
Schedule 2
Schedule 2


8
Antibody Level Also Drives Late Quit
Antibody Level Also Drives Late Quit
0%
5%
10%
15%
20%
25%
30%
35%
40%
0
4
8
12
16
20
24
28
32
36
40
44
Weeks following TQD
Top 33%
Bottom 67%
Placebo


9
Antibody Level Drives Decrease in Cigarette
Antibody Level Drives Decrease in Cigarette
Consumption in Non-Abstainers
Consumption in Non-Abstainers
0
5
10
15
20
25
0
4
8
12
16
20
24
28
32
36
40
44
48
52
Study Week
Placebo
Top 33%
Bottom 67%


10
Conclusions
Conclusions
Optimal dose and schedule drives efficacy
Optimal dose and schedule drives efficacy
400 µg/ml, Schedule 2: best regimen to attain threshold antibody
400 µg/ml, Schedule 2: best regimen to attain threshold antibody
response at target quit date (TQD)
response at target quit date (TQD)
Critical for quit rate and to achieve long term abstinence
Critical for quit rate and to achieve long term abstinence
High antibody levels drive long-term abstinence
High antibody levels drive long-term abstinence
Continued
Continued
high antibody levels sustain TQD-induced abstinence and
high antibody levels sustain TQD-induced abstinence and
elicit additional spontaneous abstinence of four months or greater
elicit additional spontaneous abstinence of four months or greater
duration
duration
High antibody levels decrease cigarette consumption
High antibody levels decrease cigarette consumption
In continuing smokers, high anti-nicotine antibody levels significantly
In continuing smokers, high anti-nicotine antibody levels significantly
reduce cigarette consumption on a long term basis
reduce cigarette consumption on a long term basis
Trial provides critical insights:
Trial provides critical insights:
Antibody concentration and duration correlate with size of abstinent
Antibody concentration and duration correlate with size of abstinent
population
population
Findings inform clinical development program moving forward
Findings inform clinical development program moving forward
Study Results Slides
A Randomized Placebo-Controlled
A Randomized Placebo-Controlled
Trial of a Conjugate Nicotine Vaccine
Trial of a Conjugate Nicotine Vaccine
(NicVAX
(NicVAX
®
®
)
)
in Smokers Who Want to
in Smokers Who Want to
Quit: 12 Month Results
Quit: 12 Month Results
Stephen Rennard, Douglas Jorenby, David
Stephen Rennard, Douglas Jorenby, David
Gonzales, Nancy Rigotti, Arjen
Gonzales, Nancy Rigotti, Arjen
de Vos, Enoch
de Vos, Enoch
Bortey, Roxanne Akhavain, Dorothy Hatsukami
Bortey, Roxanne Akhavain, Dorothy Hatsukami
U. Nebraska, U. Wisconsin, Oregon Health & Sciences U.,
U. Nebraska, U. Wisconsin, Oregon Health & Sciences U.,
Massachusetts General Hospital, Nabi Biopharmaceuticals,
Massachusetts General Hospital, Nabi Biopharmaceuticals,
and
and
U. Minnesota
U. Minnesota
Supported by a grant from the National Institute on Drug Abuse
Supported by a grant from the National Institute on Drug Abuse
Exhibit 99.3


2
Forward Looking Statements
Forward Looking Statements
Certain matters Nabi will discuss today consist of forward-looking statements
made pursuant to the safe harbor provisions of the Private Securities
Litigation Reform Act of 1995 relating to, among other things, Nabi’s
expectations concerning the company’s commercial and regulatory strategy
and business and financial outlook.  These forward-looking statements are
not guarantees of future performance and are subject to a variety of risks and
uncertainties that could cause actual results to differ materially from the
results contemplated thereby.  Any forward-looking statements made by Nabi
should be considered in light of the risks and uncertainties contained in our
filings with the Securities and Exchange Commission.  Many of these factors
are
more
fully
discussed,
as
are
other
factors,
in
the
company's
Annual
Report on Form 10-K for the fiscal year ended December 31, 2006 and
Quarterly Reports on Form 10-Q with the Securities and Exchange
Commission.  You are cautioned not to place undue reliance on these
forward-looking statements, which speak only as of today. Nabi undertakes
no obligation to update or revise the information provided herein, whether as
the
result
of
new
information,
future
events
or
circumstances
or
otherwise.


