Merck to Present Data on Mavenclad® and Rebif® in Relapsing Forms of Multiple Sclerosis at EAN

Darmstadt, Germany (ots/PRNewswire) -

- 14 abstracts to be presented, further characterizing the
complementary profiles of Mavenclad (cladribine tablets)and Rebif
(interferon beta-1a)

Merck, a leading science and technology company, will present data
from its neurology and immunology portfolio at the 4th Congress of
the European Academy of Neurology (EAN), taking place from June
16-19, in Lisbon, Portugal. Merck will present a total of 14
abstracts in the area of relapsing multiple sclerosis (RMS),
including a post-hoc analysis of the Phase III CLARITY study,
investigating whether the beneficial clinical and magnetic resonance
imaging (MRI) effects of MAVENCLAD® are consistent in older (>50
years) and younger (<=50) adult patients with relapsing remitting MS
(RRMS). Data presented at the congress will also provide further
insights into the benefit-risk profile of MAVENCLAD® in patients with
relapsing MS with high disease activity, using Multi-Criteria
Decision Analysis, an EMA-recommended methodology used to indirectly
compare the benefit-risk profile between treatments. A separate post
hoc analysis of patients in the ONWARD study evaluates the efficacy
of MAVENCLAD® as add-on to interferon beta-1a in patients with
secondary progressive MS (SPMS) with relapses, compared to patients
with RRMS from the same study.

Additionally, data presentations on Rebif® (interferon beta-1a)
include analysis of MRI in MS (MAGNIMS) score[1] to predict long-term
clinical disease activity (CDA)-free status and disability
progression following treatment with Rebif®.

In line with Merck's MS Inside Out campaign aiming to better
understand patients with MS, results of the Merck-sponsored 'MS in
the 21st Century International Unmet Needs Survey' show that MS
patients have substantially different perceptions of the current
unmet needs in MS compared to healthcare professionals (HCPs).
Identification and understanding of these differences could lead to
an improved dialogue between HCPs and patients, which is integral to
finding appropriate individualised treatment approaches for each
patient.

Attendees can learn more about Merck's programs, pipeline and
activities in neurology and immunology by visiting the company`s
medical booth A07

The following abstracts have been accepted for presentation at EAN
Congress 2018:

MAVENCLAD(R) (Cladribine Tablets) Presentations

Presentation
Title Authors Abstract No.
Date/Time/Session

Infections during
periods of grade 3 or
4 lymphopenia in
patients taking Cook S, Leist T,
cladribine tablets 3.5 Comi G, Montalban
mg/kg: data from an X, Sylvester E,
ePoster
integrated safety Hicking C, Dangond
16-18 Jun 2018
analysis F 748
Time:12:30-14:15

Effects of cladribine
tablets on CD4+ T cell
subsets in the Stuve O,
ORACLE-MS study: Soelberg-Sorensen
Results from an P, Leist T, Hyvert
ePoster
analysis of lymphocyte Y, Damian D,
16-18 Jun 2018
surface markers Boschert U 762
Time:12:30-14:15

Innate Immune Cell
Counts in Patients
with
Relapsing-Remitting
Multiple Sclerosis
(RRMS) Treated with Soelberg-Sorensen
Cladribine Tablets 3.5 P, Dangond F,
ePresentation
mg/kg in CLARITY and Hicking C,
16-18 Jun 2018
CLARITY Extension Giovannoni G 749
Time:12:30-14:15

Cladribine tablets
produce selective and
discontinuous
reduction of B and T
lymphocytes and
natural killer cells Stuve O,
in patients with early Soelberg-Sorensen
and relapsing multiple P, Giovannoni G,
sclerosis (ORACLE-MS, Leist T, Hyvert Y,
ePresentation
CLARITY and CLARITY Damian D, Boschert
16-18 Jun 2018
Extension) U 746
Time:12:30-14:15

An analysis of
malignancy risk in the
clinical development
programme of Galazka A, Nolting
cladribine tablets in A, Cook S, Leist T,
patients with Comi G, Montalban
ePoster
relapsing multiple X, Hicking C,
16-18 Jun 2018
sclerosis (RMS) Dangond F 757
Time:12:30-14:15

Pregnancy outcomes
during the clinical
development programme
of cladribine in Galazka A, Nolting
multiple sclerosis A, Cook S, Leist T,
(MS): an integrated Comi G, Montalban
ePresentation
analysis of safety for X, Hicking C,
16-18 Jun 2018
all exposed patients Dangond F 765
Time:12:30-14:15

A benefit-risk
assessment of
cladribine tablets
using Multi-Criteria
Decision Analysis for Vermersch P,
patients with Martinelli V,
relapsing multiple Pfleger C,
sclerosis Rieckmann P,
ePoster
demonstrating high Galazka A, Dangond
16-18 Jun 2018
disease activity F, Phillips L 759
Time:12:30-14:15

