THERAPEUTICS PIPELINE

Upper Limb Spasticity

Upper limb spasticity is a neurological condition that affects movement in the arms and/or hands and occurs most commonly after a stroke or traumatic brain injury. The condition is associated with muscle stiffness, spasms, and inability to perform daily tasks.1

In February 2021, Revance announced positive topline Phase 2 data supporting advancement of DAXXIFY® for Injection for the treatment of upper limb spasticity.

revance

Upper Limb Spasticity in Numbers

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Cases Worldwide
An estimated 12 million people worldwide suffer from spasticity.2
<
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%
Receiving Treatment
An estimated 20% of the patient populations currently receives treatment.3
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Cases in the U.S.
An estimated 100,000 people in the U.S. suffer from upper limb spasticity.2
botulinum toxin treatment

Botulinum toxin treatment is the standard of care for the treatment of management of focal upper limb spasticity. Other treatment options include muscle relaxants, physical therapy, splints, casts and braces, electrical stimulation, and surgery. Long-acting symptom relief is needed to address current challenges and is an unmet need of upper limb spasticity treatment.

* Not an actual patient

Unmet Need

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mos
Improvement of spasticity symptoms with currently approved botulinum toxin treatment may last an average of three months.5
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%
Survey of patients with spasticity overwhelmingly (72%) indicated the desire for a longer lasting treatment.6

We seek to bring innovation to multiple indications, including some of the most debilitating conditions and are currently evaluating DaxibotulinumtoxinA for Injection in cervical dystonia and upper limb spasticity.

References
1 – Spasticity. American Association of Neurological Surgeons. Retrieved from: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity. Accessed 9/29/2020
2 – What is spasticity? Life with Spasticity. Retrieved from: https://lifewithspasticity.com/definition-and-prevalence#definition. Accessed 10/09/2020
3 – Munin M et al. Methodology of a Phase 2, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Dose-Ranging, 36-Week, Multicenter Trial to Evaluate the Efficacy and Safety of DaxibotulinumtoxinA for Injection for the Treatment of Upper Limb Spasticity in Adults After Stroke or Traumatic Brain Injury (JUNIPER). Poster presented at 2019 TOXINS. 16-19 January, 2019. Copenhagen, Denmark.
4 – Spasticity. American Association of neurological Surgeons. Retrieved from: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity. Assessed: 11/16/2020
5 – Simpson DM, et al. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2016, May 10;86(19): 1818–1826.
6 – Jacinto J, Varriale P, Pain E, Lysandropoulos A, Esquenazi A. Patient perspectives on the therapeutic profile of botulinum neurotoxin type A in spasticity. Frontiers in Neurology, 2020, Volume 11, Article 388.

References
1. Spasticity. American Association of Neurological Surgeons. Retrieved from: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity. Accessed 9/29/2020

2. What is spasticity? Life with Spasticity. Retrieved from: https://lifewithspasticity.com/definition-and-prevalence#definition. Accessed 10/09/2020

3. Munin M et al. Methodology of a Phase 2, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Dose-Ranging, 36-Week, Multicenter Trial to Evaluate the Efficacy and Safety of DaxibotulinumtoxinA for Injection for the Treatment of Upper Limb Spasticity in Adults After Stroke or Traumatic Brain Injury (JUNIPER). Poster presented at 2019 TOXINS. 16-19 January, 2019. Copenhagen, Denmark.

4. Spasticity. American Association of neurological Surgeons. Retrieved from: https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity. Assessed: 11/16/2020

5. Simpson DM, et al. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2016, May 10;86(19): 1818–1826.

6. Jacinto J, Varriale P, Pain E, Lysandropoulos A, Esquenazi A. Patient perspectives on the therapeutic profile of botulinum neurotoxin type A in spasticity. Frontiers in Neurology, 2020, Volume 11, Article 388.

INDICATION
DaxibotulinumtoxinA for Injection is an acetylcholine release inhibitor and neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients.