Presenter Disclosure Information
Presenter Disclosure Information
DISCLOSURE INFORMATION:
DISCLOSURE INFORMATION:
The following relationships exist related to this presentation:
The following relationships exist related to this presentation:
University of Nebraska Medical Center (S. Rennard, PI)
University of Nebraska Medical Center (S. Rennard, PI)
received a research contract from Nabi
received a research contract from Nabi
to conduct this and one
to conduct this and one
other clinical trial
other clinical trial
Since 2006, Dr. Rennard has conducted clinical trials or
Since 2006, Dr. Rennard has conducted clinical trials or
consulted with the following companies on the topic of smoking
consulted with the following companies on the topic of smoking
cessation: Pfizer, Novartis, GSK
cessation: Pfizer, Novartis, GSK
Stephen I Rennard
Stephen I Rennard
A Randomized Placebo-Controlled Trial of Conjugate Nicotine
A Randomized Placebo-Controlled Trial of Conjugate Nicotine
Vaccine
Vaccine
(NicVAX
(NicVAX
)
)
in
in
Smokers
Smokers
Who
Who
Want
Want
to
to
Quit:
Quit:
12
12
Months
Months
Results
Results
NicVAX
NicVAX
is
is
investigational
investigational
3


Nicotine Levels in a Smoker
Nicotine Levels in a Smoker
Light Smoker
Time of the day
Withdrawal
High
4


3’aminomethyl Nicotine –
3’aminomethyl Nicotine –
Recombinant Ps.
Recombinant Ps.
aeruginosa
aeruginosa
Exoprotein
Exoprotein
A (rEPA) Conjugate
A (rEPA) Conjugate
Nicotine
N
N
CH
3
O
O
O
H2
N
N
N
CH3
NH
NH
O
O
3’
aminomethyl
Nicotine
rEPA
rEPA
N
N
CH
3
NH
2
AMNic
rEPA
+
+
+ alum
(Adjuant)
5


Blood
Brain
AMNic-rEPA
AMNic-rEPA
(NicVAX) Antibodies Function:
(NicVAX) Antibodies Function:
Capture Release Mechanism
Capture Release Mechanism
N
I
C
V
A
X
6


7
Phase 2 Study: Key Questions
Phase 2 Study: Key Questions
Determine most effective dose and
Determine most effective dose and
immunization schedule
immunization schedule
Determine if vaccination is associated with long
Determine if vaccination is associated with long
term quits
term quits
Determine if antibody response is associated
Determine if antibody response is associated
with long term quits
with long term quits


NicVAX Phase IIb
NicVAX Phase IIb
Trial Design
Trial Design
A randomized, double-blind, placebo-controlled trial
A randomized, double-blind, placebo-controlled trial
Week
N=50
N=50
N=50
Follow Up
Placebo (PBS + alum)
0
0
4
4
8
8
12
12
16
16
20
20
24
24
26
26
52
52
Continuous Abstinence: 2 wk post TQD to 12 mo
Endpoint
Final 8 weeks
TQD Week 7
200 µg NV
400 µg NV
N=51
Follow Up
N=50
N=50
TQD Week 5
Placebo (PBS + alum)
200 µg NV
400 µg NV
Schedule 1
Schedule 2
8