Efficacy of cladribine
tablets 3.5 mg/kg
added to
interferon-beta in
patients with
secondary progressive
multiple sclerosis
(SPMS) or
relapsing-remitting Montalban X, Cohen
multiple sclerosis B, Leist T, Moses
ePresentation
(RRMS): a post-hoc H, Hicking C,
16-18 Jun 2018
analysis from ONWARD Dangond F 766
Time:12:30-14:15

A pooled analysis of
the efficacy of
cladribine tablets 3.5
mg/kg in patients with
EDSS greater than or
equal to3.5 or less
than or equal to3.0 at Giovannoni G,
baseline in the Montalban X,
ePresentation
CLARITY and ONWARD Hicking C, Dangond
16-18 Jun 2018
studies F 747
Time:12:30-14:15
Efficacy of cladribine
tablets 3.5 mg/kg in
patients with highly
active relapsing
multiple sclerosis
(RMS): Pooled analysis
of the double-blind Giovannoni G,
ePresentation
cohort from CLARITY Montalban X, Damian
16-18 Jun 2018
and ONWARD D, Dangond F 1345
Time:12:30-14:15

Efficacy of cladribine
tablets 3.5 mg/kg in
patients less than or Giovannoni G,
equal to50 and >50 Rammohan K, Cook S,
years of age with Comi G, Rieckmann
relapsing-remitting P,
multiple sclerosis Soelberg-Sørensen
ePresentation
(RRMS): a post hoc P, Vermersch P,
16-18 Jun 2018
analysis from CLARITY Dangond F, Damian D 1341
Time:12:30-14:15

Rebif(R) (interferon beta-1a) Presentations

Disease activity as
assessed by the
MAGNIMS score predicts
long-term clinical
disease activity free
status and disability Sormani MP,
progression in Freedman MS,
patients treated with Aldridge J,
ePresentation
subcutaneous Marhardt K, De
16-18 Jun 2018
interferon beta-1a Stefano N 743
Time:12:30-14:15

Evolution of new
lesions and its Vrenken H, de Vos
temporal patterns in ML, Battaglini M,
patients with Nagtegaal GJ, de
clinically isolated Almeida Teixeira
syndrome treated with BC, Marhardt K, De
ePresentation
subcutaneous Stefano N, Barkhof
16-18 Jun 2018
interferon beta-1a F 444
Time:12:30-14:15

Additional Merck-sponsored Presentations

Patient involvement in
treatment
decision-making: a
sub-analysis of the
'MS in the 21st
Century international Rieckmann P,
unmet needs survey' Langdon D on behalf
comparing patient and of MS in the 21st
healthcare Century Steering
professional Group, and Contango
perspectives EV 1340
Poster on Display

1. Magnetic Resonance Imaging in MS

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About MAVENCLAD®

MAVENCLAD® (cladribine tablets) is a short-course oral therapy
that selectively and periodically targets lymphocytes thought to be
integral to the pathological process of multiple sclerosis (MS). In
August 2017, the European Commission (EC) granted marketing
authorization for MAVENCLAD® for the treatment of relapsing forms of
MS (RMS) in the 28 countries of the European Union (EU) in addition
to Norway, Liechtenstein and Iceland. MAVENCLAD® is now available in
over 10 countries in Europe, plus Australia, Argentina and the United
Arab Emirates. MAVENCLAD® is not yet approved for any use in the
United States.

The clinical development program of MAVENCLAD® in MS comprises
more than 10,000 patient years of data with over 2,700 patients
included in the clinical trial program, and up to 10 years of
observation in some patients. These clinical trials include the Phase
III CLARITY, CLARITY extension and ORACLE MS trials, the Phase II
ONWARD trial and the PREMIERE Long-term Safety Registry.

EU Indication

MAVENCLAD® (cladribine tablets) is indicated for the treatment of
adult patients with highly active relapsing multiple sclerosis (RMS)
as defined by clinical or imaging features.

Important EU Safety Information

Contraindications:

MAVENCLAD® is contraindicated in patients with hypersensitivity to
the active substance, human immunodeficiency virus (HIV), active
chronic infection (tuberculosis or hepatitis), active malignancy,
moderate to severe renal impairment (creatinine clearance <60
mL/min), and those who are pregnant and breast-feeding. MAVENCLAD® is
also contraindicated in immunocompromised patients, including
patients currently receiving immunosuppressive or myelosuppressive
therapy.

Special warnings and precautions for use:

The most clinically relevant adverse reactions were lymphopenia
and herpes zoster.