WARNING: DISTANT SPREAD OF TOXIN EFFECT
The effects of DaxibotulinumtoxinA for Injection and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. DaxibotulinumtoxinA for Injection is not approved for the treatment of spasticity or any conditions other than glabellar lines.

IMPORTANT SAFETY INFORMATION

Contraindications
DaxibotulinumtoxinA for Injection contraindications include hypersensitivity to any botulinum toxin preparation or any of the components in the formulation and infection at the injection site(s).

Warnings and Precautions
Please refer to Boxed Warning for Distant Spread of Toxin Effect.

The potency Units of DaxibotulinumtoxinA for Injection are not interchangeable with other preparations of other botulinum toxin products. Recommended dose and frequency of administration should not be exceeded. Patients should seek immediate medical attention if respiratory, speech or swallowing difficulties occur. Use caution when administering to patients with pre-existing cardiovascular disease. Concomitant neuromuscular disorders may exacerbate clinical effects of treatment.

Adverse Reactions
The most commonly observed adverse reactions (≥1%) were headache (6%), eyelid ptosis (2%) and facial paresis (1%).

Drug Interactions
Co-administration of DaxibotulinumtoxinA for Injection and aminoglycoside antibiotics, anticholinergic agents or any other agents interfering with neuromuscular transmission or muscle relaxants should only be performed with caution as the effect of DaxibotulinumtoxinA for Injection may be potentiated. The effect of administering different botulinum neurotoxins during course of treatment with DaxibotulinumtoxinA for Injection is unknown.

Use in Specific Populations
DaxibotulinumtoxinA for Injection is not recommended for use in children or pregnant women.

Please see DaxibotulinumtoxinA for Injection full Prescribing Information, including Boxed Warning and Medication Guide.

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DAXXIFY® (daxibotulinumtoxinA-lanm) injection IMPORTANT SAFETY INFORMATION

Indications
(daxibotulinumtoxinA-lanm) injection is an acetylcholine release inhibitor and neuromuscular blocking agent indicated for the temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adult patients and for the treatment of cervical dystonia in adults.

WARNING: DISTANT SPREAD OF TOXIN EFFECT The effects of DAXXIFY® and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. DAXXIFY® is not approved for the treatment of spasticity or any conditions other than cervical dystonia and glabellar lines.


IMPORTANT SAFETY INFORMATION  

Contraindications
DAXXIFY® contraindications include hypersensitivity to any botulinum toxin preparation or any of the components in the formulation and infection at the injection site(s).  

Warnings and Precautions
Please refer to Boxed Warning for Distant Spread of Toxin Effect.  

The potency Units of DAXXIFY® are not interchangeable with other preparations of other botulinum toxin products. Recommended dose and frequency of administration should not be exceeded. Patients should seek immediate medical attention if respiratory, speech or swallowing difficulties occur. Use caution when administering to patients with pre-existing cardiovascular disease. Concomitant neuromuscular disorders may exacerbate clinical effects of treatment.  

Adverse Reactions
The most commonly observed adverse reactions are:
Glabeller lines (≥1%) were headache (6%), eyelid ptosis (2%) and facial paresis (1%).
Cervical Dystonia (≥5%): headache (9%), injection site pain (8%), injection site erythema (5%), muscular weakness (5%), and upper respiratory tract infection (5%).

Drug Interactions
Co-administration of DAXXIFY® and aminoglycoside antibiotics, anticholinergic agents or any other agents interfering with neuromuscular transmission or muscle relaxants should only be performed with caution as the effect of DAXXIFY® may be potentiated. The effect of administering different botulinum neurotoxins during course of treatment with DAXXIFY® is unknown.

Use in Specific Populations
DAXXIFY® is not recommended for use in children or pregnant women.  

Please see DAXXIFY® full Prescribing Information, including Boxed Warning and Medication Guide.

To report side effects associated with DAXXIFY®, please visit safety.revance.com, or call 1-877-373-8669. You may also report side effects to the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch

DAXI-004726