Study Population
Study Population
2%
2%
2%
2%
Other
Other
88%
88%
91%
91%
White
White
0%
0%
1%
1%
Islander
Islander
7%
7%
5%
5%
Black
Black
3%
3%
1%
1%
Asian
Asian
Race
Race
98%
98%
98%
98%
Not Hispanic
Not Hispanic
Ethnicity
Ethnicity
47
47
48
48
Mean Age
Mean Age
Age
Age
50%
50%
46%
46%
Females
Females
50%
50%
54%
54%
Males
Males
Gender
Gender
Placebo
Placebo
n=100
n=100
NicVax
NicVax
n=201
n=201
Demographics
Demographics
96%
96%
6.12
6.12
24.3
24.3
NicVAX
NicVAX
N=201
N=201
96%
96%
Subjects with at
Subjects with at
least 1 previous
least 1 previous
quit attempt
quit attempt
6.05
6.05
Mean FTND Score
Mean FTND Score
24.8
24.8
Mean Number
Mean Number
Cigarettes
Cigarettes
Smoked Per Day
Smoked Per Day
Placebo
Placebo
n=100
n=100
Baseline Smoking
Baseline Smoking
Characteristics
Characteristics
9


10
Early Terminated Subjects*
Early Terminated Subjects*
0
1 (2%)
7 (14%)
0
0
4 (8%)
12 (24%)
50
400 µg
Schedule 2
Schedule 1
22 (43%)
24 (48%)
16 (32%)
33 (33%)
Early Terminated
Total
51
50
50
100
All Subjects
1 (2%)
0
0
1 (1%)
Other
4 (8%)
2 (4%)
0
2 (2%)
Adverse Event
7 (14%)
16 (32%)
11 (22%)
23 (23%)
Withdrawal of
Consent
2 (4%)
0
0
0
Protocol Violation
2 (4%)
1 (2%)
0
1 (1%)
Non-Compliant
with Protocol
6 (12%)
5 (10%)
5 (10%)
6 (6%)
Lost to Follow-Up
400 µg
200 µg
200 µg
Placebo
*All Early Terminations are coded as smoking thereafter.


Antibody Concentration Over Time
Antibody Concentration Over Time
Schedule 1 & Schedule 2
Schedule 1 & Schedule 2
Schedule 1
Schedule 2
0
2
4
6
8
10
12
14
16
18
20
22
24
26
28
30
32
34
36
38
40
42
44
46
48
50
52
Study Week
200 µg/Schedule 1
400 µg/Schedule 1
200 µg/Schedule 2
400 µg/Schedule 2
11


12-Month Continuous Abstinence
12-Month Continuous Abstinence
Intent to Treat Population
14%
14%
(n=7/50)
(n=7/50)
p=0.056
p=0.056
16%
16%
(n=8/51)
(n=8/51)
p=0.038
p=0.038
Schedule 2
Schedule 2
6%                       
6%                       
(n=3/50)                   
(n=3/50)                   
p=0.88
p=0.88
NicVAX         
NicVAX         
200 µg
200 µg
6%
6%
(n=6/100)
(n=6/100)
Placebo
Placebo
6%                       
6%                       
(n=3/50)                    
(n=3/50)                    
p=0.96
p=0.96
NicVAX         
NicVAX         
400 µg
400 µg
Schedule 1
Schedule 1
12


13
6%
6%
(n=6/100)
(n=6/100)
8%
8%
(n=11/140)
(n=11/140)
p=0.49
p=0.49
16%
16%
(n=10/61)
(n=10/61)
p=0.03
p=0.03
12-Month
12-Month
Abstinence
Abstinence
NicVAX  
NicVAX  
Low Antibody
Low Antibody
Placebo
Placebo
NicVAX  
NicVAX  
High Antibody*
High Antibody*
Continuous Abstinence at 12 Months by
Continuous Abstinence at 12 Months by
Anti-Nicotine Antibody Levels
Anti-Nicotine Antibody Levels
*Top 30% by AUC per protocol