Haematology

Decreases in neutrophil count, red blood cell count, haematocrit,
haemoglobin or platelet count compared to baseline values have been
observed in clinical studies, although these parameters usually
remain within normal limits.

Additive haematological adverse reactions may be expected if
cladribine is administered prior to or concomitantly with other
substances that affect the haematological profile

Lymphocyte counts must be determined

- before initiating MAVENCLAD® in year 1,
- before initiating MAVENCLAD® in year 2,
- 2 and 6 months after start of treatment in each treatment year. If
the lymphocyte count is below 500 cells/mm³, it should be actively
monitored until values increase again.

Infections

Cladribine can reduce the body's immune defence and may increase
the likelihood of infections. HIV infection, active tuberculosis and
active hepatitis must be excluded before initiation of cladribine.

The incidence of herpes zoster was increased in patients on
cladribine. If lymphocyte counts drop below 200 cells/mm³,
anti-herpes prophylaxis according to local standard practice should
be considered during the time of grade 4 lymphopenia. Interruption or
delay of MAVENCLAD® may be considered until proper resolution of the
infection.

Cases of progressive multifocal leukoencephalopathy (PML) have
been reported for parenteral cladribine in patients treated for hairy
cell leukaemia with a different treatment regimen.

In the clinical study data base of cladribine in MS (1,976
patients, 8,650 patient years) no case of PML has been reported.
However, a baseline magnetic resonance imaging (MRI) should be
performed before initiating MAVENCLAD® (usually within 3 months).

About Rebif®

Rebif® (interferon beta-1a) is a disease-modifying drug used to
treat relapsing forms of multiple sclerosis (MS) and is similar to
the interferon beta protein produced by the human body. The efficacy
of Rebif® in chronic progressive MS has not been established.
Interferon ß is thought to help reduce inflammation. The exact
mechanism is unknown.

Rebif®, which was approved in Europe in 1998 and in the US in
2002, is registered in more than 90 countries worldwide. Rebif® has
been proven to delay the progression of disability, reduce the
frequency of relapses and reduce MRI lesion activity and area*.

Rebif® can be administrated with the RebiSmart® electronic
auto-injection device (not approved in the US), or with the RebiDose®
single-use disposable pen, or the manual multidose injection pen
RebiSlide(TM). Rebif® can also be administered with the autoinjector
Rebiject II® or by manual injection using ready-to-use pre-filled
syringes. These injection devices are not approved in all countries.

In January 2012, the European commission approved the extension of
the indication of Rebif® in early multiple sclerosis. The extension
of the indication of Rebif® has not been submitted in the United
States.

Rebif® should be used with caution in patients with a history of
depression, liver disease, thyroid abnormalities and seizures. Most
commonly reported side effects are flu-like symptoms, injection site
disorders, elevation of liver enzymes and blood cell abnormalities.
Patients, especially those with depression, seizure disorders, or
liver problems, should discuss treatment with Rebif® with their
doctors.

*The exact correlation between MRI findings and the current or
future clinical status of patients, including disability progression,
is unknown.

Rebif® (interferon beta-1a) is approved in the United States for
relapsing forms of MS. RebiSmart®, an electronic device for
self-injection of Rebif®, is also not approved in the United States.

About Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, inflammatory condition of
the central nervous system and is the most common, non-traumatic,
disabling neurological disease in young adults. It is estimated that
approximately 2.3 million people have MS worldwide. While symptoms
can vary, the most common symptoms of MS include blurred vision,
numbness or tingling in the limbs and problems with strength and
coordination. The relapsing forms of MS are the most common.

Merck in Multiple Sclerosis

Merck has a long-standing legacy in neurology and immunology, with
significant R&D and commercial experience in multiple sclerosis (MS).
Merck's current portfolio includes two products for the treatment of
relapsing MS, with a robust pipeline focusing on discovering new
therapies that have the potential to modulate key pathogenic
mechanisms in MS. Merck aims to improve the lives of those living
with MS, by addressing areas of unmet medical needs.

About Merck

Merck is a leading science and technology company in healthcare,
life science and performance materials. More than 53,000 employees
work to further develop technologies that improve and enhance life -
from biopharmaceutical therapies to treat cancer or multiple
sclerosis, cutting-edge systems for scientific research and
production, to liquid crystals for smartphones and LCD televisions.
In 2017, Merck generated sales of EUR 15.3 billion in 66 countries.

Founded in 1668, Merck is the world's oldest pharmaceutical and
chemical company. The founding family remains the majority owner of
the publicly listed corporate group. Merck holds the global rights to
the Merck name and brand. The only exceptions are the United States
and Canada, where the company operates as EMD Serono, MilliporeSigma
and EMD Performance Materials.

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