200 µg
200 µg
400 µg
400 µg
200 µg
200 µg
400 µg
400 µg
5%
5%
(n=2/40)
(n=2/40)
p=0.55
p=0.55
10%
10%
(n=1/10)
(n=1/10)
p=0.84
p=0.84
3%
3%
(n=1/34)
(n=1/34)
p=0.36
p=0.36
13%
13%
(n=2/16)
(n=2/16)
p=0.57
p=0.57
Schedule 1
Schedule 1
12%
12%
(n=4/34)
(n=4/34)
p=0.23
p=0.23
19%
19%
(n=3/16)
(n=3/16)
p=0.056
p=0.056
6%
6%
(n=6/100)
(n=6/100)
13%
13%
(n=4/32)
(n=4/32)
p=0.22
p=0.22
21%
21%
(n=4/19)
(n=4/19)
p=0.038
p=0.038
Schedule 2
Schedule 2
NicVAX   
NicVAX   
Low Antibody
Low Antibody
Placebo
Placebo
NicVAX 
NicVAX 
High Antibody*
High Antibody*
12-Month           
12-Month           
Continuous
Continuous
Abstinence
Abstinence
Rates (44 wks)
Rates (44 wks)
Continuous Abstinence at 12 Months by Anti-
Continuous Abstinence at 12 Months by Anti-
Nicotine Antibody Levels, Dose  & Schedule
Nicotine Antibody Levels, Dose  & Schedule
*Top 30% by AUC per protocol
14


15
Antibody-Dependent Reduction in
Antibody-Dependent Reduction in
Cigarette Consumption in Non-Quitters
Cigarette Consumption in Non-Quitters
% Baseline @
% Baseline @
12-months
12-months
12-Months
12-Months
6-Months
6-Months
Baseline
Baseline
70%
70%
80%
80%
50%
50%
20
20
20-30
20-30
20
20
20-30
20-30
20
20
18-25
18-25
Average Daily Cigarette Consumption         
Average Daily Cigarette Consumption         
(median, inter-quartile range)
(median, inter-quartile range)
14           
14           
7-20
7-20
16
16
5-20
5-20
10
10
4-19
4-19
13           
13           
5-19
5-19
13
13
6-18.5
6-18.5
7.5
7.5
4-16
4-16
NicVAX   
NicVAX   
Low
Low
Antibody
Antibody
Placebo
Placebo
NicVAX  
NicVAX  
High
High
Antibody*
Antibody*
*Top 30% by AUC per protocol


Adverse Events
Adverse Events
11%
11%
6%
6%
Dizziness
Dizziness
10%
10%
7%
7%
Nausea
Nausea
14%
14%
9%
9%
Nasopharyngitis
Nasopharyngitis
9%
9%
10%
10%
Insomnia
Insomnia
12%
12%
12%
12%
Headache
Headache
30%
30%
29%
29%
Upper Respiratory
Upper Respiratory
Infection
Infection
Placebo
Placebo
n=100
n=100
NicVAX
NicVAX
n=201
n=201
All events
10% of either NicVAX or Placebo
16


17
Adverse events leading to early
Adverse events leading to early
terminations
terminations
Nicvax
Nicvax
groups (7/201):
groups (7/201):
Anaphylactic reaction
Anaphylactic reaction
Increasing frequency of migraine headaches
Increasing frequency of migraine headaches
Arthralgias
Arthralgias
in multiple joints
in multiple joints
Shingles
Shingles
Stiffness in left hand
Stiffness in left hand
Dozing off at the wheel
Dozing off at the wheel
Atrial
Atrial
fibrillation
fibrillation
Placebo (2/100):
Placebo (2/100):
Forgetfulness
Forgetfulness
Exacerbation of Crohn’s
Exacerbation of Crohn’s
disease
disease


18
Local Reactogenicity –
Local Reactogenicity –
Percentage of
Percentage of
Subjects Experiencing Events (ITT)
Subjects Experiencing Events (ITT)
Injection
Injection
77
77
83
83
77
77
80
80
81
81
81
81
89
89
87
87
91
91
78
78
Tenderness
Tenderness
9
9
24
24
11
11
28
28
19
19
34
34
18
18
26
26
18
18
14
14
Redness
Redness
27
27
38
38
25
25
43
43
31
31
46
46
38
38
45
45
41
41
32
32
Swelling
Swelling
15
15
29
29
20
20
32
32
21
21
32
32
30
30
28
28
18
18
17
17
Heat
Heat
6
6
28
28
13
13
28
28
19
19
24
24
24
24
21
21
17
17
19
19
Burning
Burning
68
68
79
79
69
69
77
77
81
81
73
73
85
85
84
84
83
83
75
75
Ache
Ache
Pbo
Pbo
NV
NV
Pbo
Pbo
NV
NV
Pbo
Pbo
NV
NV
Pbo
Pbo
NV
NV
Pbo
Pbo
NV
NV
5
5
4
4
3
3
2
2
1
1
NV = NicVAX
Pbo = Placebo


19
Systemic Reactogenicity –
Systemic Reactogenicity –
Percentage of
Percentage of
Subjects Experiencing Events (ITT)
Subjects Experiencing Events (ITT)
3
3
4
4
5
5
4
4
0
0
1
1
2
2
5
5
2
2
1
1
Vomiting
Vomiting
15
15
19
19
12
12
12
12
13
13
18
18
21
21
28
28
22
22
18
18
Nausea
Nausea
59
59
50
50
57
57
57
57
62
62
55
55
64
64
66
66
64
64
65
65
Muscle Aches /
Muscle Aches /
Myalgia
Myalgia
21
21
33
33
27
27
34
34
35
35
44
44
36
36
54
54
41
41
41
41
Headache
Headache
32
32
36
36
41
41
46
46
49
49
50
50
52
52
64
64
58
58
50
50
General Dis-
General Dis-
comfort / Malaise
comfort / Malaise
0
0
0
0
3
3
6
6
7
7
8
8
2
2
3
3
2
2
2
2
Fever
Fever
Pbo
Pbo
NV
NV
Pbo
Pbo
NV
NV
Pbo
Pbo
NV
NV
Pbo
Pbo
NV
NV
Pbo
Pbo
NV
NV
5
5
4
4
3
3
2
2
1
1
Injection
Injection
NV = NicVAX
Pbo = Placebo


Conclusions
Conclusions
Most effective dose and schedule
Most effective dose and schedule
identified: Schedule 2 (5 injections), 400 µg
identified: Schedule 2 (5 injections), 400 µg
Antibody level predicts continuous
Antibody level predicts continuous
abstinence
abstinence
Significantly increased abstinence through
Significantly increased abstinence through
12 months
12 months
Safety profile
Safety profile
Reactogenicity
Reactogenicity
and adverse events similar to
and adverse events similar to
placebo
placebo
No evidence of compensatory smoking or
No evidence of compensatory smoking or
increase in withdrawal symptoms
increase in withdrawal symptoms
20


Acknowledgements
Acknowledgements
National Institute on
National Institute on
Drug Abuse (NIDA)
Drug Abuse (NIDA)
RO1 DA017894
RO1 DA017894
Nabi
Nabi
Biopharmaceuticals
Biopharmaceuticals
Ali Fattom
Ali Fattom
Mariya
Mariya
Charny
Charny
Matt Hohenboken
Matt Hohenboken
Matthew Kalnik
Matthew Kalnik
Phyllis Link
Phyllis Link
Sharon Sutton
Sharon Sutton
Scott Winston
Scott Winston
Clinical Investigators
Clinical Investigators
Dorothy Hatsukami
Dorothy Hatsukami
Stephen Rennard
Stephen Rennard
Douglas Jorenby
Douglas Jorenby
Michael Fiore
Michael Fiore
David Gonzales
David Gonzales
Nancy Rigotti
Nancy Rigotti
Victor Reus
Victor Reus
Cheryl Oncken
Cheryl Oncken
Donald Tashkin
Donald Tashkin
Mitchell Nides
Mitchell Nides
Elbert Glover
Elbert Glover
Paul Pentel
Paul Pentel
21